Term
| What is cystitis and what causes it? |
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Definition
-Inflammation of the bladder
-Most commonly caused by bacteria moving up
-Catheters: high risk factor in developing nosocomial cystitis |
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Term
| What are the S&S and diagnoses for cystitis? |
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Definition
-Frequent urge to urinate
-Dysuria
-Urgency
-Urinalysis needed when testing for leukocyte esterase
-Organism type confirmed by urine culture
-Other diagnostic assessments |
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Term
| What is pyelonephritis and what are the acute symptoms? |
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Definition
-Bacterial infection in kidney and renal pelvis
Acute symptoms:
-Fever, chills, tachycardia, tachypnea
-Flank, back, or loin pain
-Abdominal discomfort
-Turning, nausea and vomiting, urgency, frequency, nocturia
-General malaise or fatigue |
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Term
| What are the symptoms of chronic pyelonephritis? |
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Definition
-Hypertension
-Inability to conserve sodium
-Decreased concentrating ability
-Development of hyperkalemia and acidosis |
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Term
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Definition
-Narrowed areas of urethra
-Most common symptom-obstruction of urine flow
-Surgical treatment by urethroplasty-best chance of long-term cure
-Dilation of urethra (temporary measure)
-Urethroplasty |
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Term
| What is stress incontinence and what are it's causes and interventions? |
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Definition
Stress incontinence is the most common type of incontinence among women.
Causes:
-Weakened pelvic muscles
-Weakening in the wall between the bladder and vagina
-Change in the position of the bladder
Interventions:
-Journaling, behavorial interventions, diet modification, pelvic flor exercises
-Diet therapy
-Drug therapy-estrogen
-Surgery
-Vaginal cone therapy |
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Term
| What are the interventions for urge incontinence? |
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Definition
-Drugs-anticholinergics, antihistamines, others
-Diet therapy-avoid caffeine and alcohol
-Behavioral interventions-exercises, bladder training, habit training, electrical stimulation |
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Term
| What is overflow incontinence? |
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Definition
| AKA known as reflex incontinence, a constantly full bladder triggers frequent urination or a constant dribbling or urine, or both |
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Term
| What are the causes and interventions for overflow incontinence? |
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Definition
Causes:
-Weakened bladder muscles related to autonamic nerve damage from diabetes and other diseases
-Blocked urethra due to kidney or urinary stones, tumors, an enlarged prostate in mean, female bladder surgery that is too tight, or a birth defect
Interventions
-Surgery to relieve obstruction
-Intermittent catheterization
-Bladder compression, intermittent self-catheterization
-Drug therapy
-Behavioral interventions |
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Term
| What is functional incontinence and what are it's causes and interventions? |
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Definition
Inability to get to toilet prior to urination
Causes: mobility, fragility, medications, diseases
Interventions:
-Treatment of reversible causes
-Urinary habit training
-Final strategy-containment of urine, protection of patient's skin
-Applied devices
-Urinary catheterization |
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Term
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Definition
| Presence of calculi (stones) in the urinary tract |
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Term
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Definition
-Uses sound, laser, or dry shock wave energy to break stones into small fragments
-Patient undergoes conscious sedation
-Topical anesthetic cream applied to skin site
-Continuous monitoring by ECG |
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Term
| What is Polycystic Kidney Disease and what are it's symptoms? |
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Definition
Inherited disorders; fluid-filled cysts develop in nephrons
Symptoms:
-Abdominal or flank pain
-Hypertension
-Nocturia
-Increased abdominal girth
-Constipation
-Bloody or cloudy urine
-Kidney stones |
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Term
| What is nephrotic syndrome? |
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Definition
-Condition of increased glomerular permeability; allows larger molecules to pass through the membrane into urine and be excreted
-Severe loss of protein into urine, edema formation, and decreased plasma albumin levels |
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Term
| What is the treatment for nephrotic syndrome? |
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Definition
-Immunosuppressive agents
-ACE inhibitors
-Heparin
-Diet changes
-Mild diuretics |
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Term
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Definition
-Thickening in nephron blood vessels; results in narrowing of vessel lumen
-Occurs with all types of hypertension, atherosclerosis, diabetes mellitus
-Collaborative management-control high blood pressure, perserve kidney function |
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Term
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Definition
-Processes affecting renal arteries; may severely narrow lumen, greatly reduce blood flow to kidneys
-Assessment
-Priority goals for care
-Interventions |
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Term
| Benign Prostatic Hyperplasia |
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Definition
| Glandular units in the prostate that undergo an increase in number of cells, resulting in enlargement of prostate gland |
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Term
| What are the symptoms of Benign Prostatic Hyperplasia? |
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Definition
-Hyperirritable bladder
-Urgency and frquency
-Hypertrophied bladder wall muscles
-Cellules and diverticula
-Hydroureter
-Hydronephrosis
-Overflow urinary incontinence |
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Term
| What is a hydrocele and what are the treatments? |
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Definition
-Cystic mass usually filled with straw-colored fluid forms around testis, results from impaired lymphatic drainage of scrotum, causing swelling of tissue surrounding the testes
Treatment:
-Drainage via needle and syringe
-Surgical removal |
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Term
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Definition
-Sperm-containing cyst develops on epididymis alongside the testicle
-Normally small and asymptomatic, require no intervention
-If large enough to cause discomfort, spermatocelectomy is performed |
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Term
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Definition
-Cluster of dilated veins occurring behind and above testis
-Can cause infertility
-Varicolcelectomy performed through an inguinal incision; spermatic veins are ligated in the cord |
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Term
| What are the treatments for epiddymitis? |
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Definition
-Bedrest
-Elevation
-Scrotal support when ambulating |
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Term
| What is orchitis and how do you treat it? |
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Definition
-Acute testicular inflammation resulting from trauma or infection
Treatment:
-Bedrest with scrotal elevation
-Application of ice
-Analgesics and antibiotics |
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Term
| Care of patients with male reproductive problems |
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Definition
1. Etiologies, risk factors, comorbities
2. Assessment (holistic approach)
3. Diagnostic tests
4. Nurse's role in management
5. Interdisciplinary team's role in management
6. Treatment and interventions
7. Teaching and health promotion
8. Teaching and health promotion for at-risk individuals |
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Term
| What are acute symptoms that indicate urgent need for dialysis? |
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Definition
-Encephalopathy
-Uncontrolled hyperkalemia
-Pericarditis
-Pulmonary edema
-Increasing acidosis
-Medications or toxins |
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Term
| Care of the patient on dialysis |
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Definition
Dialysis removes large volumes of intravascular fluid in 2-4 hours.
-Monitor closely for at least one hour for hemodynamic instability: HR, BP, orthostatic BP, dizziness, diaphoresis, nausea
Heparin given during procedure can cause bleeding
-Watch for overt/covert bleeding
Many medications are dialyzed out (many antibiotics)
-Adjust medication times if necessary to give after dialysis. Ask pharmacist or nephrologist if you have questions about pts meds.
-Discuss with MD if antihypertensives need to be held predialysis if patient regularly develops low BP |
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Term
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Definition
-Surgical anastomosis of artery and vein which allows for arterial flow through the vein which provides the rapid blood flow necessary for dialysis
-Vein becomes enlarged and tough
-Preferred access as it lasts longest and has least complications
-Must have good blood vessels for this
-Fistula must "mature" for 2-3 months before can be used |
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Term
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Definition
-Synthetic self-sealing graft that connects the artery and the vein
-Should be used primarily for patients with poor vessels
-Graft is accessed instead of vein
-Higher rate of clotting off and infection
-Needs to heal for only 2-3 weeks
-Easier for MD to put in |
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Term
| Care of patient with AV Fistula or Graft |
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Definition
-NO BP or venipuncture in affected arm. Place sign over bed and teach patient to remind caregivers
-Palpate for "thrill"
-Auscultate for "bruit"
-Monitor circulation distal to fistula or graft
-Monitor for aneurysm
-Pt. may have multiple old non-functioning grafts. Clarigy and assess current one |
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Term
| Care of patient with peritoneal dialysis |
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Definition
-Nurse may do PD or pt/family may do it. Need MD order for pt. to do it. RN still responsible for monitoring exchange and pt/family technique
-Peritonitis is a major concern:
--Wear mask and sterile gloves for procedure. Put mask on pt.
--Assess drained "effluent" for clarity. Cloudy effluent is sign of peritonitis
--Notify MD immediately for any abnormal findings. Send specimen of effluent for C&S, WBCs.
-Monitor catheter exit site for infection |
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Term
| What are the functions of the renal system? |
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Definition
-Fluid and electrolyte balance
-Blood filtration-remove waste products of the body's metabolic processes in the form of urine
-Acid-base balance
-Blood pressure regulation
-Erythropoietin production
-Vitamin D production |
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Term
| What is the significance of Mean Arterial Pressure (MAP)? |
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Definition
-Reflects the hemodynamic perfusion pressure of the vital organs
-Calculation: [(2xdiastolic) + systolic]/3
-Rule of thumb: MAP >65=adequate end organ perfusion |
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Term
| RIFLE criteria for Renal Failure |
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Definition
Risk: GFR >25%
Injury: GFR >50%
Failure: GFR >75%
Loss: Persistent AKI or complete loss of kidney function for more than 4 weeks
End-stage: Need for renal replacement therapy for more than 3 months |
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Term
| What is Pre-renal Acute Kidney Injury and what are the causes? |
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Definition
Most common type of AKI
-Hypoperfusion due to conditions that affect renal blood flow
-Nephrons remain structurally intact
Causes:
Hypovolemia
Hypotension
Sepsis
Hemorrhage
Renal atherosclerosis |
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Term
| What is Intra-renal Acute Kidney Injury and what are the causes? |
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Definition
Direct injury to the kidney with structural and functional damage to nephrons
Causes:
Ischemia (from emboli)
Inflammation
Infection
Toxins
Medications
IV contrast
Rhabdomyolysis |
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Term
| What is Post-renal AKI and what are the causes? |
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Definition
Least common cause of AKI
-Due to obstruction of urine outflow
-Reversible with removal of obstruction unless it has been present long enough to cause damage to kidney
Causes:
-Benign Prostatic hypertrophy (BPH)
-Tumors
-Kidney stone (renal calculi) - usually unilateral
-Neurogenic bladder |
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Term
| What are the signs and symptoms of Acute Kidney Injury? |
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Definition
-Oliguria: <0.5mg/kg/hr; <400ml/24hr
-Proteinuria
-Fluid retention
-Increased serum potassium
-Increased creatinine
-Decreased serum bicarb |
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Term
|
Definition
-Progressive loss of decline in kidney function that correlated with loss of nephrons
-Symptoms occur when overall renal function is less than 20-25% of nephrons remain
-Until then, remaining nephrons hypertrophy to compensate by accepting larger blood volume |
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Term
| What are the causes of Chronic Kidney Disease? |
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Definition
-Diabetes
-Hypertension
-Unsuccessfully treated ARF
-Glomerulonephritis
-Autoimmune disorders
-Congenital defects |
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