NUR 206 Test 4.docx

Test 4 - **Definitions** - **Polyuria**: excessive urination - **Anuria**: absence of urine - **Oliguria**: small amount of urine - **Dysuria**: painful urination - **Nocturia**: excessive urination during the night - **Hematuria**: blood in the urine -...

Test 4 - **Definitions** - **Polyuria**: excessive urination - **Anuria**: absence of urine - **Oliguria**: small amount of urine - **Dysuria**: painful urination - **Nocturia**: excessive urination during the night - **Hematuria**: blood in the urine - **Labeling**: - Females are more susceptible to UTIs because they have a **shorter urethra** than males. - A patient experiencing a new onset of confusion and incontinence is having **symptoms of UTI**. - We do a **biopsy** because it tells us what kind of cancer it is and how to treat it. - **Nephron** is the functional unit of the kidney. - **Clean catch urine** - Clean the area around the urinary opening - Start urinating and then stop the flow - Hold the urine cup a few inches (or a few centimeters) from the urethra and urinate until the cup is about half full. - A patient who is getting I/O **catheterization** is at risk for infection. - **Different types of catheters** - **Foley catheter**: indwelling and placed for continuous urine drainage from the bladder. - **Suprapubic catheter**: Continuous drainage of urine from the bladder; accesses the bladder from a small cut (incision) in the lower part of your abdomen. - **Nephrostomy tube**: Placed into the pelvis of the kidney through the skin to provide drainage of urine directly from the kidney to an external collection bag. - A patient returning from hemodialysis would have to wait **4 to 6 hours** before doing any other procedure the same day. - A patient returning from hemodialysis needs to have their vitals monitored, assess their fistula to make sure it is not bleeding and also monitor for muscle cramps. - A patient returning from hemodialysis would not need to urinate. - Edema and puffy eyes are facial characteristics of **fluid retention**. - A patient with **very high potassium** is at risk of a myocardial infarction (heart attack). - **Different types of incontinence** - **Urge incontinence**: involuntary loss of urine when there is a strong urge to urinate (urinary urgency). - **Stress incontinence**: occurs when the urethral sphincter fails and there is an increase in intra-abdominal pressure, caused by such things as sneezing, laughing, coughing, or aerobic exercise. - **Mixed incontinence**: is a combination of different types, such as stress and urge incontinence. - **Overflow incontinence**: occurs when there is poor contractility of the detrusor muscle or obstruction of the urethra, as in prostate hypertrophy in the male or genital prolapse in the female. - **Functional incontinence**: is caused by cognitive inability to recognize the urge to urinate or a self-care deficit caused by extreme depression. - **Neurologic incontinence**: is caused by disorders of the neurologic system (e.g., multiple sclerosis or spinal cord injury). - Characteristics of **stage 3 chronic kidney disease**: Moderate decline in GFR (glomerular filtration rate), can advance to end stage kidney disease (ESKD) with complications such as infection or nephrotoxicity. - If a female patient comes in with a **urine sample that is orange in color**, we need to ask if they are taking any medications specifically phenazopyridine (pyridium). - A patient with **renal calculi** needs to strain their urine to see if the stones have passed. - **AVF** - When caring for a hospitalized patient who has an AV graft or an AVF, it is important to check the site and protect it from injury. The site should be observed at least four times a day for signs indicating clotting or infection, and the peripheral circulation distal to the access should also be checked (capillary refill and color of nail beds). Palpate for a thrill (vibration in the vessel) by gently laying your fingers on the enlarged vessel. You should be able to feel a buzz or vibration. A bruit (soft swishing sound) should be clearly heard on auscultation, and the rhythm of the sound should coincide with the patient\'s pulse. When a graft has been inserted, the extremity is elevated postoperatively and kept at a level above the heart for 24 to 72 hours. - We release 30 ml of urine an hour. If anything, less the doctor should be notified. - A patient going for a test that needs dye should be asked if they are allergic to shellfish or iodine. - Patient that has an NG tube or any kind of tube that starts complaining, we should check the patency of the tube first, assess, flush, and make sure it is not clogged or bent. - Fluid intake of 2000 to 3000 mL per day is needed to protect the kidneys.