ATI Renal Exam | Diagnostic Procedures Lab Tests | With Solutions

ATI Renal Exam | Diagnostic Procedures Lab Tests | With Solutions Lab Tests: Serum Creatinine - protein & muscle breakdown - CKD is the ONLY CONDITION that INCREASES serum levels - kidney function loss of at least 50% causes increase - values remain constant in older adults unless diagnosed with KD Normal Values: Males = 0.6 - 1.2 mg/dL Females = 0.5 - 1.1 mg/dL Lab Tests: BUN - breakdown of protein in the liver, creating byproduct urea nitrogen excreted by liver Factors: - dehydration - infection - chemotherapy - steroid therapy - reabsorption of blood in the lover d/t tissue damage INCREASED levels suggest KD Normal Values: 7 - 20 mg/dL Lab Tests: Urinalysis - evaluates waste products from the kidney & detects urologic disorders - early morning specimen = concentrated sample - color, clarity, specific gravity, concentration/dilution, acidity/alkalinity - drug metabolites, glucose, ketone bodies & protein (abnormal) - culture & sensitivity = identifies bacteria and type of antibiotic for tx - 24/hr collection measures creatinine, BUN, sodium, chloride, calcium, catecholamines & proteins - 24/hr collection measures CREATININE CLEARANCE (GFR for px with impaired kidney function) Renal Diagnostic Procedures: Radiography (x-ray) - allows for visualization of structures and detects renal calculi, strictures, calcium deposits, or obstructions Contraindicated in pregnant women. Remove jewelry & metal objects Renal Diagnostic Procedures: CT - Dye can cause AKI Renal Diagnostic Procedures: MRI - Clients must lie down and have to remain still for the test Cystography, Cystourethrography, Voiding Cystourethrogram (VCUG) - Detects urethral or bladder injury after instillation of contrast dye thru a urinary catheters to provide an image of the bladder & ureters - Monitor for infection post 72 hr (UTI d/t catheter placement; cloudy, foul smelling urine) - Increase fluid intake to minimize burning sensation upon urination - Urine output 30 mL/hr, suspect trauma Kidney Biopsy - Complications: HEMORRHAGE & infection Cytoscopy, Cystourethroscopy - detect abnormalities of bladder wall and/or occlusion of ureter or urethra - anesthesia is administered - monitor S/S of hemorrhage & infection - PRE: NPO after midnight; laxative or enema prep - INTRA: lithotomy position - POST: color of urine (pink-tinged OK); irrigate catheter with NS if clots are present or if output is diminished or absent Excretory Urography - Detects obstruction & paranchymal masses & assesses the size of the kidneys PRE: NPO after midnight; laxative or enema prep - Allergies: iodine, seafoog, eggs, milk, chocolate, or has asthma - withhold METFORMIN 24/hr before procedure (risk of lactic acidosis from contrast dye with iodine) Renal Disorders: Gerontological Considerations - - kidney size & function DECREASE with aging - blood flow adaptability DECREASES - DM, HTN & HF can affect GFR - kidney INJURY can occur more easily from CONTRAST DYE & MEDS d/t DECREASED blood flow, size & GFR - tubular changes can cause urgency & nocturnal polyuria - weak urinary sphincter muscle & shorter urethra in WOMEN can cause incontinence & urinary tract infections - enlarged prostate in MEN can cause urinary retention & infection Function of Dialysis - - Rids body of excess F&e - Achieves acid-base balance - Eliminates waste products