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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed./
Chapter 51. Renal and Urinary ProblemsAce Your Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed. Classes and Exams with Picmonic: #1 Visual Mnemonic Study Tool for Practical Nurse (LPN) Students
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Saunders Comprehensive Review For The NCLEX-PN Examination, 8 Ed. | Practical Nurse (LPN) School Study Aid
Urinary Excretory Anatomy
- Characteristics
- Renal Medulla
- Renal Cortex
- Nephron
- Bowman's Capsule
- Glomerulus
- Proximal Tubule
- Loop of Henle
- Distal Tubule
- Collecting Duct
- Ureter
- Urinary Bladder
- Urethra
2 mins
Renal Corpuscle
- Characteristics
- Arterioles
- Glomerulus
- Capillaries
- Fenestrations
- Plasma Solutes and Other Small Molecules Become Ultrafiltrate
- Bowman's Capsule Encapsulates Glomerulus
2 mins
Collecting Duct
- Characteristics
- Na+ Reabsorption
- Vasopressin Causes Water reabsorption
- Concentrates Filtrate
2 mins
Proximal Tubule
- Characteristics
- Na+ Reabsorbed Via Active Transport
- Water Follows Na+
- Most Of Glucose Reabsorbed
- Most Of Amino Acids Reabsorbed
- Bicarbonate Exchanged For H+
- Drugs and Toxins Excreted
- Filtrate Osmolarity Same As Plasma
- Leads To Loop Of Henle
2 mins
Loop of Henle
- Characteristics
- Descending Limb
- Water Follows Na+
- Medullary Hypertonicity
- Increased Water Reabsorption
- Vasa Recta
- Na+ Reabsorbed Via Active Transport
- Ascending Limb
- Reabsorbs Na+, K+, Cl-
- Decreased Concentration of Filtrate
- Impermeable to Water
- Distal Tubule
2 mins
Distal Tubule
- Characteristics
- Hormonally Regulated
- Aldosterone Causes Na+ Reabsorption
- Na+ Reabsorbed Via Active Transport
- Water follows Na+
- Early Distal Tubule is Impermeable to Water
- Parathyroid Hormone Causes Ca2+ Reabsorption
- Leads to Collecting Duct
2 mins
Syndrome Of Inappropriate Antidiuretic Hormone (SIADH)
- Pathophysiology
- Hypersecretion of ADH
- Increased Sensitivity to ADH
- Signs & Symptoms
- Serum Hypoosmolality
- Coma and Seizure
- Dilutional Hyponatremia
- Cramps and Tremors
- Euvolemia
- Change in LOC
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Nonpharmacologic Interventions
- Monitor Serum and Urine Osmolality
- IandOs with Daily Weights
- Restrict Fluid Intake
- Monitor Cardiovascular and Neurological Status
- Seizure Precautions
2 mins
Syndrome of Inappropriate Antidiuretic Hormone (SIADH) Pharmacologic Interventions
- Diuretics
- Hypertonic IV Fluids
- Demeclocycline
- Tolvaptan and Conivaptan
1 min
Adrenal Gland (Basic)
- Characteristics
- Adrenal Cortex
- RAAS Stimulates Aldosterone
- CRF (CRH) acts on Anterior Pituitary Gland to Release ACTH
- Cortisol Released
- Androgens Released
- Adrenal Medulla
- Epinephrine & Norepinephrine
2 mins
Adrenal Gland (Advanced)
- Characteristics
- Adrenal Cortex
- Zona Glomerulosa
- Aldosterone
- Zona Fasciculata
- Cortisol
- Zona Reticularis
- Androgens
- Adrenal Medulla
- Chromaffin Cells
- Epinephrine & Norepinephrine
2 mins
Creatinine Lab Values
- Measures Renal Function
- 0.6 - 1.3 mg/dL
1 min
BUN (Blood Urea Nitrogen) Lab Values
- 10-20 mg/dL
40 secs
Urine Specific Gravity Lab Value
- 1.003-1.030
1 min
Dialysis
- Hemodialysis
- Rapid Shifts of Fluid and Electrolytes
- Disequilibrium Syndrome
- Hypotension
- NO BP IN ARM with Shunt or Fistula
- Assess for Thrill and Bruit
- Peritoneal Dialysis
- Slow Process
- Peritonitis
- Loss of Protein
- Hyperglycemia
3 mins
Renal Calculi Assessment
- Cause/Mechanism
- Hypercalcemia (Most Commonly)
- Signs and Symptoms
- Flank Pain
- Radiates Toward Bladder
- Renal Colic
- Urinary Tract Infection
- Urinary Retention
- Hematuria
- Considerations
- Stone Recurrence
2 mins
Renal Calculi Interventions
- Interventions
- Increase Fluid Intake
- Opioids
- NSAIDs
- Antibiotics
- Lithotripsy
- Surgical Stone Removal
- Considerations
- Identify Type CT-KUB
- Low Sodium Diet
2 mins
Chronic Kidney Disease Early Symptoms Assessment
- Characteristics
- GFR < 60mL/min
- Accumulation of Waste Products
- Clinical Features
- General Malaise
- Hypertension
- Proteinuria
- Hyperkalemia
- Mineral and Bone Disorders
- Neuropathy
2 mins
Chronic Kidney Disease Late Symptoms Assessment
- Metabolic Acidosis
- Severe Uremia
- Arrhythmias
- Edema
- CNS Depression
- Anemia
- Oliguria
- Pruritus
- Considerations
- End Stage Renal Disease (ESRD)
- GFR < 15mL/min
2 mins
Chronic Kidney Disease Interventions
- Interventions
- Daily Weights
- Strict I/O
- Renal Diet
- Strict Medication Regimen
- Erythropoietin
- Manage Hyperkalemia
- Manage CKD-MBD
- Dialysis
- Kidney Transplant
2 mins
Iron Deficiency Anemia
- Causes
- Malnutrition/Malabsorption
- Hemorrhage
- Signs
- Microcytic, Hypochromic Anemia
- Decreased Heme Synthesis
- Labs
- Decreased Reticulocytes
- Decreased Ferritin
- Increased Red Cell Distribution Width (RDW)
- Poikilocytosis
- Anisocytosis
- Increased Central Pallor
2 mins
Nephrotic Syndrome
- Signs and Symptoms
- Massive Proteinuria > 3.5g per Day
- Edema
- Increased risk of infection
- Thromboembolism
- Hyperlipidemia
- Fatty casts
1 min
Hyperkalemia
- Assessment
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- Interventions
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
2 mins
Hypermagnesemia
- Assessment
- Flushing
- Lethargy
- Muscle Weakness
- Decreased Deep Tendon Reflexes (DTRs)
- Decreased Respirations
- Bradycardia
- Hypotension
- Interventions
- Dialysis
- IV Calcium Gluconate
- Diuretics
- Avoid Antacids and Laxatives containing Mg2+
2 mins
Hypocalcemia
- Muscle Spasms
- Assessment
- < 8.5 mg/dL Ca2+
- Decreased Bone Density
- Tetany
- Chvostek's Sign
- Trousseau's Sign
- Increased DTR
- ECG Changes
- QT Prolongation
- Considerations
- Oral and IV Replacement of Ca2+
- Seizure Precautions
2 mins
Metabolic Acidosis Assessment
- Characteristics
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Signs & Symptoms
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
2 mins
Metabolic Acidosis Interventions
- Interventions
- Raise Plasma pH > 7.20
- Treat Underlying Cause
- Sodium Bicarbonate
- Considerations
- Follow ABGs
- Continuously Monitor Patient
2 mins
Types of Shock
- Hypovolemic
- Depleted Volume
- Cardiogenic
- Pump Failure
- Obstructive
- Indirect Pump Failure
- Distributive
- Lost Vascular Tone
- Neurogenic
- Anaphylactic
- Septic
2 mins
Pulmonary Embolism Assessment
- Assessment
- Shortness of Breath (SOB)
- Pleuritic Chest Pain
- Tachypnea
- Hemoptysis
- Hypoxemia
- Considerations
- Sudden Death
52 secs
Pulmonary Embolism Causes
- Causes
- FAT BAT Mnemonic
- Fat
- Air
- Deep Vein Thrombosis (DVT)
- Bacteria
- Amniotic Fluid
- Tumor
- Risk Factors
- Hypercoagulable
- Central Venous Lines
- Immobilized
1 min
Kidney Transplant
- Indications
- End Stage Renal Disease (ESRD)
- Considerations
- Selective Candidacy
- Close Compatibility
- Immunosuppressants
- Monitor for Rejection
- Monitor for Infection
- Monitor Urine Output
2 mins
Pyelonephritis Assessment
- Cause/Mechanism
- Ascending Urethral Bacteria
- Assessment
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
1 min
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Consideration
- Urosepsis
1 min
Urinary Tract Infection Symptoms
- More Common in Elderly
- Most Common in Females and Babies
- Change in LOC
- Dehydration
- Fever
- Urgency
- Urethral Infection
- Burning
- Smelly Urine
- Dark Cloudy Urine
- Frequency of Urination
2 mins
Urinary Tract Infection Prevention and Treatment
- Prevention
- Shower after Sex
- Urinate after Sex
- Wipe front to Back
- Treatments and Considerations
- I and Os with Daily Weights
- Increase Water Intake
- Antibiotics
- Avoid Caffeine
- Dr Appointment in 2 Weeks
- Void every 2 - 4 hours
2 mins
Prostatitis
- Chronic Bacterial Prostatitis
- Acute Bacterial Prostatitis
- Types
- Sexually Transmitted Organisms
- E. Coli Infection
- Assessment
- Flu-Like Symptoms
- Perineal Pain
- Dysuria
- Sexual Dysfunction
- Recurrent UTIs
- Urinalysis
- Tender Boggy Prostate
- Management
- Antibiotics
- Considerations
- Chronic Prostatitis
3 mins
Benign Prostatic Hyperplasia (BPH) Assessment
- Assessment
- Men Over 50
- Enlarged Prostate Gland
- Urinary Retention
- Weak Urine Stream
- Frequency
- Urgency
- Nocturia
1 min
Benign Prostatic Hyperplasia (BPH) Interventions
- Interventions
- Timed Voiding
- Decreased Caffeine Intake
- Catheterization
- Medications
- Finasteride (Proscar)
- Tamsulosin (Flomax)
- Surgical Interventions
- TURP Procedure
- Open Prostatectomy
- Continuous Bladder Irrigation (CBI)
2 mins
Benign Prostatic Hyperplasia (BPH) Diagnosis and Treatment
- Diagnosis
- Digital Rectal Exam
- Urinalysis to Detect Infection or Blood
- Treatment
- Alpha-1 Antagonists
- Tamsulosin
- 5 Alpha Reductase Inhibitors
- Finasteride
- TURP (Transurethral Resection of Prostate)
1 min
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