NCM 112 Renal Disorder Management

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Questions and Answers

What symptom can complicate the diagnosis of urologic disorders in the elderly?

Decreased neurologic innervation (correct)

Increased neurologic innervation

Increased sensitivity to pain

Decreased awareness of symptoms

Which of the following is a common result of anemia of chronic disease?

Exercise intolerance (correct)

Heightened energy levels

Weight gain

Increased appetite

During palpation of the left kidney, the correct hand placement is to reach over to which side of the patient?

Right side

Left side (correct)

Front side

Back side

What does dullness to percussion of the bladder after voiding indicate?

Incomplete bladder emptying Signup and view all the answers

What is a major criterion for diagnosing a urinary tract infection (UTI) based on urinalysis?

Colony count of at least 105 CFU/mL Signup and view all the answers

Which of the following is NOT a component typically examined in a urinalysis?

Urine viscosity Signup and view all the answers

What do renal concentration tests evaluate?

Kidneys' ability to concentrate solutes in urine Signup and view all the answers

What is the purpose of urine cultures?

To identify specific organisms causing infection Signup and view all the answers

What is the primary hormone responsible for sodium reabsorption in the kidneys?

Aldosterone Signup and view all the answers

Which term describes the condition of having less than 50 mL of urine output in 24 hours?

Anuria Signup and view all the answers

During micturition, which process takes place?

Excretion of urine Signup and view all the answers

What is the significance of renal clearance?

Measures the efficiency of the kidneys in clearing solutes Signup and view all the answers

Which of the following is a sign of infection in the urine?

Bacteriuria Signup and view all the answers

Which one of the following parameters is assessed to determine lower urinary tract function?

Frequency of urination Signup and view all the answers

What does the presence of hematuria indicate?

Kidney damage or disease Signup and view all the answers

What is the typical weight range of an adult kidney?

113 to 170 g Signup and view all the answers

What is the role of antidiuretic hormone in the kidneys?

Promotes water reabsorption Signup and view all the answers

What condition is characterized by painful or difficult urination?

Dysuria Signup and view all the answers

Which of the following is NOT a type of urinary incontinence?

Discharge incontinence Signup and view all the answers

What is considered normal urine output for oliguric conditions?

Less than 500 mL/day Signup and view all the answers

Which symptom is characterized by a strong desire to void?

Urgency Signup and view all the answers

Which condition is most likely indicated by hematuria?

Cancer of the genitourinary tract Signup and view all the answers

What is the primary cause of renal calculi (kidney stones)?

Imbalances in urine composition Signup and view all the answers

Which symptom is characterized by excessive urination at night?

Nocturia Signup and view all the answers

What are common associated symptoms of ureteral pain?

Nausea and vomiting Signup and view all the answers

Which of the following conditions can lead to urinary incontinence?

External sphincter injury Signup and view all the answers

What is considered a normal time frame for urinary frequency?

More than every 3 hours Signup and view all the answers

Which type of pain is often associated with kidney stones?

Severe, sharp, stabbing pain Signup and view all the answers

What is the leading cause of dysuria?

Urinary tract infection Signup and view all the answers

Which scenario best describes anuria?

Output of less than 50 mL of urine per day Signup and view all the answers

Which condition may lead to increased urine protein levels?

Nephrotic syndrome Signup and view all the answers

Which of the following factors can contribute to nocturia?

Diabetes mellitus Signup and view all the answers

Which of the following is NOT a function of the kidney?

Synthesis of glucose Signup and view all the answers

What are the three major processes involved in urine formation?

Glomerular filtration, tubular reabsorption, tubular secretion Signup and view all the answers

Which of the following factors should be included when obtaining a urologic health history?

Onset and effect of urinary problems on quality of life Signup and view all the answers

What role does the kidney play in the regulation of red blood cell production?

Producing erythropoietin Signup and view all the answers

Which of the following symptoms might a nurse inquire about during a urologic health assessment?

Dysuria and its relationship to voiding Signup and view all the answers

What does a creatinine clearance test measure?

Volume of blood cleared of endogenous creatinine Signup and view all the answers

What range of normal values for creatinine is considered effective renal function?

0.6–1.2 mg/dL Signup and view all the answers

An elevated BUN-to-creatinine ratio is typically seen in which condition?

Hypovolemia Signup and view all the answers

At what age does the normal range for male creatinine clearance begin to decrease significantly?

30-40 years old Signup and view all the answers

What is the primary purpose of a 24-Hour Urine Test?

Evaluate progression of renal disease Signup and view all the answers

In kidney disease, concentrating ability is typically lost at what stage?

Early stage Signup and view all the answers

What condition would a normal BUN-to-creatinine ratio alongside elevated levels of both BUN and creatinine suggest?

Intrinsic renal disease Signup and view all the answers

Which imaging study is primarily used to evaluate the size, shape, and position of the kidneys?

X-ray study of the abdomen or KUB Signup and view all the answers

Study Notes

Objectives of Renal Disorder Management

Role of kidneys includes regulation of fluid and electrolyte balance, acid-base balance, and blood pressure.
Assessment parameters vital for upper and lower urinary tract function include symptoms and prior medical history.
Diagnostic studies aid in identifying urinary tract function issues.
Patient education is crucial for those undergoing urinary system assessment.

Common Terminologies

Aldosterone: Hormone aiding sodium reabsorption by kidneys.
Antidiuretic hormone (ADH): Promotes water reabsorption in kidneys.
Anuria: Urine output < 50 mL in 24 hours.
Bacteriuria: Presence of > 100,000 bacteria colonies/mL in urine.
Creatinine: Waste from muscle metabolism, key in renal function assessment.
Dysuria: Painful or difficult urination.
Hematuria: Presence of red blood cells in urine.
Nocturia: Urination during night.
Oliguria: Urine output < 500 mL in 24 hours.
Proteinuria: Presence of protein in urine.
Pyuria: Presence of white blood cells in urine.

Kidney Structure and Location

Kidneys are bean-shaped organs, typically located retroperitoneally from T12 to L3 vertebrae.
The right kidney is positioned slightly lower than the left due to liver location.
Average weight: approximately 113-170 g; dimensions: 10-12 cm long, 6 cm wide, 2.5 cm thick.

Kidney Functions

Formation and excretion of urine.
Regulation of electrolytes, acid-base balance, and blood pressure.
Synthesis of vitamin D and erythropoietin affecting red blood cell production.

Urine Formation Process

Glomerular filtration: First step, filtering plasma into kidney tubules.
Tubular reabsorption: Movement of substances from tubules back into blood.
Tubular secretion: Movement of substances from blood into tubules.

Assessment of Kidney and Urinary System

Comprehensive health history needed, focusing on urinary symptoms and impacts on life quality.
Key symptoms to assess: urgency, hematuria, nocturia, dysuria, and urinary incontinence.
Physical examination includes careful palpation of the kidneys.

Common Symptoms in Genitourinary Assessment

Pain characteristics vary based on location:
- Kidney pain: Costovertebral angle, dull ache or severe colicky pain.
- Bladder pain: Suprapubic area, associated with voiding.
Changes in voiding patterns indicate various potential issues like infection or obstruction.

Diagnostic Procedures

Urinalysis: Assesses color, clarity, pH, specific gravity, protein, glucose, and sediments.
24-Hour urine test: Evaluates glomerular filtration rate and renal clearance.
Serum tests: Monitor creatinine levels and blood urea nitrogen (BUN) for renal function.
Imaging: KUB x-ray provides visualization of kidney, ureter, and bladder for abnormalities.

Important Laboratory Values

Normal specific gravity: 1.010–1.025.
Creatinine clearance varies by age and gender, with normal ranges provided for different age brackets.
BUN normal: 7–18 mg/dL; an elevated ratio suggests hydration issues or intrinsic renal disease.

Gastrointestinal and Anemia Symptoms

Renal disorders can mimic gastrointestinal issues, complicating diagnosis.
Chronic anemia can result from kidney disorders, leading to symptoms like fatigue and shortness of breath.

Education and Preparation

Patient education on urinary assessments is integral to patient management in renal disorders.
Communication and support are essential for comfortable and thorough assessments.

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Description

This quiz focuses on the management of patients with renal disorders, specifically discussing kidney functions such as fluid and electrolyte balance and blood pressure regulation. Participants will learn about assessment parameters and diagnostic studies relevant to urinary tract function. It's an essential resource for understanding renal health in nursing practice.