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Kidneys
| Question | Answer |
|---|---|
| Urge Incontinenec | cant suppress sudden urge to void. |
| Functional Incontinenece | Normal bladder function but has physical or cognitive impairement. Cant access toilet in time |
| Stress Incontinenence | Pelic floor muscle/ligament weakness. . Sneezing, coughing, position changes, bending. Increased intrabdominal pressure |
| Urge Incontinece Drugs | anticholinergics |
| Stress incontinenece drugs | beta 3 adrenergic agonists (Mirabegron) |
| Incontinence Pt Ed | No caffeine, carbonation, alcohol, artifical sweetener. Keep voiding diary |
| Incontinenece NC | Promote adequate fluid intake, education verbally and in writing |
| Incontinence RF | older adults, institionalized, UIT, impaction, sepsis, UTI, postmenopause, diabetes |
| External Spinchter | Maintains continence |
| Detrusor | muscle in lower pelvic floor that allows bladder to contract |
| Micturition Center | Receives signal that bladder is full, releases signal to void; in Pons in brainstem |
| Voiding | From increased parasympathetic and decreased sympathetic function; requires intact sacral nerves |
| Urgency Incontinence Patho | overactive detrusor muscle |
| Stress Incontinence RF | Obesity, childbirth, pelvic surgery, radiation, diabetes, postmenopause |
| Urgency RF | aging, UTI, BPH, radiation, stones, tumors, alcohol, diuretics |
| Overflow RF | MEN, enlarged prostate |
| Functional RF | Broken legs, dementia, |
| Transient Incontinence | Sudden, from reversible conditions. RF: UTI, constipation, fecal impaction |
| Neurogenic Bladder | CNS disturbance to bladder. RF: stroke, Parkinsons, |
| Natural Urinary Protection | low pH, high osmolality, high urea. Urination flushes bacteria |
| Men UTI RF | STIs- gonorrhea, clamydia |
| Older Adult UTI S/S | NEW ONSET confusion and incontinence |
| UTI Diagosis | Clean catch specimen, Nitrate Dipstick |
| Urethritis | inflammation of urethra. Men and STIs |
| Urethritis S/S | Pain, dysuria, discharge, abcess, epididymitis, prostatitis |
| Cystitis/UTI S/S | frequency, urgency, suprapubiv pain, pink or cloudy urine |
| UTI medications | tatracycline, doxycycline. 3 days for uncomplicated. Antispasmodics for pain |
| Urinary Analgesic | phenazopyridine. Will turn secretions orange. For UTI. Reduce pain |
| Urinary antiseptics | Nitrofurantoin. Prevent UTIs |
| UTI Pt Ed | no coffee, tea, pain, spices, cola, alcohol. Void q 2-3 hours. Daily cranberry juice or capsules |
| Functional Unit of Kidney | nephron |
| Glomerulus | Within bowmans capsule. Blood vessels, capillaries. Affernet brings blood in. Efferent carreis it away. Pressure gradient |
| Acute Pyelo Expected S/S | CVA tenderness- flank pain, pyuria, chills, fever, increased WBC |
| Acute Pyelo Treatment | 2 wks of antibiotics |
| Acute Pyelo Dx | IV pyelogram, UA shows WBC casts, bacteria, cloudiness |
| Chronic Pyelo RF | urine stasis or obstruction- neruogenic bladder, kidney stones, intrarenal disease |
| Chronic Pyelo Patho | atrophied kidneys, calices scarring, chronic inflammation |
| Chornic Pyelo S/S | flank pain, polyuria, weight loss, thirst, fatigue |
| Chronic Pyelo Treat | Long term antimicrobials. 3-4 L fluids a day. |
| Nephrolithiasis RF | dehydration, meds, excess solutes |
| Kidney Stone S/S | spasmodic intermittent pain that radiates, N/V, diaphoresis, hematuria |
| High oxalate foods | apinach, swiss chard, chocolate, peanuts, pecans |
| Prevent Kidney Stones | limit protein intake, 3-4 L fluids/day, avoid excess sweating |
| Low Purine Diet | To prevent uric acid stones. Shellfish, anchovies, asparagus, mushrooms, organ meats, proteins |
| Acute Glomerulonephritis | Impaired filtration in glomerulus- increased proteinuria, casts, and hematuria |
| Chronic glomerulonephritis | small, fibrotic kidneys; leads to need for dialysis |
| Chronic glomerulonephritis Labs | hypoalbuminemia, GFR under 50, hypocalcemia, hyperphosphatemia, hyperkalemia, metabolic acidosis, tall T waves |
| Nephrotic Syndrome S/S | Massive proteinuria, ascites, hyperlipidemia, diffuse edema, hypoalbuminemia |
| AGN S/S | hematuria, casts, proteinuria, cola colored uris, azotemia, periorbital edema |
| How to diagnosis AGN | ASO titer, possible kidney biopsy |
| Treat AGN | Corticosteroids, HTN meds, restrict sodium, increase carbohydrates |
| Chronic glomerulonephritis S/S | HTN, weight loss, dizziness, yellow gray skin, periorbital edema, Pericarditis |
| Nephrotic Syndrome Treat | Lisinopril (ACE inhibitor), diuretics, statin, low sodium diet |
| AKI RF | obstruction, hypotension, renal vein or artery obstruction |
| Polycystic Kidney Disease S/S | stones, proteinuria, flank pain, increased abdominal fullness |
| Polycystic Kidney Disease RF | genetic- dominant or recessive |
| Polycystic Kidney Disease Dx | Kidney US or abdominal palpitation- shows enlarged kidneys |
| Intrarenal AKI RF | renal ischemia, rhabdomyolisis, ATN, ACEs, NSAIDs, AGN, pyelo |
| Postrenal AKI RF | Stones, strictures, BPH, pregnancy |
| Prerenal AKI RF | Hypoperfusion- burns, renal artery stenosis, HF, hemorrhage |
| Oliguria | Less than 400 mg/day or 0.5mg/kg/hr for 6 hours |
| Diuresis Phase of AKI | Monitor for dehydration; increased uric acid in blood; gradual increase in urine output: 1-3 L/day |
| Oliguric Phase of AKI | Hyperkalemia, hyponatremia, metabolic acidosis, elevated BUN/creatinine |
| Recovery Phase of AKI | begins when GFR increased and BUN/creatinine decrease |
| Cola colored urine, proteinuria, azotemia, HTN, increased BUN | AGN |
| AGN Patho | Immune response to infection increases glomerular permiability |
| Chronic Glomerulonephritis Patho | Chronic inflammation leads to nephron loss and atrophied kidneys; eventual kidney failure |
| Persistent proteinuria, HTN, progressive decline | Chronic Glomerulonephritis |
| Nephrotic Syndrome Patho | Increased glomerular membrane permianility |
| Risk for AKI | creatinine increased to 1.5x over baseline or less that .5mg/kg/hr for 6 hours. GFR deceaseds by less that 25% |
| Impaired healing, pruriitis, dermatitis, frost | Uremic syndrome. CKD complication |
| Gross hematuria and RBC casts | Nephritic syndrome |
| AV Fistula | No IV or BP on arm. |
Created by:
Student1999
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