Adult health test 2 Urinary part 3
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Questions and Answers

A patient with chronic kidney disease is prescribed erythropoietin (Epogen). What is the primary therapeutic goal of this medication?

  • To prevent seizures.
  • To decrease itching.
  • To stimulate red blood cell production. (correct)
  • To reduce nausea.

    • Which dietary modification is most important for a patient with chronic kidney disease who is not undergoing dialysis?

  • High-sodium, high-protein diet.
  • Low-calorie, low-sodium diet.
  • Unlimited potassium, high-calorie diet.
  • Restricted protein, restricted potassium diet. (correct)

    • Which of the following best describes the primary function of dialysis?

  • To stimulate the kidneys to function more efficiently.
  • To regulate blood glucose levels for diabetic patients.
  • To increase the body's natural production of red blood cells.
  • To remove waste products, extra fluids, and electrolytes from the blood. (correct)

    • What is the typical frequency of hemodialysis treatments?

    <p>Three times a week for 4-6 hours. (B)</p> Signup and view all the answers

    Why do dietary restrictions become more stringent as the time for dialysis nears?

    <p>To minimize electrolyte and fluid imbalances before the next treatment. (C)</p> Signup and view all the answers

    Which procedure uses sound waves to break down kidney stones?

    <p>Lithotripsy (B)</p> Signup and view all the answers

    A client with kidney stones is advised to modify their diet. Which food should the client avoid?

    <p>Spinach (D)</p> Signup and view all the answers

    What is a primary characteristic of Polycystic Kidney Disease (PKD)?

    <p>Growth of numerous fluid-filled cysts in the kidneys (D)</p> Signup and view all the answers

    What is a common symptom of Benign Prostatic Hypertrophy (BPH)?

    <p>Difficulty starting and stopping urination (D)</p> Signup and view all the answers

    Which diagnostic test is used to evaluate the size and shape of the kidneys, ureters, and bladder using X-rays?

    <p>KUB (kidney, ureter, bladder X-ray) (A)</p> Signup and view all the answers

    A client with nocturia, hematuria, and elevated blood pressure should be assessed for?

    <p>Polycystic Kidney Disease (PKD) (A)</p> Signup and view all the answers

    Following a lithotripsy, which post-procedure instruction is most important for the nurse to provide?

    <p>Strain your urine to catch stone fragments (A)</p> Signup and view all the answers

    Which of the following medications is commonly used to treat uric acid kidney stones?

    <p>Allopurinol (D)</p> Signup and view all the answers

    Which surgical approach for prostatectomy involves an incision in the perineum?

    <p>Radical perineal prostatectomy (D)</p> Signup and view all the answers

    What is the most common presenting symptom of prostate cancer?

    <p>Painless hematuria (D)</p> Signup and view all the answers

    Which of the following is a typical manifestation of nephrotic syndrome?

    <p>Proteinuria and hypoalbuminemia (C)</p> Signup and view all the answers

    A patient with acute glomerulonephritis is likely to demonstrate which of the following?

    <p>Hyperkalemia (B)</p> Signup and view all the answers

    Which laboratory finding is most indicative of the oliguric phase of acute renal failure?

    <p>Elevated BUN and creatinine (D)</p> Signup and view all the answers

    A patient with chronic kidney disease presents with a white powdery substance on their skin. What is this finding called?

    <p>Uremic frost (D)</p> Signup and view all the answers

    What is the primary dietary recommendation for a patient with nephrotic syndrome regarding protein intake?

    <p>Moderate protein intake (D)</p> Signup and view all the answers

    Which of the following is a common symptom of chronic glomerulonephritis?

    <p>Morning headaches (A)</p> Signup and view all the answers

    During which stage of acute renal failure does urine output typically increase dramatically?

    <p>Diuretic phase (D)</p> Signup and view all the answers

    What is a key characteristic symptom of uremia associated with chronic kidney disease?

    <p>Halitosis with a urine smell (C)</p> Signup and view all the answers

    What is the primary goal of treatment for chronic kidney disease?

    <p>Conserving renal function as long as possible (C)</p> Signup and view all the answers

    What is the recommended daily sodium restriction for a patient with nephrotic syndrome?

    <p>1,000 mg per day (C)</p> Signup and view all the answers

    Which of the following is a potential complication of a prostatectomy that should be monitored?

    <p>Bladder Spasms (C)</p> Signup and view all the answers

    What is a defining feature of the transurethral resection of the prostate (TURP) procedure?

    <p>Tissue removal through the urethra, leaving the capsule intact. (C)</p> Signup and view all the answers

    A patient with chronic kidney disease is experiencing Kussmaul respirations. What does this indicate?

    <p>Uremic encephalopathy (D)</p> Signup and view all the answers

    Flashcards

    Urinary Obstructions

    Obstructions in the urinary tract, such as kidney stones, tumors, or trauma, can disrupt urine flow. A cystoscopy procedure can offer relief by visualizing and potentially removing the obstruction.

    What are the symptoms of kidney stones?

    Kidney stones can form anywhere in the urinary tract from the kidneys to the bladder. Symptoms include intense pain, often radiating to the groin and thighs, nausea, vomiting, blood in the urine, and frequent urination.

    What is a KUB X-ray?

    A specialized imaging test that uses X-rays to visualize the kidneys, ureters, and bladder. It helps diagnose conditions like kidney stones, blockage, or infections.

    What is Lithotripsy?

    A procedure that uses shock waves to break down kidney stones into smaller fragments, making them easier to pass. It is usually performed with sedation and may cause bruising and blood in the urine.

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    What is Polycystic Kidney Disease (PKD)?

    A genetic disorder causing numerous fluid-filled cysts to grow in the kidneys, often leading to decreased kidney function.

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    What is Benign Prostatic Hypertrophy (BPH)?

    The enlargement of the prostate gland, common in men over 50. The enlarged prostate can press on the urethra causing various urinary symptoms.

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    What is a Digital Rectal Exam (DRE)?

    A medical examination where a doctor inserts a finger into the rectum to feel the size and texture of the prostate. It can help detect BPH and other prostate problems.

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    How is BPH treated?

    Treating BPH can involve medications to reduce prostate size and improve urine flow, or surgery (prostatectomy) to remove part of the prostate.

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    Prostatectomy

    Surgical removal of the prostate gland. It is typically performed to relieve obstruction of the urethra caused by an enlarged prostate.

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    Suprapubic Prostatectomy

    A type of prostatectomy performed through an incision in the abdomen.

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    Radical Perineal Prostatectomy

    A type of prostatectomy performed through an incision in the perineum, the area between the scrotum and the anus.

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    Retropubic Prostatectomy

    A type of prostatectomy performed through a low abdominal incision.

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    Transurethral Resection of the Prostate (TURP)

    The least invasive type of prostatectomy, where tissue is removed through the urethra and the prostate capsule remains intact.

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    Prostate Cancer

    A common cancer affecting men over 50, characterized by painless hematuria (blood in the urine).

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    Hypoalbuminemia

    A protein in the blood that is low in nephrotic syndrome, leading to fluid leakage from the blood vessels into the tissues.

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    Nephrotic Syndrome

    A serious condition caused by inflammation of the kidney glomeruli, resulting in protein leaking into the urine.

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    Anticonvulsants

    Medication used to prevent or manage seizures.

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    Nephritis

    Inflammation of the kidney glomeruli, tubules, or interstitial tissue.

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    Acute Glomerulonephritis

    A type of nephritis often caused by a streptococcal infection, affecting teens and children more than adults.

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    Hemodialysis

    A type of dialysis that uses a machine to filter blood through a semipermeable membrane.

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    Peritoneal dialysis

    A type of dialysis that uses the peritoneum as a semipermeable membrane to filter blood.

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    Chronic Glomerulonephritis

    A progressive kidney disease that can lead to kidney failure.

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    Renal Failure

    Kidney's inability to remove waste products, concentrate urine, or conserve/eliminate electrolytes.

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    Dialysis

    A medical procedure that mimics kidney function, removing waste, extra fluids, and electrolytes from the blood.

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    Dialysis Diet Restrictions

    Dietary restrictions for patients on dialysis become more stringent as the time for dialysis nears.

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    Oliguric Phase

    The first phase of acute kidney injury (AKI) characterized by decreased urine output, elevated BUN and creatinine, and can last days to months.

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    Diuretic Phase

    The phase of acute kidney injury (AKI) where blood chemistry returns to normal and urine output increases.

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    Recovery Phase

    The phase of acute kidney injury (AKI) where kidney function returns to normal or near normal, taking up to a year.

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    Study Notes

    Urinary Obstructions

    • Obstructions in the urinary tract can be caused by kidney stones, tumors, or significant trauma.
    • Cystoscopy can relieve urinary obstructions.

    Kidney Stones

    • Kidney stones can form in any part of the urinary tract (kidney, ureter, bladder).
    • Symptoms: intense pain near the stone, pain radiating to groin, genitalia, and thigh; nausea, vomiting; hematuria; urge to urinate.
    • Diagnosis and treatment: KUB (kidney, ureter, bladder X-ray); IVP (intravenous pyelogram); urinalysis (UA) to check for hematuria; IV fluids to flush the urinary system; surgery might be needed.
    • Lithotripsy: uses sound waves to break down kidney stones, usually under sedation; bruising and hematuria are common; urine must be strained to collect stones.
    • Calcium stones are the most common type.
    • Dietary modifications for calcium stones: decrease calcium, phosphorus, animal protein, and salt; increase water intake (2,000 ml or more daily); avoid cheese, leafy greens, whole grains, carbonated drinks, nuts, chocolate, shellfish, and organ meats.
    • Medications: calcium binding medication (e.g., aluminum hydroxide); allopurinol for uric acid stones.

    Polycystic Kidney Disease (PKD)

    • Genetic disorder causing numerous fluid-filled cysts in the kidneys.
    • Cysts replace nephrons, reducing kidney function.
    • Symptoms: abdominal and flank pain; headache; digestive issues (e.g., constipation); urinary disturbances (e.g., nocturia); recurrent UTIs; hematuria or cloudy urine; elevated blood pressure.
    • No specific treatment; symptom management is key.

    Benign Prostatic Hypertrophy (BPH)

    • Overgrowth of the prostate gland, common in men over 50.
    • Enlarged prostate presses on the urethra and bladder neck, hindering urination.
    • Symptoms: urinary tract infection (UTI) symptoms (frequency, dribbling, urgency); hematuria; low urine output (oliguria); difficulty starting and stopping urination; dribbling.
    • Diagnosis: digital rectal exam; cystoscopy; biopsy; IVP; residual urine measurement; blood tests.
    • Treatment: medical management (medications); surgery (prostatectomy).

    Prostatectomy

    • Surgical removal of the prostate to relieve urethral obstruction.
    • Types: suprapubic, radical perineal, retropubic, transurethral resection of the prostate (TURP - most common, least invasive).
    • Post-op care: monitor urinary output and characteristics; observe for blood clots; bladder spasms are common; continuous closed bladder irrigation may be used to prevent clots; educate patient about outcomes and complications.

    Prostate Cancer

    • Common in men over 50; linked to cigarette exposure.
    • Most common symptom is painless hematuria.
    • Metastasis is common to pelvic lymph nodes and bones.
    • Annual rectal exams and PSA measurements are recommended for men over 50 (or 45 for high-risk); PSA level of 4 or less is considered normal.
    • Post-op care: maintain bowel and bladder function; avoid perineal trauma; monitor drains.
    • Treatment depends on cancer stage and metastasis: hormone therapy; radiation therapy; surgery (radical prostatectomy).

    Nephrotic Syndrome

    • Glomeruli inflammation causing protein leakage into urine.
    • Often triggered by upper respiratory infection or allergic reaction.
    • Symptoms: proteinuria; hypoalbuminemia; edema; hyperlipidemia; ascites; pleural effusion; anasarca; anorexia, fatigue; foamy urine; oliguria.
    • Dietary management: moderate protein intake (0.8-1 gram per kilogram per day); iron and vitamin supplements; sodium restriction (1,000 mg per day); fluids equal to output + 500 ml.

    Nephritis

    • Inflammation of kidney glomeruli, tubules, or interstitial tissue.

    • Types: acute glomerulonephritis (often from streptococcal infection, more common in teens/children); chronic glomerulonephritis (gradual progression to kidney failure).

    • Acute glomerulonephritis symptoms: facial swelling (periorbital edema); anorexia, fatigue; nocturia; dyspnea; hematuria; proteinuria; oliguria; dysuria; elevated BUN and creatinine; elevated potassium; elevated ESR.

    • Acute glomerulonephritis treatment : manage primary symptoms; dietary adjustments for sodium and potassium; monitor level of consciousness; bed rest; adjust fluid intake; long-term antibiotics; monitor weight; watch for elevated blood pressure.

    • Chronic glomerulonephritis symptoms: malaise; morning headaches; dyspnea; visual/digestive disturbances; edema; weight loss; fatigue; hypertension; anemia; proteinuria; anasarca; cardiac/cerebral manifestations.

    • Chronic glomerulonephritis treatment: manage symptoms; preventive health maintenance; early infection treatment.

    Renal Failure (Acute Kidney Injury/Chronic Kidney Injury)

    • Kidney's inability to remove wastes, concentrate urine, or regulate electrolytes.
    • Causes: diabetes, infections, shock, drug side effects, hemorrhage, trauma, infection, decreased cardiac output, nephrotoxic drugs, vascular disorders, acute glomerulonephritis.
    • Acute renal failure phases: oliguric phase (decreased urine output, elevated BUN/creatinine, lasting days to months); diuretic phase (blood chemistry normal, increased urine output, lasting 1-3 weeks); recovery phase (kidney function normal/near normal, up to a year).
    • Acute renal failure symptoms: anorexia, nausea, vomiting; edema, ascites; headaches; CNS signs (drowsiness, muscle twitching, seizures); elevated BUN and creatinine.
    • Acute renal failure treatment: fluids to prevent decreased renal perfusion; managing fluid volume; treat electrolyte imbalances; renal dialysis (if needed); dietary restrictions (protein-sparing, high-carbohydrate, low potassium/sodium); diuretics; potassium reducers; antihypertensives; monitor for uremic frost.
    • Chronic renal failure (CKD)/Chronic Kidney Disease: progressive, irreversible kidney disease; three stages leading to end-stage; causes: pyelonephritis, chronic glomerulonephritis, glomerulosclerosis, chronic urinary obstruction, severe hypertension, diabetes, polycystic kidney disease; requires dialysis and/or transplant.
    • Chronic renal failure symptoms: headaches, lethargy, anorexia; oliguria (less than 100 ml daily); muscle cramps; dusky skin color; disorientation; anemia; acidosis; hypertension; glucose intolerance; joint pain, edema, chest pain; fatigue; intractable hiccups; decreased libido; menstrual irregularities; impaired concentration; uremia (waste buildup); uremia encephalopathy (CNS effects, reduced alertness); halitosis; uremic frost.
    • Chronic renal failure treatment :preserve kidney function; initiate dialysis when needed; prepare for transplant (if eligible); medications (anticonvulsants, erythropoietin, iron supplements, vitamins, antiemetics, antipruritics); dietary management (high-calorie diet, restricted protein, potassium, and sodium).

    Dialysis

    • Mimics kidney function, removing waste, excess fluid, and electrolytes.
    • Used for temporary or permanent kidney failure.
    • Types: hemodialysis (blood filtering with a machine, requires AV fistula/graft); peritoneal dialysis (uses peritoneum as membrane).
    • Dietary restrictions for dialysis patients: restrictions less strict right after dialysis but become more stringent as the time for next dialysis nears.
    • Post-dialysis care: monitor vital signs; watch for complications; and educate about proper care.

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    Description

    Explore the causes, symptoms, and treatments related to urinary obstructions and kidney stones in this comprehensive quiz. Understand the diagnostics like KUB and IVP and learn about procedures such as lithotripsy for effective relief. Enhance your knowledge of urinary health and management.

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