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