Repiratory assessment Assess site Assess system – upright, below chest, patent, water levels, no air leaks, drainage, tubing - kinks Flap or shunt if pneumothorax - air RENAL CONDITION Who is at risk? Signs/Symptoms Lab/Diagnostics Nursing Management Polycystic kidney Congenital anomaly Abdominal/flank pain Ultrasonography, Preserve renal fxn, prevent disease HTN tomography, radioisotope complications Increased abd girth scans Control HTN Constipation Retrograde Dialysis Bloody/cloudy urine ureteropyelography Kidney stones Urinalysis - for Uremia and death protein/blood Serum Cr >1.5 mg/dL BUN >25 mg/dL Hydronephrosis Enlarged prostate Slight discomfort Intravenous pyelogram (IVP) Treat cause of obstruction Urethral/ureteral strictures Slightly decreased urine flow Renal US Remove obstruction Also: Renal calculi Acute: Severe, colicky BUN, Cr, Cr clearance Prostatectomy Hydroureter Abdominal tumors renal/flank pain Dilation of stricture Urethral stricture Blood clots Chronic: vague abd/back pain Sx removal of stone/tumor Ureteritis/prostatitis May be unilateral Nephrostomy tube Neurogenic bladder Fever, nausea Diet low in protein, Na, K Congenital abnormalities Pain on urination Check for bleeding, hematuria, infection Pyelonephritis Women Fever, chills, tachycardia, Urinalysis Antipyretics Inability to empty bladder tachypnea Cloudy urine Clean-catch urine specimen Sexually active Flank/back/loin pain Foul smelling urine Antibiotic tx Pregnancy Abdominal discomfort Low specific gravity 2,000-3,000 mL fluids/day Diabetes N/V, urgency, frequency, Proteinuria Activity & rest Compromised renal function nocturia Hematuria Urinary analgesics Instrumentation Malaise or fatigue Positive WBC Chronic: Casts HTN Urine culture HypoNa KUB Decreased concentration HyperK and acidosis
Repiratory assessment Assess site Assess system – upright, below chest, patent, water levels, no air leaks, drainage, tubing - kinks Flap or shunt if pneumothorax - air RENAL CONDITION Who is at risk? Signs/Symptoms Lab/Diagnostics Nursing Management Polycystic kidney disease Congenital anomaly Abdominal/flank pain HTN Increased abd girth Constipation Bloody/cloudy urine Kidney stones Uremia and death Ultrasonography, tomography, radioisotope scans Retrograde ureteropyelography Urinalysis - for protein/blood Serum Cr >1.5 mg/dL BUN >25 mg/dL Preserve renal fxn, prevent complications Control HTN Dialysis Hydronephrosis Also: Hydroureter Urethral stricture Enlarged prostate Urethral/ureteral strictures Renal calculi Abdominal tumors Blood clots Ureteritis/prostatitis Neurogenic bladder Congenital abnormalities Slight discomfort Slightly decreased urine flow Acute: Severe, colicky renal/flank pain Chronic: vague abd/back pain May be unilateral Fever, nausea Pain on urination Intravenous pyelogram (IVP) Renal US BUN, Cr, Cr clearance Treat cause of obstruction Remove obstruction Prostatectomy Dilation of stricture Sx removal of stone/tumor Nephrostomy tube Diet low in protein, Na, K Check for bleeding, hematuria, infection Pyelonephritis Women Inability to empty bladder Sexually active Pregnancy Diabetes Compromised renal function Instrumentation Fever, chills, tachycardia, tachypnea Flank/back/loin pain Abdominal discomfort N/V, urgency, frequency, nocturia Malaise or fatigue Chronic: HTN HypoNa Decreased concentration HyperK and acidosis Urinalysis Cloudy urine Foul smelling urine Low specific gravity Proteinuria Hematuria Positive WBC Casts Urine culture KUB Antipyretics Clean-catch urine specimen Antibiotic tx 2,000-3,000 mL fluids/day Activity & rest Urinary analgesics