What does DKA stand for? - Answer Diabetic ketoacidosis
What can DKA be mistaken for? - Answer Acting Intoxicated
What are 4 clinical manifestations of DKA? - Answer 1. Fruity Breath
2. Polyuria
3. Polydipsia (extreme thirst)
4. Polyphagia
5. Slurring words
6. Unsteady Gait
7. Vomiting
8. Decreased LOC
What is an important teaching with further preventing DKA? - Answer Manage blood
glucose and ketones levels to avoid prolonged damage to legs and eyes.
What is a UTI (urinary tract infection)? - Answer It is an infection in ANY part of the
urinary system. Kidneys, ureter, bladder, urethra
What is Cystitis? - Answer Infection of the bladder or lower urinary tract
What is pyelonephritis? - Answer An infection of the kidney or upper urinary tract
What type of infection is a UTI? - Answer Bacterial
When elderly patients have a UTI, what s/s could be the ONLY one present? - Answer
Delirium or confusion
If a urinalysis is performed, what would indicate a UTI is present?
Colour:
Clarity:
Odour:
,pH:
Nitrites:
Casts:
RBC: - Answer Colour: dark, concentrated
Clarity: cloudy
Odour: foil
******* pH: Alkaline *******
Nitrites: Positive
Casts: WBC with acute pyelonephritis
RBC: hematuria
What type of procedure is a urinalysis? - Answer Non-invasive
What urine is the best to use for testing? - Answer FIRST urine - provides most accurate
results
Clean technique should be used when performing a urinalysis. (T/F) - Answer False - it's
a sterile procedure
Why is it important to treat a UTI? - Answer Can lead to urosepsis - septic shock
Name the 3 treatments for cystitis. - Answer Antibiotics - Bactrim (sulphamethoxazole or
trimethoprim)
Ciprofloxacin for reoccurring UTI
Increase fluid intake - including cranberry juice
Name the 2 treatments for uncomplicated pyelonephritis and the additional 1 treatment
that would be included if it was complicated. - Answer Uncomplicated:
1. Antibiotics
2.Heat
Complicated:
1. IV Levaquin with IV isotonic fluids
What is the Creatinine Clearance Test?
What would indicate decreased kidney function and eGFR? - Answer The BEST indicator
of renal function. It compares the Cr in the blood and the Cr in the urine.
, Increased blood Cr and decreased urine Cr = poor kidney function and low eGFR.
How long is the Creatinine Clearance test for and what occurs during that time? -
Answer The test is 24 hours long. Urine will be collected that entire time and at the end
of the 24 hours, blood will be drawn. Medications required to be stopped will be
discussed by the physician prior to the test.
What electrolytes are EXCRETED or REUPTAKE by the kidneys? - Answer Excreted:
Potassium, Phosphorous
Reuptake: Calcium, Sodium
With complications: Calcium reuptake will be decreased leading to less clotting in the
blood and weakness. Phosphorous is ALWAYS the opposite of calcium so if calcium is
decreased, phosphorous is increased and therefore still causes bleeding risk.
Potassium excretion would be decreased therefore could cause hyperkalemia and
cardiac dysrhythmias. Sodium will usually stay at a normal level until the end renal stage
when the RAAS pathway fails.
What does the Cr and BUN diagnostic blood test represent?
Name 2 other things that could elevate Cr and 2 for BUN. - Answer BUN - the ability of
kidneys to excrete urea
Other: shock, nephrotoxic, sepsis, athletes with muscle breakdown, high protein diet,
kidney disease, starvation, GI bleeding.
Cr - waste product of skeletal muscle
Other: kidney stones, inflammation in the kidneys, kidney failure, glomerulonephritis
If bacteria is present in the urine, what next step occurs? - Answer Urine is sent for C&S
in a vacutainer with medium
How many blood cultures are taken from an adult and why? - Answer 2 - to be sure that
the first one was not contaminated.
What is the FIRST thing needed when treating a UTI?
In cystitis?
in Pyelonephritis? - Answer Cystitis: Sterile urine sample
Pyelonephritis: Blood cultures x 2 (because they can become septic, fast)
What is the BEST lab test to determine kidney function? - Answer Cr - creatinine
What is the normal Urea/Creatinine ratio? - Answer 10:1
What prep is needed prior to diagnostic tests and procedures of the urinary system? -
Answer Bowel prep. Clear the bowel of feces and flatus in order to have a good view of
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