week 8D2
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Questions and Answers

Which structure is primarily responsible for filtering blood in the kidneys?

  • Nephron (correct)
  • Medulla
  • Renal pelvis
  • Cortex

    • What is the primary function of the renal pelvis in the urinary system?

  • Store urine
  • Control urine flow
  • Filter blood
  • Collect and drain urine (correct)

    • How many kidneys are typically found in a human anatomy?

  • 2 (correct)
  • 1
  • 4
  • 3

    • What role do sphincters play in the urinary system?

    <p>Control urine flow</p> Signup and view all the answers

    Which area of the kidney contains the nephron and glomerulus?

    <p>Cortex</p> Signup and view all the answers

    What primary role does the urinary system fulfill regarding urea and creatinine?

    <p>Excrete waste products from the body</p> Signup and view all the answers

    Which structure is not a part of the nephron?

    <p>Renal pelvis</p> Signup and view all the answers

    What is the primary mechanism that the body utilizes to regulate its internal environment?

    <p>Homeostasis through feedback loops</p> Signup and view all the answers

    Which ion is critical for neuro-muscular activity?

    <p>Potassium (K+)</p> Signup and view all the answers

    What is the average daily intake and output of fluids for a healthy adult?

    <p>2500 mL</p> Signup and view all the answers

    What does an increased Blood Urea Nitrogen (BUN) typically indicate?

    <p>Renal dysfunction</p> Signup and view all the answers

    Which of the following substances dissociates in solution to form ions?

    <p>Electrolytes</p> Signup and view all the answers

    What percentage of body weight is typically water in a healthy adult?

    <p>55-60%</p> Signup and view all the answers

    What is the primary functional unit of the kidneys?

    <p>Nephron</p> Signup and view all the answers

    The bladder serves as a reservoir for urine.

    <p>True</p> Signup and view all the answers

    How many areas does the kidney have?

    <p>3</p> Signup and view all the answers

    The _____ carries urine from the bladder and expels it from the body.

    <p>urethra</p> Signup and view all the answers

    Match the following structures of the urinary system with their functions:

    <p>Kidney = Filters blood and creates urine Ureter = Transports urine to the bladder Bladder = Stores urine Urethra = Expels urine from the body</p> Signup and view all the answers

    Which of the following is NOT a primary waste product excreted by the urinary system?

    <p>Sodium</p> Signup and view all the answers

    Homeostasis refers to the body’s tendency to maintain balance in constantly changing conditions.

    <p>True</p> Signup and view all the answers

    What is the primary component of body fluid?

    <p>Water</p> Signup and view all the answers

    The kidneys are the primary means of ridding the body of __________ waste products.

    <p>Drug</p> Signup and view all the answers

    Match the following electrolytes with their respective ions:

    <p>Sodium = Na+ Potassium = K+ Chloride = Cl- Calcium = Ca++</p> Signup and view all the answers

    Which electrolyte is critical for regulating water balance in the body?

    <p>Sodium</p> Signup and view all the answers

    Elderly individuals typically have a higher percentage of body weight that is water compared to younger adults.

    <p>False</p> Signup and view all the answers

    What is the average daily intake and output of fluids for a healthy adult in milliliters?

    <p>2500</p> Signup and view all the answers

    What happens to urine if an individual is dehydrated?

    <p>It appears dark and concentrated.</p> Signup and view all the answers

    What is the normal range for serum sodium levels?

    <p>135 – 145 mEq/L</p> Signup and view all the answers

    Which of the following is a common cause of hypokalemia?

    <p>Vomiting</p> Signup and view all the answers

    What is a primary intervention for a patient with fluid volume deficit?

    <p>Monitor vital signs and daily weight.</p> Signup and view all the answers

    What is the chemical symbol for potassium?

    <p>K</p> Signup and view all the answers

    Which treatment is essential for a client suffering from hypokalemia?

    <p>Potassium replacement therapy</p> Signup and view all the answers

    Which of the following symptoms is common in both hypokalemia and hyperkalemia?

    <p>Nausea and vomiting</p> Signup and view all the answers

    What is the expected change in urine specific gravity for a patient in fluid overload?

    <p>Decrease in specific gravity</p> Signup and view all the answers

    Which of the following is a common cause of fluid volume deficit?

    <p>Inadequate fluid intake</p> Signup and view all the answers

    What is a significant sign of fluid volume excess?

    <p>Tachycardia with a full bounding pulse</p> Signup and view all the answers

    What happens to serum osmolality in a dehydrated client?

    <p>It increases</p> Signup and view all the answers

    Which symptom is NOT typically associated with fluid volume deficit?

    <p>Edema</p> Signup and view all the answers

    Which test is primarily used to assess fluid volume deficit?

    <p>Hematocrit</p> Signup and view all the answers

    What is a common respiratory sign of fluid volume excess?

    <p>Increased respiratory rate</p> Signup and view all the answers

    What symptom indicates hypotension related to fluid volume deficit?

    <p>Dry mucous membranes</p> Signup and view all the answers

    Fluid volume excess is most commonly associated with which organ's dysfunction?

    <p>Kidney</p> Signup and view all the answers

    What is a common cause of fluid volume deficit?

    <p>Diarrhea</p> Signup and view all the answers

    Hypotension is a sign of fluid volume excess.

    <p>False</p> Signup and view all the answers

    What happens to serum osmolality if a client is dehydrated?

    <p>It increases.</p> Signup and view all the answers

    Fluid volume excess is also known as __________.

    <p>Hypervolemia</p> Signup and view all the answers

    Match the following signs and symptoms with fluid volume deficit or excess:

    <p>Tachycardia = Fluid Volume Deficit Hypertension = Fluid Volume Excess Weak pulse = Fluid Volume Deficit Full bounding pulse = Fluid Volume Excess</p> Signup and view all the answers

    Which of the following is a sign of fluid volume excess?

    <p>Crackles in breath sounds</p> Signup and view all the answers

    Inadequate fluid intake is a cause of fluid volume deficit.

    <p>True</p> Signup and view all the answers

    What lab test measures the percentage of red blood cells in a volume of blood?

    <p>Hematocrit.</p> Signup and view all the answers

    What is the normal range for serum potassium levels?

    <p>3.5 – 5.3 mEq/L</p> Signup and view all the answers

    Hyperkalemia is defined as a serum potassium level greater than 5.3 mEq/L.

    <p>True</p> Signup and view all the answers

    What treatment do clients with hypokalemia need?

    <p>Potassium replacement</p> Signup and view all the answers

    Hyponatremia indicates a low serum sodium level of less than _____ mEq/L.

    <p>135</p> Signup and view all the answers

    Which of the following symptoms is common in both hypokalemia and hyperkalemia?

    <p>Muscle weakness</p> Signup and view all the answers

    Match the following causes of electrolyte imbalances with their correct types:

    <p>Water retention = Hyponatremia Vomiting = Hypokalemia Renal failure = Hyperkalemia Diuretics = Hypokalemia</p> Signup and view all the answers

    Specific gravity of urine decreases with dehydration.

    <p>False</p> Signup and view all the answers

    Name one natural source of potassium.

    <p>Banana</p> Signup and view all the answers

    Which risk factor is NOT associated with the development of kidney stones?

    <p>Increased physical activity</p> Signup and view all the answers

    Which clinical manifestation is characteristic of pyelonephritis?

    <p>Flank pain</p> Signup and view all the answers

    What is a common nursing intervention for a patient with glomerulonephritis?

    <p>Monitor daily weight</p> Signup and view all the answers

    In cystitis, which of the following is typically found in a urinalysis?

    <p>Pyuria</p> Signup and view all the answers

    What dietary modification is recommended for patients with kidney stones?

    <p>Decrease sodium intake</p> Signup and view all the answers

    Which condition is characterized by inflammation of the bladder due to bacterial infection?

    <p>Cystitis</p> Signup and view all the answers

    Which of the following nursing interventions is NOT appropriate for a patient experiencing renal calculi?

    <p>Advocate for high dietary sodium intake</p> Signup and view all the answers

    A patient with glomerulonephritis is likely to show which abnormal lab finding?

    <p>Hypoalbuminemia</p> Signup and view all the answers

    What is a potential complication of fluid volume excess related to the cardiovascular system?

    <p>Heart failure</p> Signup and view all the answers

    Which medication is primarily used to manage fluid volume excess?

    <p>Furosemide</p> Signup and view all the answers

    What is the most crucial nursing intervention for monitoring fluid volume status?

    <p>Daily weight measurement</p> Signup and view all the answers

    In assessing urine characteristics, which finding is least indicative of fluid volume excess?

    <p>Light straw color</p> Signup and view all the answers

    Which lab value is most critical to monitor in a patient receiving diuretics for fluid volume excess?

    <p>Potassium</p> Signup and view all the answers

    What type of edema is assessed with a 6mm indentation after pressing a swollen area?

    <p>+3 pitting edema</p> Signup and view all the answers

    Which symptom most directly suggests a urinary tract infection (UTI)?

    <p>Dysuria</p> Signup and view all the answers

    When educating a patient about diuretics, which advice is most important to include?

    <p>Change positions slowly</p> Signup and view all the answers

    Which medication is commonly used as a diuretic to help increase urination?

    <p>Furosemide</p> Signup and view all the answers

    Monitoring daily weights is an essential part of managing fluid volume excess.

    <p>True</p> Signup and view all the answers

    What is the term for the presence of blood in the urine?

    <p>Hematuria</p> Signup and view all the answers

    Elevating the feet is recommended for patients experiencing __________.

    <p>edema</p> Signup and view all the answers

    Match the following terms with their definitions:

    <p>Nocturia = Urinating at night Dysuria = Painful urination Oliguria = Low urine output Azotemia = Excess nitrogen waste in blood</p> Signup and view all the answers

    Which of the following is NOT a risk factor for kidney stones?

    <p>High physical activity</p> Signup and view all the answers

    Which of the following is a common sign of fluid volume excess?

    <p>Pitting edema</p> Signup and view all the answers

    Providing ice chips is not advisable for patients with fluid restrictions.

    <p>False</p> Signup and view all the answers

    Cystitis is primarily caused by viral infections.

    <p>False</p> Signup and view all the answers

    What are the common signs and symptoms of pyelonephritis?

    <p>Flank pain, vomiting, diarrhea, fever, chills, malaise.</p> Signup and view all the answers

    What is the recommended position for a patient experiencing respiratory distress due to fluid overload?

    <p>Semi-fowler position</p> Signup and view all the answers

    Renal calculi are commonly known as __________.

    <p>kidney stones</p> Signup and view all the answers

    Match the following disorders with their common symptoms:

    <p>Cystitis = Pyuria Pyelonephritis = Flank pain Glomerulonephritis = Edema Kidney Stones = Hematuria</p> Signup and view all the answers

    Which dietary modification can help manage kidney stones?

    <p>Decrease protein intake</p> Signup and view all the answers

    Elderly individuals may show different symptoms of urinary tract infections compared to younger individuals.

    <p>True</p> Signup and view all the answers

    What is a common pharmacological management for glomerulonephritis?

    <p>Corticosteroids</p> Signup and view all the answers

    Which symptom is specifically associated with End Stage Renal Failure?

    <p>Uremia</p> Signup and view all the answers

    What is the typical frequency and duration of Hemodialysis treatment?

    <p>2-3 times a week for 9-12 hours total</p> Signup and view all the answers

    Which of the following treatments would NOT be appropriate for a patient experiencing renal failure?

    <p>Nephrotoxic medications</p> Signup and view all the answers

    Which factor is primarily responsible for edema in patients with renal failure?

    <p>Sodium and water retention</p> Signup and view all the answers

    What complication is most commonly associated with Peritoneal Dialysis?

    <p>Infection</p> Signup and view all the answers

    What is the primary mechanism by which dialysis removes waste from the blood?

    <p>Diffusion and osmosis across a semi-permeable membrane</p> Signup and view all the answers

    What is a characteristic of acute renal failure?

    <p>Abrupt onset and often reversible</p> Signup and view all the answers

    Uremia is the term used to describe the condition where urine is present in the blood.

    <p>True</p> Signup and view all the answers

    Name one common cause of end-stage renal failure.

    <p>Chronic kidney disease</p> Signup and view all the answers

    Dialysis is a mechanical means of removing _____ from the blood.

    <p>waste</p> Signup and view all the answers

    Match the type of dialysis with its description:

    <p>Hemodialysis = Uses a machine and semi-permeable membrane to filter blood Peritoneal Dialysis = Uses the lining of the abdominal cavity for filtration Dialysate = Solution used in hemodialysis to help remove waste Catheter = Device used to access the peritoneal space for dialysis</p> Signup and view all the answers

    Which of the following symptoms is associated with end-stage renal failure?

    <p>Oliguria</p> Signup and view all the answers

    Study Notes

    Renal and Urinary System Structures

    • The urinary system is essential for life, involving the kidneys, ureters, bladder, and urethra.
    • Each person has two kidneys.
    • Main anatomical areas of the kidney include:
      • Cortex: Outer layer containing nephrons and glomeruli.
      • Medulla: Inner area, responsible for draining urine through pyramids.
      • Renal Pelvis: Central part where urine drains before moving to the ureters.

    Kidney Functions

    • The functional unit of the kidney is the nephron, which filters blood and produces urine.
    • Urine formation involves a complex process occurring within nephrons.
    • Urine flows through:
      • Ureter: Long, muscular tube carrying urine from the kidney to the bladder.
      • Bladder: Hollow sac acting as a reservoir for urine.
      • Urethra: Tube that expels urine from the body, controlled by sphincters to manage flow.

    Functions of the Urinary System

    • Main functions of the urinary system include:
      • Excretion of waste products: Key wastes include urea and creatinine.
      • Regulation of electrolytes and acid-base balance.
      • Controls water balance and blood pressure.

    Nephrons Anatomy

    • Major components of nephrons include:
      • Glomerulus: Filters blood.
      • Bowman’s capsule: Collects filtrate.
      • Proximal convoluted tubule: Reabsorbs essential nutrients.
      • Loops of Henle: Concentrates urine and conserves water.
      • Distal convoluted tubule: Final site for secretion and reabsorption.

    Glomerular Filtration Rate (GFR)

    • GFR measures the volume of fluid filtered by the glomeruli, indicating kidney function.
    • Balance of fluid intake and output is crucial:
      • Increased intake leads to diluted urine output.
      • Decreased intake results in concentrated urine.

    Primary Waste Products

    • Urea and creatinine are key waste products in urine.
    • Elevated Blood Urea Nitrogen (BUN) and serum creatinine levels may indicate renal dysfunction.
    • Kidneys eliminate drug metabolites from the body, playing a role in drug excretion.

    Fluid and Electrolyte Balance

    • Homeostasis refers to the body’s ability to maintain stable internal conditions despite changes.
    • Body fluid is primarily composed of water, constituting about 60% of total body weight.
    • Elderly individuals have less body water, averaging 45-50% of body weight.
    • Average daily fluid intake and output is about 2500 mL.

    Electrolytes

    • Electrolytes are substances that dissociate to form ions in solution, crucial for maintaining water balance and conducting electricity.
    • Key electrolytes include:
      • Sodium (Na+): Regulates blood pressure and fluid balance.
      • Potassium (K+): Essential for muscle function and nerve signaling.
    • Ions play a significant role in neuromuscular activity.

    Summary of Regulatory Mechanisms

    • The urinary system plays a vital role in regulating water and electrolyte balance through filtration and excretion processes that adapt to the body's needs.

    Renal and Urinary System Structures

    • The urinary system is essential for life, involving the kidneys, ureters, bladder, and urethra.
    • Each person has two kidneys.
    • Main anatomical areas of the kidney include:
      • Cortex: Outer layer containing nephrons and glomeruli.
      • Medulla: Inner area, responsible for draining urine through pyramids.
      • Renal Pelvis: Central part where urine drains before moving to the ureters.

    Kidney Functions

    • The functional unit of the kidney is the nephron, which filters blood and produces urine.
    • Urine formation involves a complex process occurring within nephrons.
    • Urine flows through:
      • Ureter: Long, muscular tube carrying urine from the kidney to the bladder.
      • Bladder: Hollow sac acting as a reservoir for urine.
      • Urethra: Tube that expels urine from the body, controlled by sphincters to manage flow.

    Functions of the Urinary System

    • Main functions of the urinary system include:
      • Excretion of waste products: Key wastes include urea and creatinine.
      • Regulation of electrolytes and acid-base balance.
      • Controls water balance and blood pressure.

    Nephrons Anatomy

    • Major components of nephrons include:
      • Glomerulus: Filters blood.
      • Bowman’s capsule: Collects filtrate.
      • Proximal convoluted tubule: Reabsorbs essential nutrients.
      • Loops of Henle: Concentrates urine and conserves water.
      • Distal convoluted tubule: Final site for secretion and reabsorption.

    Glomerular Filtration Rate (GFR)

    • GFR measures the volume of fluid filtered by the glomeruli, indicating kidney function.
    • Balance of fluid intake and output is crucial:
      • Increased intake leads to diluted urine output.
      • Decreased intake results in concentrated urine.

    Primary Waste Products

    • Urea and creatinine are key waste products in urine.
    • Elevated Blood Urea Nitrogen (BUN) and serum creatinine levels may indicate renal dysfunction.
    • Kidneys eliminate drug metabolites from the body, playing a role in drug excretion.

    Fluid and Electrolyte Balance

    • Homeostasis refers to the body’s ability to maintain stable internal conditions despite changes.
    • Body fluid is primarily composed of water, constituting about 60% of total body weight.
    • Elderly individuals have less body water, averaging 45-50% of body weight.
    • Average daily fluid intake and output is about 2500 mL.

    Electrolytes

    • Electrolytes are substances that dissociate to form ions in solution, crucial for maintaining water balance and conducting electricity.
    • Key electrolytes include:
      • Sodium (Na+): Regulates blood pressure and fluid balance.
      • Potassium (K+): Essential for muscle function and nerve signaling.
    • Ions play a significant role in neuromuscular activity.

    Summary of Regulatory Mechanisms

    • The urinary system plays a vital role in regulating water and electrolyte balance through filtration and excretion processes that adapt to the body's needs.

    Fluid Volume Deficit and Dehydration

    • Dehydration is defined as excessive loss of body fluids leading to hypovolemia (output < input).
    • Nursing diagnosis for fluid volume deficit is crucial for patient assessment.

    Common Causes of Fluid Volume Deficit

    • Diarrhea
    • Vomiting
    • Excessive urine output (polyuria)
    • Hemorrhaging
    • Inadequate fluid intake

    Signs & Symptoms of Fluid Volume Deficit

    • Energy depletion and fatigue; confusion and headaches
    • Blood pressure changes: hypotension and orthostatic hypotension
    • Pulse characteristics: tachycardia and weak pulse strength
    • Weight decreases and dry skin/mucous membranes; decreased skin turgor
    • Urine output: decreased volume and dark color

    Fluid Volume Excess

    • Fluid volume excess is commonly associated with sodium and water retention, also referred to as hypervolemia.

    Common Causes of Fluid Volume Excess

    • Renal failure (related to kidney dysfunction).

    Signs & Symptoms of Fluid Volume Excess

    • Elevation in blood pressure (hypertension)
    • Pulse rate: tachycardia with full bounding pulse strength
    • Respiratory changes: increased rate, cough, dyspnea, and crackling breath sounds
    • Weight gain and edema

    Lab Tests for Fluid Volume Imbalances

    • Serum osmolality: indicates blood viscosity; increases with dehydration and decreases with fluid overload.
    • Hematocrit: measures the percentage of red blood cells; elevated in dehydration and decreased with fluid overload.
    • Urine specific gravity: dark and high in dehydration; clear and low in fluid overload.

    Normal and Abnormal Serum Electrolyte Values

    • Sodium (Na): normal range is 135 – 145 mEq/L; low sodium (< 135 mEq/L) indicates fluid volume excess (hyponatremia).
    • Potassium (K): normal range is 3.5 – 5.3 mEq/L; hypokalemia defined as low potassium (< 3.5 mEq/L) with potential causes including vomiting, diarrhea, and diuretics.
    • Hyperkalemia defined as high potassium (> 5.3 mEq/L) primarily due to renal failure; both conditions may lead to serious dysrhythmias.

    Interdisciplinary Care for Electrolyte Imbalances

    • Hypokalemia treatment involves potassium replacement through medications.
    • Natural dietary sources of potassium include bananas, oranges, cantaloupe, carrots, cauliflower, and potatoes.
    • Loop diuretics (e.g., furosemide) can be used to manage hyperkalemia.

    Nursing Measures for Managing Fluid and Electrolyte Imbalances

    • Monitor vital signs and conduct daily weight checks at the same time with similar clothing for consistency.
    • Assess urine, skin, mucous membranes, mental status, and breath sounds.
    • For patients with fluid volume deficit, encourage fluid intake, primarily water.
    • Educate patients to avoid sun exposure and limit caffeine and sugar.
    • For vomiting, recommend small, frequent sips of fluids like tea or flat cola; for diarrhea, suggest consuming fruit juice or broth, not just water.

    Intake Considerations

    • In an intake and output assessment, include all fluids consumed, including those ingested during meals and beverages.

    Fluid Volume Deficit and Dehydration

    • Dehydration is defined as excessive loss of body fluids leading to hypovolemia (output < input).
    • Nursing diagnosis for fluid volume deficit is crucial for patient assessment.

    Common Causes of Fluid Volume Deficit

    • Diarrhea
    • Vomiting
    • Excessive urine output (polyuria)
    • Hemorrhaging
    • Inadequate fluid intake

    Signs & Symptoms of Fluid Volume Deficit

    • Energy depletion and fatigue; confusion and headaches
    • Blood pressure changes: hypotension and orthostatic hypotension
    • Pulse characteristics: tachycardia and weak pulse strength
    • Weight decreases and dry skin/mucous membranes; decreased skin turgor
    • Urine output: decreased volume and dark color

    Fluid Volume Excess

    • Fluid volume excess is commonly associated with sodium and water retention, also referred to as hypervolemia.

    Common Causes of Fluid Volume Excess

    • Renal failure (related to kidney dysfunction).

    Signs & Symptoms of Fluid Volume Excess

    • Elevation in blood pressure (hypertension)
    • Pulse rate: tachycardia with full bounding pulse strength
    • Respiratory changes: increased rate, cough, dyspnea, and crackling breath sounds
    • Weight gain and edema

    Lab Tests for Fluid Volume Imbalances

    • Serum osmolality: indicates blood viscosity; increases with dehydration and decreases with fluid overload.
    • Hematocrit: measures the percentage of red blood cells; elevated in dehydration and decreased with fluid overload.
    • Urine specific gravity: dark and high in dehydration; clear and low in fluid overload.

    Normal and Abnormal Serum Electrolyte Values

    • Sodium (Na): normal range is 135 – 145 mEq/L; low sodium (< 135 mEq/L) indicates fluid volume excess (hyponatremia).
    • Potassium (K): normal range is 3.5 – 5.3 mEq/L; hypokalemia defined as low potassium (< 3.5 mEq/L) with potential causes including vomiting, diarrhea, and diuretics.
    • Hyperkalemia defined as high potassium (> 5.3 mEq/L) primarily due to renal failure; both conditions may lead to serious dysrhythmias.

    Interdisciplinary Care for Electrolyte Imbalances

    • Hypokalemia treatment involves potassium replacement through medications.
    • Natural dietary sources of potassium include bananas, oranges, cantaloupe, carrots, cauliflower, and potatoes.
    • Loop diuretics (e.g., furosemide) can be used to manage hyperkalemia.

    Nursing Measures for Managing Fluid and Electrolyte Imbalances

    • Monitor vital signs and conduct daily weight checks at the same time with similar clothing for consistency.
    • Assess urine, skin, mucous membranes, mental status, and breath sounds.
    • For patients with fluid volume deficit, encourage fluid intake, primarily water.
    • Educate patients to avoid sun exposure and limit caffeine and sugar.
    • For vomiting, recommend small, frequent sips of fluids like tea or flat cola; for diarrhea, suggest consuming fruit juice or broth, not just water.

    Intake Considerations

    • In an intake and output assessment, include all fluids consumed, including those ingested during meals and beverages.

    Fluid Volume Excess Management

    • Diuretics such as Lasix (Furosemide) are used to increase urination and manage fluid overload.
    • Fluid and Sodium Restrictions are prescribed by a physician to prevent further accumulation.
    • Nursing Plan Components include:
      • Baseline Measurements: Monitor weight, vital signs, and fluid intake/output.
      • Physical Assessments: Evaluate skin turgor and edema.
      • Daily Weights: Track weight changes to assess fluid status.

    Laboratory Monitoring

    • Key Lab Tests: Monitor potassium (K+) levels, fluid, and sodium restrictions.
    • Provide Ice Chips as a means of hydration within restriction limits.

    Patient Care Considerations

    • Oral Care: Important for comfort in patients restricted from fluid intake.
    • Positioning: Elevate feet, maintain semi-fowler’s position to promote comfort.
    • Education on Diuretics: Inform patients on side effects and the importance of potassium monitoring.
    • Nocturia: Frequent urination at night.
    • Hematuria: Presence of blood in urine.
    • Pyuria: Presence of pus in urine.
    • Dysuria: Painful urination.
    • Oliguria: Reduced urine output.
    • Urgency: Sudden strong need to urinate.
    • Azotemia: Elevated nitrogen waste product in blood.
    • Uremia: Clinical syndrome related to kidney failure.
    • Bruit and Thrill: Indicators of vascular changes.

    Subjective Information and Physical Assessment

    • Assessment of Urine: Color, odor, amount, and fluid intake must be evaluated.
    • Pain Consideration: Include assessment for abdominal, suprapubic, and flank pain.
    • History Taking: Document history of UTIs, medication use, and lifestyle factors (e.g., smoking, alcohol).
    • Physical Assessment: Check vital signs, skin color, moisture, and presence of edema.

    Edema Assessment

    • Pitting Edema Grading:
      • +1 = 2mm
      • +2 = 4mm
      • +3 = 6mm
      • +4 = 8mm

    Urinalysis Normal Values

    • Color: Light straw to amber, clear.
    • Specific Gravity: 1.005 to 1.030.
    • pH Levels: 4.5 to 8.0.
    • Proteins: Negative to trace concentrations.
    • RBC and WBC Values: 1-2 RBCs, 3-4 WBCs per high power field are normal.

    Risk Factors for Kidney Stones (Renal Calculi)

    • Dehydration, Urinary Stasis, Infection, Immobility are key contributors.

    Clinical Manifestations of Renal Calculi

    • Symptoms: Severe abdominal/flank pain, nausea/vomiting, hematuria.
    • Diagnostic Findings: Urinalysis, X-ray, CT scan/MRI, cystoscopy.

    Management of Renal Calculi

    • Pain Management: Use opioid analgesics and NSAIDs.
    • Dietary Adjustments: Increase fluid intake, decrease sodium and protein consumption.
    • Prevent Dehydration: Monitor fluid intake and urine output, strain urine with gauze.

    Cystitis (UTI)

    • Etiology: Caused by bacteria. Common in females.
    • Symptoms: Pyuria, hematuria, lower abdominal discomfort.
    • Gerontologic Considerations: Fatigue and altered cognitive function may be observed.

    Pyelonephritis (Kidney Infection)

    • Etiology: Primarily caused by E. coli.
    • Symptoms: Flank pain, vomiting, diarrhea, fever, chills, malaise.
    • Diagnosis: Urinalysis and culture.

    Glomerulonephritis

    • Definition: Inflammation and damage to the glomerulus leading to blood and protein leakage.
    • Etiologies: Can be acute (bacterial infection) or chronic (e.g., diabetes).
    • Symptoms: Edema, hypertension, proteinuria, fatigue due to azotemia.

    Complications and Management of Glomerulonephritis

    • Potential Complications: Renal failure and embolism.
    • Management Strategies: Use diuretics for edema, corticosteroids for inflammation, and antibiotics for infections.
    • Nursing Management: Daily weights, monitor input/output, evaluate electrolytes and lung assessment. Follow dietary restrictions regarding sodium, protein, and fats.

    Fluid Volume Excess Management

    • Diuretics such as Lasix (Furosemide) are used to increase urination and manage fluid overload.
    • Fluid and Sodium Restrictions are prescribed by a physician to prevent further accumulation.
    • Nursing Plan Components include:
      • Baseline Measurements: Monitor weight, vital signs, and fluid intake/output.
      • Physical Assessments: Evaluate skin turgor and edema.
      • Daily Weights: Track weight changes to assess fluid status.

    Laboratory Monitoring

    • Key Lab Tests: Monitor potassium (K+) levels, fluid, and sodium restrictions.
    • Provide Ice Chips as a means of hydration within restriction limits.

    Patient Care Considerations

    • Oral Care: Important for comfort in patients restricted from fluid intake.
    • Positioning: Elevate feet, maintain semi-fowler’s position to promote comfort.
    • Education on Diuretics: Inform patients on side effects and the importance of potassium monitoring.
    • Nocturia: Frequent urination at night.
    • Hematuria: Presence of blood in urine.
    • Pyuria: Presence of pus in urine.
    • Dysuria: Painful urination.
    • Oliguria: Reduced urine output.
    • Urgency: Sudden strong need to urinate.
    • Azotemia: Elevated nitrogen waste product in blood.
    • Uremia: Clinical syndrome related to kidney failure.
    • Bruit and Thrill: Indicators of vascular changes.

    Subjective Information and Physical Assessment

    • Assessment of Urine: Color, odor, amount, and fluid intake must be evaluated.
    • Pain Consideration: Include assessment for abdominal, suprapubic, and flank pain.
    • History Taking: Document history of UTIs, medication use, and lifestyle factors (e.g., smoking, alcohol).
    • Physical Assessment: Check vital signs, skin color, moisture, and presence of edema.

    Edema Assessment

    • Pitting Edema Grading:
      • +1 = 2mm
      • +2 = 4mm
      • +3 = 6mm
      • +4 = 8mm

    Urinalysis Normal Values

    • Color: Light straw to amber, clear.
    • Specific Gravity: 1.005 to 1.030.
    • pH Levels: 4.5 to 8.0.
    • Proteins: Negative to trace concentrations.
    • RBC and WBC Values: 1-2 RBCs, 3-4 WBCs per high power field are normal.

    Risk Factors for Kidney Stones (Renal Calculi)

    • Dehydration, Urinary Stasis, Infection, Immobility are key contributors.

    Clinical Manifestations of Renal Calculi

    • Symptoms: Severe abdominal/flank pain, nausea/vomiting, hematuria.
    • Diagnostic Findings: Urinalysis, X-ray, CT scan/MRI, cystoscopy.

    Management of Renal Calculi

    • Pain Management: Use opioid analgesics and NSAIDs.
    • Dietary Adjustments: Increase fluid intake, decrease sodium and protein consumption.
    • Prevent Dehydration: Monitor fluid intake and urine output, strain urine with gauze.

    Cystitis (UTI)

    • Etiology: Caused by bacteria. Common in females.
    • Symptoms: Pyuria, hematuria, lower abdominal discomfort.
    • Gerontologic Considerations: Fatigue and altered cognitive function may be observed.

    Pyelonephritis (Kidney Infection)

    • Etiology: Primarily caused by E. coli.
    • Symptoms: Flank pain, vomiting, diarrhea, fever, chills, malaise.
    • Diagnosis: Urinalysis and culture.

    Glomerulonephritis

    • Definition: Inflammation and damage to the glomerulus leading to blood and protein leakage.
    • Etiologies: Can be acute (bacterial infection) or chronic (e.g., diabetes).
    • Symptoms: Edema, hypertension, proteinuria, fatigue due to azotemia.

    Complications and Management of Glomerulonephritis

    • Potential Complications: Renal failure and embolism.
    • Management Strategies: Use diuretics for edema, corticosteroids for inflammation, and antibiotics for infections.
    • Nursing Management: Daily weights, monitor input/output, evaluate electrolytes and lung assessment. Follow dietary restrictions regarding sodium, protein, and fats.

    Renal Failure Overview

    • Impairment in the kidneys leading to accumulation of waste in the blood.
    • Two main types: Acute Renal Failure and End-stage Renal Failure.

    Acute Renal Failure

    • Characterized by an abrupt onset.
    • Often reversible under appropriate treatment.
    • Common etiologies include trauma and infection.

    End-stage Renal Failure

    • Results from gradual destruction of kidney function.
    • Considered chronic in nature and irreversible.

    Signs and Symptoms of Renal Failure

    • Oliguria: urinary output less than 400 mL/day.
    • Elevated Blood Urea Nitrogen (BUN) levels.
    • Decreased Glomerular Filtration Rate (GFR).
    • Azotemia: buildup of nitrogen waste in the blood.
    • Sodium and water retention leading to edema and hypertension.
    • Hyperkalemia: high potassium levels.

    Signs and Symptoms of End-stage Renal Failure

    • Uremia: presence of urine in the blood.
    • Symptoms include nausea, vomiting, weakness, fatigue, and confusion.

    Treatment Approaches for Renal Failure

    • Avoidance of nephrotoxic medications.
    • Use of antihypertensives to manage blood pressure.
    • Diuretics may be administered to help remove excess fluid.
    • Restrictions on fluid and sodium intake are important.

    Dialysis Overview

    • Purpose: effectively removes fluids and waste products from the blood.
    • Definition: mechanical process to eliminate waste through a semi-permeable membrane.

    Types of Dialysis

    • Hemodialysis: involves a machine and requires access via a dialysate.
    • Peritoneal Dialysis: uses the peritoneal lining of the abdominal cavity for filtration.

    Hemodialysis Process

    • Involves diffusion and osmosis across a semi-permeable membrane.
    • Generally performed 2-3 times per week for a total of 9-12 hours.
    • Shunt for access in hemodialysis includes a graph or fistula.

    Assessing Hemodialysis Shunt

    • Check for thrill (palpable vibration) and bruit (audible whooshing sound).
    • Monitor for signs of infection such as elevated skin temperature, erythema, and inflammation.
    • Clinical alert: No blood pressure measurements, IV placements, or blood draws on the arm with the shunt.

    Peritoneal Dialysis Details

    • A catheter is surgically inserted into the peritoneal cavity.
    • Preferred procedure usually involves 4 exchanges daily, 7 days a week.
    • Major complication risk is infection.
    • Peripheral edema can lead to swelling in the feet, and oxygen delivery may be impaired in overly watery blood.

    Renal Failure Overview

    • Impairment in the kidneys leading to accumulation of waste in the blood.
    • Two main types: Acute Renal Failure and End-stage Renal Failure.

    Acute Renal Failure

    • Characterized by an abrupt onset.
    • Often reversible under appropriate treatment.
    • Common etiologies include trauma and infection.

    End-stage Renal Failure

    • Results from gradual destruction of kidney function.
    • Considered chronic in nature and irreversible.

    Signs and Symptoms of Renal Failure

    • Oliguria: urinary output less than 400 mL/day.
    • Elevated Blood Urea Nitrogen (BUN) levels.
    • Decreased Glomerular Filtration Rate (GFR).
    • Azotemia: buildup of nitrogen waste in the blood.
    • Sodium and water retention leading to edema and hypertension.
    • Hyperkalemia: high potassium levels.

    Signs and Symptoms of End-stage Renal Failure

    • Uremia: presence of urine in the blood.
    • Symptoms include nausea, vomiting, weakness, fatigue, and confusion.

    Treatment Approaches for Renal Failure

    • Avoidance of nephrotoxic medications.
    • Use of antihypertensives to manage blood pressure.
    • Diuretics may be administered to help remove excess fluid.
    • Restrictions on fluid and sodium intake are important.

    Dialysis Overview

    • Purpose: effectively removes fluids and waste products from the blood.
    • Definition: mechanical process to eliminate waste through a semi-permeable membrane.

    Types of Dialysis

    • Hemodialysis: involves a machine and requires access via a dialysate.
    • Peritoneal Dialysis: uses the peritoneal lining of the abdominal cavity for filtration.

    Hemodialysis Process

    • Involves diffusion and osmosis across a semi-permeable membrane.
    • Generally performed 2-3 times per week for a total of 9-12 hours.
    • Shunt for access in hemodialysis includes a graph or fistula.

    Assessing Hemodialysis Shunt

    • Check for thrill (palpable vibration) and bruit (audible whooshing sound).
    • Monitor for signs of infection such as elevated skin temperature, erythema, and inflammation.
    • Clinical alert: No blood pressure measurements, IV placements, or blood draws on the arm with the shunt.

    Peritoneal Dialysis Details

    • A catheter is surgically inserted into the peritoneal cavity.
    • Preferred procedure usually involves 4 exchanges daily, 7 days a week.
    • Major complication risk is infection.
    • Peripheral edema can lead to swelling in the feet, and oxygen delivery may be impaired in overly watery blood.

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    Explore the structures and functions of the renal and urinary systems in this quiz. Understand the anatomy of the kidneys, including the cortex, medulla, and renal pelvis. Test your knowledge on how these components contribute to the essential functions of filtering blood and creating urine.

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