REnal and Uro NCLEX

cystectomy with creation of an ileal conduit asks the nurse why the bowel needs to be cleansed before surgery if the bladder is being removed

"A portion of the bowel will be used to create the conduit for urinary diversion." The client scheduled for surgical creation of either an ileal conduit or a reservoir undergoes bowel preparation the night before the procedure. Preparation can include intake of copious clear liquids, laxatives, enemas, and antibiotics, depending on primary health care provider preference. This is done primarily to prevent infection because a loop of bowel will be used to create the urinary diversion.

discharge - prostatectomy

A daily intake of 2.5 L of fluid should be maintained to limit clot formation and prevent infection. Driving a car and sitting for long periods are restricted for at least 3 weeks. The client should be instructed to avoid lifting objects heavier than 20 lb (9 kg) for at least 6 weeks. Passing small pieces of tissue or blood clots in the urine for up to 2 weeks after surgery is expected and does not necessitate contacting the PHCP.

calcium oxalate - stone - oxalate kidney stone

Avoid green, leafy vegetables such as spinach. Oxalate is found in dark green foods such as spinach. Other foods that raise urinary oxalate are rhubarb, strawberries, chocolate, wheat bran, nuts, beets, and tea.

acid ash diet

Decrease pH (makes urine acid) Chz, eggs, Meat, fish, oysters, poultry, Bread, Cereal, Whole Grains, Pastries, Cranberries, Prunes, Plums, Tomatoes, Peas, Corn, Legumes.

epididymitis

Fever, nausea, vomiting, and painful scrotal edema

polycystic kidney disease

Flank pain and hematuria

symptomatic polycystic kidney disease

Hemodialysis, Kidney transplant, Bilateral nephrectomy

hydronephrosis due to urolithiasis

Insertion of a nephrostomy tube, Placement of a ureteral stent with ureteroscopy

serum myoglobin level for a client with a crush injury to the right lower leg - acute kidney injury

Intrarenal Serum myoglobin levels increase in crush injuries when large amounts of myoglobin and hemoglobin are released from damaged muscle and blood cells. The accumulation may cause acute tubular necrosis, an intrarenal cause of renal failure.

enalapril

On return from dialysis Antihypertensive medications such as enalapril are given to the client following hemodialysis. This prevents the client from becoming hypotensive during dialysis and from having the medication removed from the bloodstream by dialysis

ough and deep breathe after nephrectomy "That's easy for you to say! You don't have to do this."

Pain that is intensified because of the location of the incision near the diaphragm

transurethral resection of the prostate (TURP)

Pale pink urine the bladder irrigation is infusing at a sufficient rate, the urinary drainage through the Foley tubing should be pale pink. Dark pink urine indicates that the rate of the irrigation solution should be increased. Tea-colored urine is not seen after TURP but may be noted in a client with other renal disorders such as renal failure. Bright red bleeding and clots could indicate a complication

risk for arterial steal syndrome

Pallor, diminished pulse, and pain in the left hand

peritoneal dialysis

Reduced outflow from the dialysis catheter may be caused by the catheter position, infection, or constipation.

ADH works to reabsorb water in which parts of the nephron

The distal tubule and the collecting duct of the nephron require the presence of ADH for water reabsorption. The hormone increases the permeability of the membranes to allow water to flow more easily along the concentration gradient. The glomerulus filters but does not reabsorb. The calices are responsible for collecting the urine. The proximal tubule and the loop of Henle reabsorb water without the assistance of ADH.

The nurse is monitoring the urine output of a client with a low serum protein level and urinary output less than 30 mL in the last hour. Based on these data, the nurse understands that low urinary output is caused by which force within the kidneys?

The pulling pressure within the capillaries that is exerted by the plasma proteins is referred to as the oncotic pressure. Osmotic pressure is the movement of water along a pressure gradient. Filtration pressure is the pressure that is exerted with ultrafiltration, in which the pressure within the capillaries is greater than the pressure outside them; this results in fluids being pushed across the membrane into Bowman's capsule. Hydrostatic pressure in the capillaries allows fluid to be filtered out of the blood in the glomerulus.

alkaline residue

alkaline residue diet, all fruits are allowed except cranberries, blueberries, prunes, and plums.

Transurethral resection syndrome

caused by increased absorption of nonelectrolyte irrigating fluid used during surgery. The client may show signs of cerebral edema and increased intracranial pressure, such as increased blood pressure, bradycardia, confusion, disorientation, muscle twitching, visual disturbances, and nausea and vomiting.

aluminum hydroxide

combines with phosphorus and helps eliminate phosphates from the body.

AKI caused by glomerulonephritis

commonly manifests with hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload.

arteriovenous fistula for access -access site

hepatitis or infection

Aluminum intoxication

mental cloudiness, dementia, and complaints of bone pain

bacterial prostatitis - fever, perineal pain, and urinary urgency, frequency, and dysuria

prostate examination - Tender, indurated prostate gland that is warm to the touch

disequilibrium syndrome

returned from the dialysis unit following hemodialysis. The client is complaining of headache and nausea and is extremely restless - Notify the primary health care provider (PHCP) -Headache, deteriorating level of consciousness, and twitching