RENAL & UROLOGIC PROBLEMS
KUB X-ray:
• X-ray of abd. and pelvis
o Kidneys, ureters, & bladder
• Delineates size, shape, & position of kidneys
• Nursing responsibilities:
o Take jewelry off from belly buon down
o Women underage of 55 à take pregnancy test before
o Pt needs to be able to lay flat on table
Renal Ultrasound:
• Used to detect masses
• Conductive gel is applied to skin
• Passing sound waves into body structures & recording images as they are reflected back
• Computer interprets tissue density based on sound waves & displays it in picture form
• Nursing responsibilities:
o Not invasive à nothing to do before the test
o Provide pt teaching on how test will go
Intravenous Pyelogram:
• Visualizes urinary tract after IV injection of contrast media
• Position, size, & shape of kidneys, ureters & bladder can be evaluated
• Contrast media can be nephrotoxic
• Nursing responsibilities:
o Check for shellfish/iodine allergy
o Teach pt they will feel a warm flush with dye
o Turn down IV fluids before procedure/during à dilutes dye
o NPO @ midnight
o Increase fluids postop à dye is nephrotoxic
Renal Arteriogram (Angiogram):
• Visualizes renal blood vessels
• Can assist in diagnosing renal artery stenosis & cyst vs. tumor
• Catheter is inserted into femoral artery & passed up aorta to renal arteries & contrast media is then injected
• Nursing responsibilities:
o Increase fluids after to flush out dye
o Monitor BUN/ creatinine
o Monitor puncture site
, Voiding Cystourethrogram:
• Voiding study of bladder opening (neck) & urethra
o Basically, like giving a urinary enema
• Bladder filled w contrast media
• Films are taken & again after urination à residual
• Nursing responsibilities:
o Tell pt they are periodically taking pictures
o Don't need to flush dye because it is not nephrotoxic
Cystoscopy:
• Inspects interior of bladder w a lighted scope
• Can be used to insert urethral catheters, remove calculi, obtain biopsy, & treat bleeding lesions
• Lithotomy position
• Local or general anesthesia
• Nursing responsibilities:
o Invasive procedure
o Need informed consent
o Hold anticoagulants before procedure
Pyelonephritis:
• Acute pyelonephritis
o Inflammation of the renal parenchyma & collecting system
o Most common cause à bacterial infection
o Other causes:
§ Fungi, protozoa, viruses
§ Backward movement of urine,
§ BPH
§ CAUTI
§ Kidney stones
§ Lower UTI à moves up and flows through body
o Urosepsis à systemic infection from a urologic source
• Preventative measures:
o Emptying à emptying the bladder regularly
o Evacuating à evacuating bowel regularly
o Wiping à wiping the perineal area from front to back after voiding & defecating
o Drinking à drinking an adequate amt. of liquid each day
o Avoiding à avoiding unnecessary catheterization
• Clinical manifestations:
o Fever & chills
o N/V
o Malaise
o Flank pain
o LUTS à lower urinary tract symptoms
o CVA tenderness à find boom of rib & punch the back
§ Pt will jump in pain if pyelonephritis is present
KUB X-ray:
• X-ray of abd. and pelvis
o Kidneys, ureters, & bladder
• Delineates size, shape, & position of kidneys
• Nursing responsibilities:
o Take jewelry off from belly buon down
o Women underage of 55 à take pregnancy test before
o Pt needs to be able to lay flat on table
Renal Ultrasound:
• Used to detect masses
• Conductive gel is applied to skin
• Passing sound waves into body structures & recording images as they are reflected back
• Computer interprets tissue density based on sound waves & displays it in picture form
• Nursing responsibilities:
o Not invasive à nothing to do before the test
o Provide pt teaching on how test will go
Intravenous Pyelogram:
• Visualizes urinary tract after IV injection of contrast media
• Position, size, & shape of kidneys, ureters & bladder can be evaluated
• Contrast media can be nephrotoxic
• Nursing responsibilities:
o Check for shellfish/iodine allergy
o Teach pt they will feel a warm flush with dye
o Turn down IV fluids before procedure/during à dilutes dye
o NPO @ midnight
o Increase fluids postop à dye is nephrotoxic
Renal Arteriogram (Angiogram):
• Visualizes renal blood vessels
• Can assist in diagnosing renal artery stenosis & cyst vs. tumor
• Catheter is inserted into femoral artery & passed up aorta to renal arteries & contrast media is then injected
• Nursing responsibilities:
o Increase fluids after to flush out dye
o Monitor BUN/ creatinine
o Monitor puncture site
, Voiding Cystourethrogram:
• Voiding study of bladder opening (neck) & urethra
o Basically, like giving a urinary enema
• Bladder filled w contrast media
• Films are taken & again after urination à residual
• Nursing responsibilities:
o Tell pt they are periodically taking pictures
o Don't need to flush dye because it is not nephrotoxic
Cystoscopy:
• Inspects interior of bladder w a lighted scope
• Can be used to insert urethral catheters, remove calculi, obtain biopsy, & treat bleeding lesions
• Lithotomy position
• Local or general anesthesia
• Nursing responsibilities:
o Invasive procedure
o Need informed consent
o Hold anticoagulants before procedure
Pyelonephritis:
• Acute pyelonephritis
o Inflammation of the renal parenchyma & collecting system
o Most common cause à bacterial infection
o Other causes:
§ Fungi, protozoa, viruses
§ Backward movement of urine,
§ BPH
§ CAUTI
§ Kidney stones
§ Lower UTI à moves up and flows through body
o Urosepsis à systemic infection from a urologic source
• Preventative measures:
o Emptying à emptying the bladder regularly
o Evacuating à evacuating bowel regularly
o Wiping à wiping the perineal area from front to back after voiding & defecating
o Drinking à drinking an adequate amt. of liquid each day
o Avoiding à avoiding unnecessary catheterization
• Clinical manifestations:
o Fever & chills
o N/V
o Malaise
o Flank pain
o LUTS à lower urinary tract symptoms
o CVA tenderness à find boom of rib & punch the back
§ Pt will jump in pain if pyelonephritis is present
