What are some changes in the kidney function related to age?
Decrease kidney perfusion Decrease filtration (GFR) Tubules shorten and thicken
Decrease permeability
2.
When taking care of the elderly, RT kidney function, they are at risk for? Electrolyte imbalance Tolerance for medicine is decreased because they stay in the body longer due to decrease GFR
Teaching points to improve incontinence Kegel exercise (60 repetitions, twice a day, do 10x then relax): tighten their pelvic muscle 4. Stress incontinence It is all related to stress Will leak if cough, sneeze Going to the bathroom frequently is not going to take care of the problem. Kegel exercise will help. 5. Functional incontinence Will benefit from going to the bathroom on a schedule (urge and stress will not benefit from this) 6. Medications that can cause urge incontinence (latrogenic incontinence) Alpha 1 adrenergic blocker
7.
Teaching patients for Incontinence patients
Avoid caffeine, alcohol, and smoking
ff. Teaching points for prevention of UTI Take vitamin C and cranberry juice daily
Do not stay in wet clothing for a longtime.
9.
What is the only symptom the elderly show related to infection ? Confusion or delirium We do a urinalysis and culture to make sure they do not have a UTI 10. Teachings for kidney stones Uric acid stone: limit food high in purine (red meat, sausages, wine, cheese, beer, shrimp, crabs) Calcium stones: we restrict food high in calcium
Avoid decreasing fluid intake, we want them to drink lots of fluid to help them pass the stone
11. If someone comes to the ER and the patient has a kidney stone, what is a priority intervention? Give opioids for pain
Pain is priority
12. After lithotripsy for kidney stones removal what do we want to encourage? Flid intake. 13. If someone is on antibiotics and has a rash. Stop the medication and call the doctor, ?l don't treat with OTC med
14. Pyelonephritis, what is it and how do we treat it?
Temperature, chills, NV, flank pain
Administer lots of IV NS fluids Do not restrict fluids Urinary and blood culture Broad spectrum antibiotics while waiting of results
15. Your patient is about to go for pyelogram with contrast and the patient is diabetic, what do you need to verify?
Metformin because if combined with contrast it will result in kidney failure Let the doctors know they are on metformin
16. Glomerulonephritis: Patient comes in with sore throat a few weeks ago(strep) and they have fever, proteinuria, malaise. This is an inflammation of the glomeruli how do we treat? Give them lots of fluids except if they are showing s/s of fluid overload (edema, JVD,crackles, SOB,congested cough
Give diuretics, antihypertensive and daily weight for fluid overload Weight gain of 2Ibs in 24hrs and 5lbs in a week 17. Patients with glomerulonephritis should be on what type of diet? High carbohydrate diet
1ff. What else is affected when patient has Chronic glomerulonephritis? Erythropoietin production decreases leading t