Urologic Disorders ch42

In chronic kidney disease, what percentage of nephrons can be lost before kidney function is impaired?

80%

glomerulonephritis

An immunologic disease characterized by inflammation of the capillary loops in the glomeruli

A patient has a UTI. Which are the kinds of drugs that may be used to treat the UTI?

Antibiotics Urinary tract antiseptics Analgesics Antispasmodic agents

When the patient with renal calculi is discharged, what will the nurse teach about prevention of renal calculi?

Continue appropriate fluid intake Advise the patient to dink 2 glasses when awakening at night

A patient has acute glomerulonephritis. Which medications are used in the treatment of this patient?

Diretics antihypertensives

A patient is recovering from a streptococcal infection and experiencing decreased urine output that is tea colored. What urinary condition commonly follows a streptococcal infection?

Dyspnea

A patient has urethritis. Which are common symptoms the nurse would expect to find?

Dysuris frequency bladder spasms urgency

Which diet is recommended for patients with chronic kidney disease that will reduce the accumulation of urea?

High carbohydrates Low protein

In which group is the incidence of renal calculi high?

Jewish males

calculus (plural: calculi)

Most are precipitations of calcium salts (calcium phosphate or calcium oxalate), uric acid, magnesium ammonium phosphate (struvite), or cystine

A patient has had a nephrectomy an dis protecting his chest by not breathing deeply. For which related complication must the nurse monitor?

Pneumonia and atelectasis

urolithiasis

The formation of calculi (stones) in the urinary tract; often called kidney stones

oliguric (anuric) phase

The urine output during this phase decreases to 400mL/day or less. The serum values for BUN, creatinine, potassium, and phosphorus increase. Serum calcium and bicabonate decrease. The phase continues between 8 and 14 days.

initial (onset) phase

This phase is short with a duration between hours and days. It is characterized by increasing BUN and serum creatinine with normal to decreased urine output. The primary treatment goal during this stage is reversal of failing renal function to prevent further damage

After a nephrectomy, the position of the flank incision causes pain with expansion of which body part?

Thorax

Which signs of dehydration would the nurse monitor in the patient who has had a renal transplant?

Thready pulse Poor tissue turgor Hypotension

The most common health care-associated infections are

UTIs

polycystic kidney disease

a genetic disorder characterized by the growth of numerous grapelike fluid-filled cysts in the kidneys

Normally, urine is sterile and slightly

acidic

The passage of renal calculi is facilitated by:

ambulation

Patients in renal failure have a deficiency of erythropoietin, which causes them to have:

anemia

Hyperkalemia

as kidney function fails, potassium is retained, resulting in this condition, the most life threatening effect of renal failureglomerulonephritis

recovery phase

as renal tissue recovers, serum electrolytes. BUN, and creatinine return to normal, and the glomerular filtration rate returns to 70%-80% of normal

Which is the most common malignancy of the urinary tract?

bladder cancer

Complications of lithotripsy include:

bruising and hemorrhage

Patients with urinary disorders who have potassium imbalances may have:

cardiac dysrhythmias

Chronic Kidney Disease (CKD)

characterized by progressive destruction of nephrons irreversible deterioration of the kidneys

Risk factors for bladder cancer include

cigarette smoking

Which foster development of renal calculi?

concentrated urine low dietary calcium intake altered urine pH sedentary lifestyle

An older patient with pyelonephritis experiences a sudden increase in fluid volume. Which complication may develop for which the nurse must monitor?

congestive heart failure

Which are symptoms of a patient with cystitis?

dark, tea colores, or cloudy urine frequency and urgency of urination bladder spasms low grade fever

kidney failure

decreased ability to filter waste products, slow onset,(months to years) progressive, irreversible damage

Which are possible causes of AKI?

decreased blood flow to the glomeruli kidney infections prostate cancer nephrotoxic antibiotics trauma

Tissue turgor is evaluated in patients with urinary disorders to detect:

dehydration

The edema found in renal failure is described as:

dependent

In patients with chronic kidney disease, the skin is likely to be described as:

dry and yellow or pale gray

What are signs of hypervolemia (increased blood volume)?

elevated blood pressure and edema

Which is a common symptom of pyelonephritis?

flank pain

Urinary calculi form in the urinary tract and may move spontaneously through the tract by what method?

flow of urine

A patient is in the acute phase of glomerulonephritis. Bed rest is prescribed to prevent or treat heart failure and severe hypertension that result from:

fluid overload

The eyes of a patient with a urinary disorder are examined and periorbital edema is present. What is the reason for periorbital edema in this patient?

fluid retention

renal calculi

formation of stones in the urinary tract: often called kidney stones

The most frequent symptom of bladder cancer is intermittent:

hematuria

Long term management to prevent recurrence of renal calculi includes:

high fluid intake dietary restrictions (e.g. animal protein, purines) urine pH altering medications

The most life-threatening effect of renal failure is:

hyperkalemia

When the bladder is removed completely, urinary diversion is sometimes provided, which allows urine to be excreted through the

ileal conduit

Which medication is the transplant recipient given to control the body's response to foreign tissue?

immuno suppressants

lithotomy

incison of organ or duct to remove calculi

azotemia

increased nitrogenous waste products in the blood

pyelonephritis

inflammation of the renal pelvis and the kidney

urethritis

inflammation of the urethra

cystitis

inflammation of the urinary bladder

interstitial cystitis

inflammatory disease of the bladder that usually is chronic

Urologic Trauma

injury that is penetrating or blunt

AKI (acute kidney injury)

kidney failure that has a sudden onset and may be reversible

Following urologic surgery, which output should be reported to the health care provider?

less than 30mL/ hour

renal or bladder cancer

malignancies of the kidney or urinary tract

Which musculoskeletal changes are characteristics of chronic kidney disease?

metastatic calcification bone demineralization osteitis fibrosa

UTI (urinary tract infection)

most common form of bacteria infection in urinary system and caused by viruses, yeasts and fungi

Management of renal disorders requires the nurse to pay attention to:

pain management fluid balance decreased activity patient education

A major nursing concern for patients with renal calculi is

pain relief

A patient with a urinary disorder has dyspnea. The nurse recognizes that this may be a sign of:

potassium imbalance

hemodialysis

process by which blood is removed from the body and circulated through an artificial kidney

When a patient is diagnosed with glomerulonephritis, glomerular permeability increases, allowing what substance to leak into the urine?

proteins

The treatment of choice for renal cancer is

radical nephrectomy

which is the most effective means of assessing changes in fluid status of patients in acute renal failure?

recording intake and output

Which are common risks for UTI's?

renal calculi female gender prolonged immobility urinary diversion indwelling urinary catheters

Untreated or recurring UTIs can result in

renal scarring that may lead to renal failure

The pain of urethritis may be reduced by

sitz bath

The most common type of glomerulonepnritis follows a respiratory tract infection caused by?

streptococcus

As urine output decreases due to glomerulonephritis, what color does the urine become

tea colored

dialysis

the passage of molecules through a semipermeable membrane into a special solution called dialysate solution

uremia

the term used for the symptoms that develop when chronic kidney disease advances to the point of end stage renal disease and the kidneys are unable to maintain fluid and electrolyte or acid base balance

uremic frost

the term used when whitish crystals composed of urea and other salts precipitate on the skin

diuretic phase

this phase begins when the cause of AKI is corrected. Urine output exceeds 400mL/day and may rise above 4L/day. Despite the production of large quantities of urine, few waste products are excreted, and wastes accumulate in the blood. Toward the end of the phase, the kidneys begin to excrete BUN, creatinine, potassium, and phosphorus and retain calcium and bicarbonate.

If crystals on the skin are observed during the examination of patients with urinary disorders, this is recorded as:

uremic frost

If a patient cannot pass a renal calculus spontaneously, what are the possible procedures used to destroy or remove it?

ureteral stent lithotripsy cystoscope stone removal

A diagnostic test for the identification of micro-organisms present in urine is

urinalysia

osteitis fibrosa

when calcium is lost from bones and is replaced by fibrous tissue

Hypocalcemia

when diseased kidney tissue cannot activate vit.D, and therefore calcium levels are depleted