Med Surg II Exam 3
Normal creatinine level
0.6-1.2 mg/dL
Normal Output of Urine
1 mL/kg/hour
Urine output is a sign of kidney perfusion. The nurse knows the minimum range per hour is what?
1-2 ml/kg
With Nephrotic Syndrome, urine can be tea colored. t/f
False
sickle cell treatment
Fluids, Pain Meds, Oxygen, blood transfusions
PDK labs to monitor:
H&H: low creatinine/BUN: high sodium: high potassium: high calcium: low phosphorus: high
Hemolytic Uremic Syndrome s/s
HTN Edema Pallor Bruising Oliguria Irritability, lethargy, stupor
What is reabsorbed in the distal convoluted tubule?
Hydrogen, Potassium, Ammonia
Accumulation of urine in the renal pelvis as a result of obstructed outflow that can result in renal scarring
Hydronephrosis
altered sodium and fluid balance cause
Hypertension that can lead to LV hypertrophy, HF, pulmonary edema
Renin is released as a response to what?
Hypotension
The nurse teaches parents that the anticholinergic drug used to treat enuresis is:
Oxybutynin
A patient presents with a high lactate concentration from urinalysis. This could be indicative of a malfunction of what part of the nephron?
PCT
Sildenafil (Viagra)
PO ED medication (vasodilator)
lab test for BPH
PSA (prostate-specific antigen)
Nephrotic syndrome manifestations
Periorbital Edema Pallor HTN Irritability Anorexia Hematuria Decreased UOP Nonspecific malaise Urine frothy or foamy Respiratory distress from pleural effusion
renal failure (chronic)
Progressive, irreversible reduction in kidney function
G6PD Deficiency
RBCs break down prematurely, resulting in hemolysis
Which intervention for a 5yr old child, who still wets the bed would be best assigned to a nursing assistant?
Reminding child to use restroom before going to bed
Untreated urinary tract infections could most likely lead to which of the following problems?
Renal scarring
What does the kidney release after detecting low blood pressure, blood volume, or blood flow?
Renin
Enuresis
Repeated involuntary voiding by a child old enough that bladder control is expected (usually 5-6 years old). - can be nocturnal, diurnal, or both - primary or secondary
topical estrogen
Restore tone in urethra and vaginal areas
what occurs during dialysis?
The blood is circulated out of the body, filtered for wastes and toxins and circulated back into the body.
Wilm's tumor stage 3
The tumor has spread, but is confined to the abdomen and lymph nodes
A HUS child that has no urine output for 24 hours with uremia or hypertension with seizures needs dialysis. t/f
True
DDAVP has an antidiuretic effect that can be given at night time or as needed. t/f
True
VUR can lead to hydronephrosis. t/f
True
Wilm's tumor stage 4
Tumor has metastasized to the lung, liver, bone, and brain
acute glomerulonephritis labs
UA: WBC, WBC casts, RBC, protein CBC: increased WBC creatinine/BUN: high albumin: low
pyelonephritis labs
UA: pyuria, bacteriuria, hematuria, WBC casts WBC: increased WBCs, increased neutrophils (left shift)
UTI symptoms newborn
Unexplained fever Hypothermia Failure to thrive Poor feeding Vomiting and diarrhea Strong-smelling urine Irritability
Which of the following sets of symptoms are characteristic of a preschool-age child with a urinary tract infection?
Urgency, dysuria, and fever
Phenazopyridine
Urinary Tract Analgesic for UTI patients
Males undergoing brachytherapy will need to do what?
Use condoms d/t radioactivity. (will eventually become infertile)
Anatomical abnormality that allows the retrograde flow of urine from the bladder into the ureters.
VUR
RBCs
contain hemoglobin, which allows them to carry oxygen to tissues
Platelets:
control bleeding after injury. They form a platelet plug.
Bag specimen
controversial method of urine collection d/t lack of sterility
____ leads to increased risk of testicular cancer.
cryptorchidism
Polycystic Kidney Disease
cysts form in renal tubule and compress/destroy surrounding tissue
Labs to assess for infection in dialysis patients
dialysate culture WBC level
precision medicine
different cancers require specific treatments.
BPH manifestations
difficulty starting flow of urine, weak urine stream, nocturia, bladder outlet obstruction
Intrarenal
direct damage to the renal system
UTI manifestations
dysuria, frequency, suprapubic pain, mental status change (elderly)
A 6 year old is bed wetting. Which factor is NOT known to contribute to enuresis?
electrolyte imbalance
renal cancer stage I
encapsulated- confined, tougher to spread.
What is observed on US that indicates Hydronephrosis?
enlarged kidneys
BPH (benign prostatic hyperplasia)
enlarged prostate that affects bladder emptying
platelet count
evaluates the function of platelets, or thrombocytes, which promote coagulation and formation of a hemostatic plug in vascular injury. The platelet count also determines the ability of the patient's blood to clot normally. under 50,000=spontaneous bleeding.
Polycythemia
excessive # of RBCs
Prerenal
external factors that reduce renal blood flow
pyelonephritis manifestations
fever/chills/n/v back/flank pain costovertebral tenderness enlarged kidneys
Prostate cancer stage T4
fixation onto or invasion of neighboring organs
renal cancer unique manifestations
flank mass, weight loss, fatigue, anemia
Sickle Cell priority treatment
fluids, O2, pain control (ABC's)
UTI symptoms preschool age and beyond
frequency urgency dysuria lower/flank abdominal pain
glomerulonephritis causes:
genetics, strep, lupus, autoimmune response.
What is secreted in the proximal convoluted tubule?
glucose, amino acids, protein, bicarb, water
renal trauma manifestations
hematuria, flank pain/mass, flank/back bruising, hypotension and tachycardia with blood loss
Hemolytic Uremic Syndrome
hemolytic anemia, renal insufficiency and thrombocytopenia together
PKD (polycystic kidney disease) manifestations
hypertension, hematuria (rupture), LBP/flank pain, headaches, abd pain
What causes the release of Aldosterone?
hypotension, hyponatremia, hyperkalemia
Heparin-induced thrombocytopenia (HIT)
immune response to heparin
Prostate cancer stage T1
impalpable
brachytherapy
implantation of small, sealed containers or seeds of radioactive material directly into the tumor or in a cavity of the tumor
urinary incontinence
inability to control bladder and/or bowels
Left Shift:
increase in number of immature WBCs, indicates acute infection. also increase in neutrophils
Polycythemia Vera
increased # of RBCs, causing thick blood (hyperviscosity)
What causes ADH to be released?
increased sodium concentration
urinary tract infection
infection of the upper or lower urinary tract
glomerulonephritis
inflammation of the glomeruli of the kidney, most often caused by group a beta hemolytic strep.
pyelonephritis
inflammation of the renal pelvis and the kidney
Intrinsic Pathway:
initiated when the blood is exposed to a stimulus and activates factor XII. The process continues in a chainlike reaction, activating factors IX and XI, in combination with calcium, generating factor Xa. The clotting cascade then continues by converting prothrombin to thrombin, which acts on fibrinogen to produce fibrin, leading to final clot formation.
Alprostadil pellets
inserted into the urethra (increases blood flow)
bladder cancer treatment
intravesical therapy, topical chemotherapy, precision medicine
Phosphorus and calcium have an _______ relationship.
inverse
Wilm's tumor stage 5
involves both kidneys
Chronic Kidney Disease (CKD)
irreversible loss of kidney function
A client indicates an understanding of the function aldosterone plays in the body when they state that:
it increases H2O and sodium reabsorption
high BUN and creatinine indicate
kidney damage/poor kidney function
urolithiasis
kidney stones form in urinary tract
If a brachytherapy patient's source becomes dislodged, what type of device is used to put the source(s) in a shielded container?
lead-lined container, do not touch with hands.
What happens to CBC with infection?
left shift (larger number of immature leukoctyes/WBCs)
PKD patients diet modification should include
less protein
altered potassium excretion can lead to
lethal arrhythmias
Prostate cancer stage T2
locally confined to the prostate
Prostate cancer stage T3
locally extensive
patients who receive kidney transplant for ESRD will need
long-term immunosuppressants to prevent transplant rejection and infection.
Vitamin B12 Anemia
low B12 leads to inability to form RBCs. (found in meat, seafood, eggs, dairy)
leukopenia
low WBC count
Thrombocytopenia
low platelet count
a patient with kidney stones will have a ____ urine pH.
low/acidotic (metabolic acidosis)
renal cancer stage III
lymph node, renal blood vessels, vena cava involved.
WBC count
measures leukocytes in the blood to indicate inflammation or infection, detect/identify various types of leukemia, monitor response to ABX therapy, chemo/radiation therapy. Increased level indicates infection. Decreased level indicates bone marrow depression.
Postrenal
mechanical obstruction of the lower urinary tract
topical chemotherapy
meds used in IVT
decreased acid clearance and bicarbonate production can lead to
metabolic acidosis
renal cancer stage IV
metastasis to other parts of the body
normal GFR should be
more than 60
impaired metabolic waste elimination can lead to
n/v, anorexia, neurological symptoms
What are reticulocytes?
non-nucleated, immature RBCs that remain in the peripheral blood for 24 to 48 hours while maturing. useful for evaluating anemia, blood loss, bone marrow response to anemia, and treatments for anemia.
acute glomerulonephritis manifestations
oliguria, hematuria, edema, ascites, flank pain, HTN
PSA test result _____ requires investigation to test for prostate cancer.
over 4.
renal colic (sign of urolithiasis)
pain from kidney to suprapubic region
bladder cancer
painless hematuria is most common symptom
Testicular cancer manifestation
painless mass (most common symptom)
VUR common in
patients under 2 years old (females at higher risk)
Hematocrit
percentage of blood volume occupied by red blood cells
What is a priority concern for a patient receiving peritoneal dialysis?
peritonitis/infection
Erythrocyte
pick up oxygen from the lungs and transport it to systemic tissues and pick up carbon dioxide from the tissues and deliver it in the lungs.
Sickle Cell Anemia
result of genetics. from both parents. cells become stiff, carry less oxygen and can form thrombi
Folic Acid Deficiency
result of inadequate dietary intake, Gastrointestinal conditions that affect malabsorption. (cereals, leafy green veggies, nuts)
polycythemia vera interventions
routine CBC (high RBCs) Hgb, Hct
Which diagnostic lab is false regarding glomerulonephritis?
serum protein elevated
stage 5 of VUR
severe dilation of the ureter and renal pelvis with severely blunted calyces
urolithiasis manifestations
severe pain when stone lodges in ureter, hematuria
urinary incontinence treatment
skin care, kegel exercises, stopping urinary leaking
Malignant Lymphomas
solid tumor develops in lymph node, can spread to other lymph tissues and the spleen, involves other major organs.
urolithiasis managment
stent placement to allow stone to be passed, lithotripsy to break up stone(s)
Which bacteria is glomerulonephritis mostly associated with?
streptococcus
Hemoglobin
substance found in RBCs that binds to and carries oxygen molecules.
Renal Failure (acute)
sudden loss of adequate renal function
cremasteric reflex
superficial reflex of the muscle that pulls up the scrotum when the inner portion of the thigh is stimulated
Which of the following is NOT a main characteristic of Nephrotic Syndrome?
tea colored urine
Patients with cryptorchidism are at increased risk for
testicular cancer
MCHC (mean corpuscular hemoglobin concentration)
the Hgb weight-to-Hct ratio, defines the concentration of Hgb in 100 mL of packed RBCs. It helps to distinguish normally colored (normochromic) RBCs from paler (hypochromic) RBCs.
MCH (mean corpuscular hemoglobin)
the Hgb-to-RBC count ratio, gives the weight of Hgb in an average RBC
MCV (mean corpuscular volume)
the average size of the erythrocytes and indicates whether they are undersized (microcytic), oversized (macrocytic), or normal (normocytic) and is useful in classifying anemias.
erectile dysfunction (ED)
the inability of the male to attain/maintain an erection sufficient for sexual intercourse
Primary nephrotic syndrome
the kidney is affected
Hemoglobin Electrophoresis
the most useful laboratory method for separating and measuring normal and abnormal hemoglobin. The purpose of this test is to help diagnose thalassemias
bone marrow
the primary site for blood formation and maturation (hematopoiesis)
Hemolytic Uremic Syndrome treatment
treat complications of Acute Renal Failure
Clotting Cascade:
triggered by the formation of a platelet plug, where platelets clump together. It is a stepwise process resulting in the conversion of the soluble plasma protein, fibrinogen, into fibrin. The insoluble fibrin strands create a sticky meshwork that cements platelets and other blood components together to form the temporary clot.
renal cancer
tumor grows and presses on other structures, can cause renal failure
What is reabsorbed in the loop of Henle?
urea
What is reabsorbed in the proximal convoluted tubule?
urea, uric acid, ammonia, creatinine, hydrogen
Hypospadias
urethral meatus located on ventral surface
Epispadias
urethral opening located on dorsal surface
renal trauma assessments to complete
urine output, BUN, creatinine GFR, H&H
Renal Trauma
usually the result of blunt force trauma
Hemodialysis requires
vascular access. The patient cannot have BP measurements/needle sticks in the arm with the fistula.
Angiotensin II causes what
vasoconstriction (CV system) Aldosterone release by kidneys thirst/drinking (hypothalamus)
The collecting tubule secretes what?
water and urea
What is secreted into the blood in the loop of Henle?
water, sodium, potassium, chloride
cryptorchidism
when 1 or both testes fail to descend into the scrotum.
PSA test
will be elevated when new prostate epithelial cells are forming in the body. (indicates BPH)
Nursing intervention for Bladder Exstrophy
wrap the abdominal wall in plastic wrap to keep natural moisture in place.
malignant lymphoma treatment
- chemotherapy - radiation therapy - surgical removal of tumor - Stem Cell transplant
Primary enuresis
- child never had a dry nigh - associated with a small functional bladder
Patients with Nephrotic syndrome are given _________ to decrease proteinuria.
Corticosteroids (will need to be tapered before d/c)
In renal failure, the kidneys lose the ability to:
- clear metabolic wastes - regulate extracellular fluid - regulate sodium balance - regulate acid-base homeostasis
glomerulonephritis treatment
- control BP - identify/treat infection - monitor/maintain fluid/electrolyte balance - bed rest (inc. blood flow to kidneys)
Acute Renal Failure manifestations
- dark urine/gross hematuria - crackles - lethargy
Polycythemia vera manifestations
- difficulty breathing while lying flat - splenomegaly, tender abdomen
Medications used for enuresis
- ditropan (bladder spasms) - tofranil/imipramine (enuresis) - DDAVP/desmopressin (frequent urination) - oxybutynin (anticholinergic)
considerations for patients on imipramine
- do not use in children under 6-7 - must see physician every 3-6 months - effects on mood/danger of OD - if stopped, enuresis will return
What is the main goal of surgery for hypospadias repair? SATA
- enable child to void while standing - enable normal sexual function
multiple myeloma symptoms
- fatigue/weakness - bone pain - recurrent infections - weight loss - paresthesia
Wilm's tumor can cause
- hematuria - hypertension
vitamin b12 anemia diagnosis
- history and physical - vitamin B12 serum assay test
G6PD deficiency symptoms
- jaundice - dark urine
multiple myeloma diagnosis
- lab tests - bone marrow aspiration - skeletal survey - bone density measurement (hypocalcemia)
Polycythemia vera diagnosis
- lab tests - bone marrow biopsy - genetic testing
malignant lymphoma diagnostic tools
- lymph node biopsy - bone marrow biopsy - lumbar puncture - Assess for enlarged lymph nodes
Chronic Renal Failure manifestations
- malaise - poor appetite - failure to thrive - decreased mental alertness - chronic anemia - fractures with minimal trauma
What interventions would you expect to perform in a patient with Diabetes Insipidus? Select all that apply
- monitor intake and output - administer desmopressin as ordered - monitor electrolytes - monitor daily weights
After testicle removal, what teaching should be done?
- monitor signs of infection - lymph node resection (monitor lymphedema) - sperm storage (preserves ability to reproduce)
Epi/Hypospadias post-surgery concerns
- pain control - Ditropan to relax bladder muscles and prevent spasms
malignant lymphoma manifestations
- painless swelling of lymph nodes - low grade fevers - drenching night sweats - unexplained weight loss
Epispadias/Hypospadias surgery goals
- place the urethral meatus in the proper location - release the chordee to straighten the penis - satisfactory cosmetic appearance
vitamin B12 anemia treatment
- prevention - B12 injections
polycythemia vera treatment
- reduce hyperviscosity - prevent hemorrhage
Testicular cancer management
- removal of affected testicle - radiation - chemotherapy
thrombocytopenia treatment
- resolve underlying condition - replacement of clotting factors - d/c heparin
After kidney transplant, what should the nurse monitor closely?
- strict I&O - signs of rejection (pain, fever, increased WBCs)
folic acid deficiency treatment
- supplementation - cereals, leafy green veggies, nuts
iron deficiency anemia treatment
- supplementation - increased iron intake (spinach, meats)
VUR treatment
- surgery - Deflux injection
Leukemia manifestations
- swollen lymph glands - increased infections - anemia - bleeding
Cryptorchordism causes
- testosterone deficiency - absent/defective testes - structural problems
Highest risk of UTI
- uncircumcised males until 1yo - males until 6 months - females
Manifestations of Bladder Exstrophy
- urine continually leaks onto the skin - separated rectus abdominis and symphysis pubis - inguinal hernias or cryptochordism may occur
altered calcium and phosphorus levels can cause
bone breakdown, defective bone development
secondary nephrotic syndrome
caused by disease, infection
Wilm's tumor treatment
chemo/radiation to shrink the size of the tumor before surgical removal.
pessary
appliance inserted into the vagina to support the bladder in effort to help with incontinence.
Hypospadias/Epispadias repair patients will come back from surgery with a stent to maintain new urethral opening. What should the nurse's main concern be with these patients?
Monitor the new urethral opening for signs of infection
WBCs
are components of the body's defense system against infection and disease (aka leukocytes)
when is cryptorchidism surgery done?
around 12 months of age
What is secreted in the distal convoluted tubule?
Sodium, Chloride, Bicarb, water
Bladder Exstrophy repair
- Primary closure within 72 hours of birth (do not circumcise until surgery-foreskin is used for reconstruction) - Epispadias repair 1-2 years of age same time as surgical repair - Surgery to reconstruct bladder is done when bladder capacity is 80-90 mL.
VUR diagnostic tests
- Renal US - Voiding Cystourethrogram - DMSA scan
Wilm's tumor diagnostic tests
- Ultrasound - IV pyelogram
UTI diagnostic tools
- Urinalysis - Renal ultrasound - Voiding Cystourethrogram (test for VUR) - IV Pyelogram- xray of kidneys, ureters, bladder with iodine contrast
A 62-year-old female presents to the emergency department following an MVA where she experienced renal trauma. Which of the following is not typical of an adequate functioning RAAS system?
- Vasodilation - Na+ Excretion
High sodium levels can cause
altered mental status
glomerulonephritis manifestations
- abrupt onset - flank/abdominal pain - irritability - malaise - fever - tea-colored urine (gross hematuria) - mild periorbital edema - dependent edema - Acute HTN (risk for encephalopathy) - increased Sodium, Creatinine, BUN, and decreased GFR (patients can be asymptomatic)
When choosing catheter size you should consider
- age - anatomy - weight
sickle cell symptoms
- anemia (fatigue, pallor, shortness of breath) - vasoocclusion/thrombi (pain, swelling)
thrombocytopenia considerations
- avoid rectal temps (may cause bleeding) - use minimal inflation with BP cuff
multiple myeloma treatment
- bisphosphonates - radiation therapy - DVT prophylaxis - dexamethasone - autologous stem cell transplant - chemotherapy - treat cancer and calcium loss
Leukemia patients should be on
- bleeding precautions - neutropenic precautions
Sickle cell diagnosis
- blood tests - genetic tests
Iron Deficiency Anemia
anemia caused by inadequate iron intake
Leukemia
"blood cancer," is a disorder of the bone marrow in which WBCs begin multiplying uncontrollably
Nephrotic syndrome diagnostic tests
- 3+ to 4+ protein - hematuria - protein excretion >40mg/m2/hr - protein to creatinine ratio >2.0 - serum albumin less than 2.5 g/dL (hypoalbuminemia)
UTI management
- ABX (IV) - antipyretics - fluid intake - Document I&O - follow up UA (monthly for 3 months, then every three months x2, then annually)
Labs to monitor- CKD
- BUN, creatinine, - Potassium: high - Sodium: depends on fluid status - Calcium: low - Phosphate: high - H&H: low - arterial pH: metabolic acidosis may occur d/t decreased H+ excretion and Bicarbonate production
aplastic anemia treatment
- Blood transfusions - Bone marrow transplantations - Filgrastim, Epoetin-alfa -neutropenic precautions
folic acid deficiency diagnosis
- CBC - Serum folate - serum MMA
G6PD deficiency diagnosis
- CBC - reticulocyte count - smear analysis for Heinz bodies
iron deficiency anemia diagnosis
- CBC - serum iron tests
thrombocytopenia diagnosis
- CBC with differential - Coagulation studies - Bone marrow biopsy
aplastic anemia diagnosis
- CBC, Coagulation studies, iron levels - bone marrow biopsy
Which is an example of insensible fluid loss? Select all that apply
- Diaphoresis - Tachypnea
leukemia risk factors
- Down Syndrome - Genetic anomalies
aplastic anemia symptoms
- Fatigue - Shortness of breath - Tachycardia - Pallor - Dizziness - Headache - Susceptibility to infections - Bleeding
Leukemia diagnosis
- Genetic Testing - bone marrow biopsy - lab tests
secondary enuresis
- Has been reliably dry for at least 6 months and begins bed-wetting - Associated with: stress, infections, sleep disorders - ADHD, chronic constipation, pituitary problem (ADH)
iron deficiency anemia manifestations
- Hypoxia - Fatigue - Pallor - Tachycardia - Tachypnea - Koilonychia (fingernails) - glossitis (tongue inflammation)
Where is NH4+ subject to tubular secretion in the tubular system? Select all that apply
- PCT - DCT - Collecting Tubule
folic acid deficiency manifestations
- Pallor, tachycardia, tachypnea, dizziness, and fatigue - Increased risk of bleeding
vitamin B12 anemia manifestions
- Peripheral neuropathy - Altered mental status, depression - Fatigue
renal replacement therapy
- Peritoneal Dialysis - Hemodialysis - Kidney transplant (ESRD)
thrombocytopenia manifestations
- Petechiae - ecchymosis - bleeding
BUN/Creatinine Ratio normal
10:1 to 20:1
Catheter size range for adults
12-14 french
Normal sodium level
135-145 mEq/L
Platelet normal range
150,000-500,000
Normal phosphorus level
2.7-4.5 mg/dL
A patient's urinalysis came back with a result of glycosuria indicating a possible diagnosis of diabetes. What bedside glucose would appropriately demonstrate this finding?
220 mg/dL
serum glucose over what level affects kidney's ability to reabsorb glucose leading to glycosuria?
220 mg/dL
Normal urge to void occurs at
250 mL
cryptorchidism usually corrects spontaneously by
3 months old
normal potassium level
3.5-5 mg/dL
Catheter size range for NICU patients
4-6 french
Normal levels of WBC?
4.5 to 11 x10^3
Normal BUN level
6-20 mg/dL
Normal calcium level
8.5-10.5 mg/dL
A 46-year-old male presents to his primary care provider with complaints of non-productive cough after starting a new medication. The nurse knows that this is a possible adverse effect of what class of medications?
ACE inhibitors
Wilm's tumor stage 2
Extends beyond the kidney, but can be excised
Which of the following is NOT an intervention for Nephrotic Syndrome?
antibiotics
Normal levels of HCT?
Male: 41-49% Female: 36-47%
Sickle cell most often affects
African-Americans
nephrotic syndrome
Alteration in kidney function secondary to increased glomerular basement membrane permeability to plasma protein. common between 2-7 y.o.
Wilms tumor (nephroblastoma)
An asymptomatic, firm mass located on either side of midline in the abdomen. the most common abdominal tumor in children
As part of the RAAS, the lungs release what?
Angiotensin Converting Enzyme
Angiotensinogen and Renin form
Angiotensin I
Angiotensin Converting Enzyme converts Angiotensin I to what?
Angiotensin II
As part of the RAAS system, the liver releases what?
Angiotensinogen
Multiple Myeloma
Asymptomatic premalignant proliferation of monoclonal plasma cells
Rare congenital defect where the posterior bladder wall extrudes through the lower abdominal wall
Bladder Exstrophy
Clean-catch
Method of obtaining a urine sample so that it is free of contamination from the external genital area.
Primary concerns with dialysis patients
Clotting (will use heparin) BP/circulatory collapse
Plasma:
Complex mixture of water, proteins, nutrients, electrolytes, nitrogenous wastes, hormones, and gases
The nurse is teaching a child experiencing severe edema associated with acute glomerulonephritis about his diet. The nurse should include which of the following?
Moderate sodium restriction
A child with nephritic syndrome has been placed on prednisone. The nurse knows that for this syndrome, the administration will be:
Daily for six weeks and then alternate-day doses for six weeks
Wilm's Tumor major consideration
Do not palpate this. It can help the cancerous tissue spread to the rest of the body.
Which of the following best describes chordee?
Downward curvature of the penis and an incomplete foreskin
The most common bacteria to infect the urinary tract
E. Coli
Nephrotic syndrome characteristics
Edema Massive proteinuria Hypoalbuminemia Hypoproteinemia Hyperlipidemia Altered immunity
The final result of the RAAS is ____.
Elevated blood pressure.
intracavernosal injection
Injection into the shaft of the penis to address ED
Renal examination sequence
Inspection, Auscultation, Palpation, Percussion
Wilm's tumor stage 1
Limited to the kidney
Normal levels of HGB?
Male: 13.5 - 17.5 Female: 12-16
vesicoureteral reflux
Retrograde flow of urine from bladder into the ureters due to lack of sphincter at the junction of ureter(s) and bladder
ED medications
Sildenafil (Viagra) Alprostadil pellets Intracavernosal injection
Aldosterone released by the kidneys causes ____.
Sodium and water retention
During glomerulonephritis care, which of the following is false?
administration of bronchodilator
renal cancer stage II
adrenal glands affected, but still confined
vesicoureteral reflux
backflow of urine from the bladder into the ureters
What is an appropriate intervention for enuresis?
bedwetting alarms
deflux injection
biodegradable gel, creates a bulge at sphincter, stops backflow of urine. Tissue will replace deflux over time and form its own natural bulge to maintain prevention of backflow.
cystocele
bladder hernia that protrudes into the vagina
Intravesical therapy
bladder irrigation with oncologic meds
radical cystectomy
bladder removal. will require patient to have urostomy after surgery. (men may have reproductive structures removed.
Oxybutynin (Ditropan)
block impulses from the parasympathetic nervous system to relax and control the bladder.
pyelonephritis
can be irreversible if kidney damage has not yet occurred
Acute Kidney Injury (AKI)
can be reversible if not prolonged.
Aplastic Anemia
damage to bone marrow causes decreased RBC production
high potassium levels can cause
dangerous cardiac arrhythmias
Imipramine (Tofranil)
decreases bladder contracility and has an antispasmodic effect on the bladder.
Hemophilia
deficiency of factor VIII or IX, causes risk of bleeding
G6PD deficiency treatment
prevention, diet, blood transfusions
tamsulosin (Flomax), terazosin
promote urethral relaxation; aid in issues of urinary retention
Extrinsic Pathway:
prothrombin is converted to thrombin, then fibrinogen and, ultimately, fibrin. causes clotting to occur more quickly because some of the steps in the intrinsic pathway are bypassed.
Upper UTI
pyelonephritis
UTI patients at risk for
pyelonephritis and sepsis
Stage 1 of VUR
reflux of urine into ureter only
Mirabegron
relaxes bladder muscles