Term
| What is a urinary tract obstruction? |
|
Definition
| Any interference with urine flow |
|
|
Term
| What is the etiology of a urinary tract obstruction? |
|
Definition
|
|
Term
| What does severity of a urinary tract obstruction depend on? |
|
Definition
Location
Unilateral or Bilateral
Duration
Cause |
|
|
Term
| What is another term for kidney stones? |
|
Definition
|
|
Term
| What are clinical manifestations of kidney stones? |
|
Definition
|
|
Term
| What are risk factors of kidney stones? |
|
Definition
Male
Age 20-40
Inadequate fluid intake
Living in desert or tropical region |
|
|
Term
| What is the primary factor of developing kidney stones? |
|
Definition
|
|
Term
| What are factors of living in desert or tropical region that lead to kidney stones? |
|
Definition
Temperature
Humidity
Fluids
Diet |
|
|
Term
| How do you evaluate and manage kidney stones? |
|
Definition
Stone analysis
Kidney-ureter-bladder (KUB)
Intravenous pyelogram (IVP)
Computed tomography (CT) of abdomen |
|
|
Term
| What is treatment for kidney stones |
|
Definition
|
|
Term
| What are kidney stones made of? |
|
Definition
|
|
Term
| What type of mineral salts make up kidney stones? |
|
Definition
-Calcium oxalate/phosphate -70-80%
-Struvite (magnesium, ammonium, phosphate) – 15%
-Uric acid - 7% |
|
|
Term
| What is a neurogenic lower urinary tract problems cause? |
|
Definition
| Problems with urine storage or emptying |
|
|
Term
| What is the etiology of neurogenic lower urinary tract problems? |
|
Definition
|
|
Term
| What is a neurogenic bladder? |
|
Definition
| A general term for the class of problems |
|
|
Term
|
Definition
| Loss of coordinated neuromuscular contraction |
|
|
Term
| What is detrusor hyperreflexia? |
|
Definition
| Bladder empties when full |
|
|
Term
| Overactive bladder syndromes causes involuntary __? |
|
Definition
|
|
Term
| What happens to detrusor muscle in overactive bladder syndrome? |
|
Definition
| Too weak to empty bladder |
|
|
Term
| What does overactive bladder syndrome result in? |
|
Definition
| Urinary retention with overflow |
|
|
Term
| What type of incontinence does overactive bladder syndrome cause? |
|
Definition
|
|
Term
| What are anatomical causes of resistance to flow in lower urinary tract? |
|
Definition
Urethral stricture
Enlarged prostate
Pelvic organ prolapse |
|
|
Term
| What is urethral stricture? |
|
Definition
|
|
Term
| What causes urethral stricture? |
|
Definition
Infection
Injury
Surgical manipulation
Scarring |
|
|
Term
| What is treatment for urethral stricture? |
|
Definition
|
|
Term
| What is another term for pelvic organ prolapse in women? |
|
Definition
|
|
Term
| What happens during cystocele? |
|
Definition
| Bladder prolapses into vagina |
|
|
Term
| How do you treat cystocele? |
|
Definition
| Pessary (vaginal implant) |
|
|
Term
| What are benign renal tumors called? |
|
Definition
|
|
Term
| True or False: Adenomas are usually small and asymptomatic |
|
Definition
|
|
Term
| Which tumors are more common in renal tumors? |
|
Definition
|
|
Term
| What are clinical manifestations of renal tumors? |
|
Definition
|
|
Term
| What is treatment of renal tumors? |
|
Definition
Nephrectomy
Chemo
Radiation |
|
|
Term
| What percentage of all malignant tumors are bladder tumors? |
|
Definition
|
|
Term
| Where are common metastasis of bladder tumors? |
|
Definition
Lymph nodes
Liver
Bone
Lungs |
|
|
Term
| What increases risk of bladder tumor? |
|
Definition
|
|
Term
| What are clinical manifestations of bladder tumors? |
|
Definition
|
|
Term
| True or False: Urinary tract infections are uncommon |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What is UTI inflammation of? |
|
Definition
|
|
Term
|
Definition
| Bacteria (escherichia coli) |
|
|
Term
| Who is UTI more common in? |
|
Definition
|
|
Term
| Why is UTI more common in women? |
|
Definition
| Short length of the urethra |
|
|
Term
|
Definition
| Inflammation of the bladder |
|
|
Term
| What are clinical manifestations of acute cystitis? |
|
Definition
Low back or suprapubic pain
Frequency
Dysuria
Urgency
Burning pain with urination
Hematuria
Cloudy urine |
|
|
Term
| What is treatment of acute cystitis? |
|
Definition
Antimicrobial therapy
Increased fluid intake
Avoidance of bladder irritants
Urinary analgesics |
|
|
Term
| What is interstitial cystitis? |
|
Definition
|
|
Term
| What is cause of interstitial cystitis? |
|
Definition
|
|
Term
| What are clinical manifestations of interstitial cystitis? |
|
Definition
Bladder fullness
Frequency
Small urine volume
Chronic pelvic pain |
|
|
Term
| What is acute pyelonephritis? |
|
Definition
| Upper urinary tract infection |
|
|
Term
| What structures are involved in acute pyelonephritis? |
|
Definition
Ureter
Renal pelvis
Renal parenchyma |
|
|
Term
| What are contributing factors to acute pyelonephritis? |
|
Definition
Cystitis
Urinary tract obstruction with reflux infection
Females |
|
|
Term
| Women are how many more times likely than men to get acute pyelonephrits? |
|
Definition
|
|
Term
| What are clinical manifestations of acute pyelonephritis? |
|
Definition
Flank pain or back ache
Abdominal pain
Fever
Chills
Nausea and vomiting
Costovertebral tenderness
Purulent urine |
|
|
Term
| True or False: Acute pyelonephritis can become a chronic condition? |
|
Definition
| True (Chronic pyelonephritis) |
|
|
Term
| What is the difference between cystitis and pyelonephritis? |
|
Definition
-Cystitis - inflammation of bladder
-Pyelonephritis - upper urinary tract infection |
|
|
Term
| What type of onset are glomerular disorders? |
|
Definition
|
|
Term
| What can cause glomerular disorders? |
|
Definition
hypertension
edema
elevated blood urea nitrogen (BUN) |
|
|
Term
| What happens to GFR in glomerular disorders? |
|
Definition
|
|
Term
| What does a decreased GFR cause? |
|
Definition
Elevated plasma creatinine
Elevated urea
Reduced creatinine clearance |
|
|
Term
| What is etioloy of glomerular disorders? |
|
Definition
Decreased:
-glomerular membrane surface area
-glomerular capillary blood flow
-blood hydrostatic pressure |
|
|
Term
| What happens to plasma proteins in glomerular disorders? |
|
Definition
|
|
Term
| What does plasma proteins passing into the urine cause? |
|
Definition
Increased glomerular capillary permeability
Nephrotic Syndrome
Loss of negative ionic charge barrier |
|
|
Term
| What does hypoalbuminemia cause? |
|
Definition
| plasma fluid to move into interstitial spaces which causes edema |
|
|
Term
| Nephrotic syndrome produces? |
|
Definition
| Susceptibility to infection |
|
|
Term
| What are a group of diseases that cause glomerular damage? |
|
Definition
|
|
Term
| What is the most common cause of chronic renal failure and end-stage renal disease (ESRD)? |
|
Definition
|
|
Term
| What is etiology of Glomerulonephritis? |
|
Definition
Immune responses - most common
Drugs or toxins
Hepatitis
Vascular disorders
Systemic diseases
Viral causes |
|
|
Term
| What is acute glomerulonephritis associated with? |
|
Definition
|
|
Term
| What happens in acute glomerulonephritis? |
|
Definition
| Antigen/antibody complexes form and deposit in glomerulus |
|
|
Term
| What does acute glomerulonephritis activate? |
|
Definition
|
|
Term
| Acute glomerulonephritis causes recruitment/activation of? |
|
Definition
| Immune cells and mediators |
|
|
Term
| Acute glomerulonephritis causes a decrease in? |
|
Definition
|
|
Term
| What does a decrease in GFR in acute glomerulonephritis cause? |
|
Definition
-Decreased glomerular perfusion due to inflammation
-Glomerular sclerosis (scarring)
-Thickening of the glomerular basement membrane (but increased permeability to proteins) |
|
|
Term
| What are clinical manifestations of acute glomerulonephritis? |
|
Definition
Hematuria
Proteinuria
Eventual oliguria |
|
|
Term
| What does hematuria look like? |
|
Definition
Smoky, brown-tinged urine
Red blood cell casts |
|
|
Term
| What does proteinuria cause? |
|
Definition
|
|
Term
|
Definition
| Urine output < 30mL/hour or <400 mL/day |
|
|
Term
| What is acute renal failure (ARF)? |
|
Definition
| Sudden and rapidly progressive within hours |
|
|
Term
| True or False: Acute renal failure is not reversible? |
|
Definition
|
|
Term
| What is acute renal failure an abrupt reduction in? |
|
Definition
|
|
Term
| What can acute renal failure be classified as? |
|
Definition
Pre renal failure
Intra renal failure
Post renal failure |
|
|
Term
| What is the most common cause of ARF? |
|
Definition
|
|
Term
|
Definition
| Impaired renal blood flow r/t sudden reduction in perfusion to the kidneys |
|
|
Term
| What does PreRenal ARF do to GFR? |
|
Definition
|
|
Term
| Why does GFR decline in PreRenal ARF? |
|
Definition
| GFR declines due to decrease filtration pressure resulting in oliguria |
|
|
Term
| What does ischemia in PreRenal ARF cause? |
|
Definition
| hypoxic injury and acute tubular necrosis (ATN) |
|
|
Term
| What is damaged in intrarenal ARF? |
|
Definition
|
|
Term
| What is most common cause of intrarenal ARF? |
|
Definition
|
|
Term
| What can cause intrarenal ARF? |
|
Definition
ATN
Vascular disease
Toxic injury |
|
|
Term
| What vascular disease can cause intrarenal ARF? |
|
Definition
|
|
Term
| What toxic injuries can cause intrarenal ARF? |
|
Definition
| Drugs (antibiotics - nephrotoxins) |
|
|
Term
| What does postrenal ARF occur with? |
|
Definition
| urinary tract obstructions that affect both kidneys |
|
|
Term
| What does postrenal ARF increase? |
|
Definition
| Intraluminal pressure upstream |
|
|
Term
| What happens to GFR in postrenal ARF? |
|
Definition
|
|
Term
| What are associated conditions with postrenal ARF? |
|
Definition
Prostatic hypertrophy
Bladder outlet obstruction
Bilateral ureteral obstruction |
|
|
Term
| A person with acute renal failure is prescribed glucose and insulin. The nurse understands this is intended to: |
|
Definition
| Reduce serum potassium concentration |
|
|
Term
| What are clinical manifestations of ARF? |
|
Definition
Azotemia
Uremia
Oliguria/anuria
Hyperkalemia
Metabolic acidosis
Hypertension (volume overload) |
|
|
Term
|
Definition
| increased urea and creatinine levels |
|
|
Term
|
Definition
| increased urea and creatinine levels |
|
|
Term
| What are clinical manifestations associated with uremia? |
|
Definition
fatigue, anorexia, nausea, vomiting, diarrhea, weight loss,
pruritus, edema, neurologic changes |
|
|
Term
| What are symptoms of ARF related to? |
|
Definition
| retention of toxic wastes, deficiency states, and electrolyte disorders |
|
|
Term
| What is chronic renal failure? |
|
Definition
| retention of toxic wastes, deficiency states, and electrolyte disorders |
|
|
Term
| True or False: Chronic renal failure affects most all organ system? |
|
Definition
|
|
Term
| Chronic renal failure is a progressive condition leading to? |
|
Definition
Reduced renal reserve
Renal insufficiency
Renal failure |
|
|
Term
| End-stage renal disease (ESRD) causes alterations in? |
|
Definition
Creatinine and urea clearance
Na and water balance
Phosphate and calcium balance
Potassium balance
Acid-base balance |
|
|
Term
| What systems does chronic renal failure affect? |
|
Definition
Skeletal and bone alterations
Cardiopulmonary
Neurologic
Hematologic
Gastrointestinal
Integument
Immunologic
Reproductive |
|
|
Term
| What systems are involved in multiorgan/multisystem failure? |
|
Definition
CV
Neurologic
Hematologic
GI |
|
|
Term
| What happens to CV system in multisystem failure? |
|
Definition
-Hypertension, heart failure
-Atherosclerosis, stroke, coronary artery disease |
|
|
Term
| What does hypertension and heart failure cause in multisystem failure? |
|
Definition
Volume overload
Hyperactivity of renin system |
|
|
Term
| What does atherosclerosis, stroke, and coronary artery disease cause? |
|
Definition
|
|
Term
| What happens to neurologic system in multisystem failure? |
|
Definition
Neuropathies
Encephalopathy |
|
|
Term
| What happens to the hematologic system in multisystem failure? |
|
Definition
|
|
Term
| Why do you have anemia in multisystem failure? |
|
Definition
|
|
Term
| What do platelet defects cause in multisystem failure? |
|
Definition
|
|
Term
| What happens to GI during multisystem failure? |
|
Definition
Nausea and vomiting
Anorexia
Uremic |
|
|
Term
| What happens to metabolic system in multisystem failures? |
|
Definition
| Altered protein, lipid, CHO metabolism |
|
|
Term
| What happens to integumentary/musculoskeletal system during multisystem failures? |
|
Definition
Hyperphosphatemia and Hypocalcemia
Hyperparathyroidism
Brittle bones
Skin changes |
|
|
Term
| What skin changes are present in multisystem failures? |
|
Definition
Bruises
Itching
Uremic frost
Yellowing |
|
|
Term
| What happens to immune system during multisystem failures? |
|
Definition
|
|
Term
| What happens to endocrine system during multisystem failure? |
|
Definition
Insulin resistance
Decreased sex hormones |
|
|
Term
| What happens during chronic renal failure progression? |
|
Definition
Reduced renal reserve
Renal insufficiency
Renal failure |
|
|
Term
| What happens to GFR when there is reduced renal reserve? |
|
Definition
|
|
Term
| What are clinical symptoms of reduced renal reserve? |
|
Definition
|
|
Term
| What may be elevated with reduced renal reserve? |
|
Definition
|
|
Term
| What happens to GFR with renal insufficiency? |
|
Definition
|
|
Term
| What happens to remaining nephrons? |
|
Definition
|
|
Term
| What are clinical symptoms? |
|
Definition
|
|
Term
| What do you see an increase in renal insufficiency? |
|
Definition
|
|
Term
| What happens during stress with renal insufficiency? |
|
Definition
|
|
Term
| What happens in renal failure? |
|
Definition
| Significant loss of function |
|
|
Term
| What is GFR in renal failure? |
|
Definition
|
|
Term
| What is there an increase in with renal failure? |
|
Definition
|
|
Term
| What are symptoms of renal failure? |
|
Definition
Oliguria
Metabolic acidosis
Electrolyte imbalance
Severe anemia
Increasing uremia |
|
|
Term
| What electrolyte imbalances will you see in renal failure? |
|
Definition
Hyperkalemia
Hypernatremia |
|
|
Term
| True or False: There will be effects on non-renal organs in renal failure? |
|
Definition
|
|
Term
| What happens to GFR in ESRD? |
|
Definition
| Near absence - <5 (likely near 0) |
|
|
Term
| What are clinical manifestations of ESRD? |
|
Definition
-Severe uremia
-Severe water, electrolyte, acid-base imbalances
-Multiorgan /multisystem failure |
|
|
Term
| A person with chronic renal failure develops a pH of 7.23. The nurse understands this indicates the person has: |
|
Definition
| reduced bicarbonate reabsorption |
|
|
Term
| Individuals with chronic renal failure have: |
|
Definition
|
|
Term
| Why would a person be on dialysis or need a transplant? |
|
Definition
-Immediately life threatening, e.g. hyperkalemia
-Severe uremia and multi-organ effects
-Metabolic acidemia |
|
|
