Adult health test 2 Urinary part 4

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Questions and Answers

What is an ileal conduit?

A surgical procedure to remove the kidney.

A valve that prevents urine leakage in the bladder.

A loop of the ileum where the ureters are implanted, brought to the abdominal surface forming a stoma. (correct)

A pouch created from a segment of the large intestine.

What is the typical appearance of a healthy ileal conduit stoma?

Pale and dry

Bluish and painful

Covered in a thick layer of mucous and bleeding

Pink to beefy red and moist (correct)

What is a key self-care instruction for a client with an ileal conduit?

Restricting fluid intake.

Understanding that mucus in the urine indicates infection.

Increasing fluid intake and learning stoma care. (correct)

Avoiding stoma care at home.

How does a continent ileal reservoir differ from an ileal conduit?

It allows for urine drainage by inserting a catheter rather than having a stoma bag. (A) Signup and view all the answers

What is a typical method of managing urine drainage with a continent ileal reservoir?

The client inserts a catheter to drain urine from the reservoir. (B) Signup and view all the answers

Which of the following best describes the most serious and common complication associated with long-term peritoneal dialysis?

Peritonitis (D) Signup and view all the answers

A client undergoing peritoneal dialysis experiences decreased output, elevated temperature, and tenderness over the peritoneal site. Which complication is the client MOST likely experiencing?

Peritonitis (A) Signup and view all the answers

Following a nephrectomy, which nursing intervention is essential to promote client recovery?

Implementing turning, deep breathing exercises, pain management, and dressing care (B) Signup and view all the answers

A nurse is caring for a client with a nephrostomy catheter. Which action should the nurse AVOID doing, to prevent potential complications?

Clamping the nephrostomy catheter (C) Signup and view all the answers

During a kidney transplant, where is the donor kidney typically positioned?

In the iliac fossa, anterior to the iliac crest (C) Signup and view all the answers

What is the PRIMARY purpose of immunosuppressive drugs following a kidney transplant?

To prevent graft rejection (C) Signup and view all the answers

A client post-kidney transplant shows signs of rejection, such as fever, oliguria, and tenderness over the graft. Which other symptoms might indicate graft rejection?

Hypertension and generalized edema (D) Signup and view all the answers

What is a urinary diversion most often used to treat?

Bladder cancer, invasive cervical cancer, neurogenic bladder, and congenital abnormalities (B) Signup and view all the answers

Study Notes

Peritoneal Dialysis

Typically performed at home.
Done four times daily, seven days per week.
Each session lasts 30-40 minutes.
Uses the peritoneum as a semi-permeable membrane.
Requires more time per day compared to hemodialysis.
A catheter is placed in the peritoneal space by a doctor.
Dialysate dwelling time is 15-45 minutes (typically 30-40 minutes).
Clients should drain more dialysate than instilled.
Clients can eat and drink during dialysis.
Fluid restriction is still necessary due to renal failure.
Peritonitis is a serious and common complication (60-80% of clients on long-term peritoneal dialysis).
Signs of infection include elevated temperature, decreased output, and peritoneal tenderness.

Nephrectomy

Surgical removal of the kidney.
Careful monitoring is needed for hemorrhage, GI complications, and urinary output.
Nursing interventions include turning every two hours, deep breathing exercises, pain management, and dressing changes.
Adequate urinary output from the remaining kidney is crucial post-surgery.

Nephrostomy

An incision to drain the kidney pelvis using a catheter.
Ensure catheter patency to prevent obstruction.
Monitor drainage amount and turn the client to the affected side to detect obstructions.
Do not clamp a nephrostomy catheter, as this could cause damage.

Kidney Transplant

The non-functioning kidney remains in place.
The donor kidney is positioned in the iliac fossa, anterior to the iliac crest, for bone protection.
The donor kidney ureter is connected to the recipient's ureter or bladder.
Relatives, particularly siblings with similar genetics, are the best matches for successful transplants.
Post-operatively, clients require immunosuppressants to prevent rejection.
Post-transplant nursing care monitors for rejection or infection symptoms (apprehension, generalized edema, fever, increased blood pressure, oliguria, edema, tenderness at the graft site).
Immunosuppressants (sometimes combined with steroids) are often used post-transplant.
Post-transplant care includes preventing hemorrhage and shock, educating clients on fluid intake, daily weight tracking, and infection prevention.

Urinary Diversion

Used for bladder cancer, invasive cervical cancer, neurogenic bladder, and congenital anomalies.
Cystectomy (bladder removal) may involve an ileal conduit where ureters are implanted into an ileum loop and brought to the abdominal surface, creating a stoma.
The stoma should be pink to beefy red and moist.
Teach clients about stoma care and increased fluid intake at home.
Mucus in urine is normal and does not indicate infection.

Continent Ileal Reservoir

A pouch created from a segment of the removed small intestine.
Ureters are implanted into this intestinal segment.
An anastomosis connects to the abdominal wall.
A valve prevents urine leakage, and the client inserts a catheter to drain the reservoir.
This allows the client to be continent of urine.

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Description

This quiz covers essential aspects of peritoneal dialysis and nephrectomy. It includes details about the procedure, potential complications, and nursing care involved in these medical processes. Test your knowledge on renal therapies and postoperative management.