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UA alterations

autoregulation of kidneys afferent arteriolar constriction
neural regulation of kidneys autonomic (SNS)
hormonal regulation of kidneys renin-angiotension system
secreted by the kidneys to synthesize RBCs eyrthropoetin
functions of the nephron 1) filter plasma at glomerulus 2) reabsorb and secrete dofferent substances along renal tubule 3) form filtrate of protein-free plasma 4) regulate the filtrate to maintain body fluid volume, lytes, and pH
lab tests of kidney function electrolytes and pH
UTI infection anywhere in the urinary system
types of UTIs bacterial, viral, fungal
bladder UTI cystitis
sx of UTI dysuria, frequency, urgency, suprapubic pain, WBCs in UA, fever, hematuria
pyelonephritis UTI of entire renal pelvis
sx of pyelonephritis fever, chills, flank pain, dysuria
common cause of UTIs in males BPH obstruction
risk factors for UTIs women, DM (decreased immune & high glucose), frequeny catheters, elderly, occupation where urine must be held, pregnancy, improper hygeine
Dx of UTI UA; C&S, WBCs, history, s/s
Tx of UTIs antibiotics, bladder analgesics, eliminate cause
teaching points for antibiotics increased risk for yeast infections, N/V, must take whole bottle
prevention of UTIs encourage fluids (esp. cranberry juice), proper hygeine, avoid frequent bubble baths, urination after intercourse, don't "hold" urine, Vit C
irritant to UTI caffeine
pyelonephritis inflammation of the renal pelvis and parenchyma; caused by bacterial infection
types of bacterial infection active, remenants of previous infection
2 types of pyelonephritis acute-bacterial contamination and chronic- chronic obstruction
common causes of bacterial(acute) pyelonephritis ppl who didn't finish out previous antobiotics; superbugs; urine reflux
causes of pyelonephritis d/t caliculi, trauma, malignancy, or most commonly extension of bladder infection via the ascending urethra
ureteral reflux obstruction allows infected UA back into ureter and allows organism to multiply
pathophysiology of pyelonephritis bacteria in renal pelvis intiates infalmmatory response; with resolution inflammation recedes and scarring may develop
result of scar tissue formation on kidneys increased work load for other nephrons
time period of acute pyelonephritis brief; usu recurs 2 weeks after completion of therapy
s/s of acute pyelonephritis enlarged kidneys, focal abscess, accumulation of lymphocytes in renal tubules, appearance of acute distress, fever/chills, CVAT, radiating pain from back to pelvis floor
s/s of cystitis urine cloudy/bloody & malodorous, increased WBC
test for cystits/pyelonephritis UA C&S, KUB, IVP, CT
sx of chronic pyelonephritis no specific, HTN, abnormal azotemia, pyuria, anemia, acidosis, proteinuria
detection of chronic pyelonephritis usu incidentally during other exams/ follow up for HTN
common cause of pyelonephritis blockage
medical tx of pyelonephritis antibiotics (10 days to 2weeks), relieve pain, prevention of further recurrence/renal damage
Glomerularnephritis disease of glomerulus caused by an immune response, toxins or drugs, vascular disorders, and other systemic diseases
injury caused by glomerularnephritis proliferation of glomerular capillary endothelial cells and rapid loss of renal function leading to nephrotic syndrome
acute glomerularnephritis r/t deposition of antibody/ antigen complexes in glomerular capillaries
chronic glomerularnephritis long-term inflammation of glomeruli, often treated by dialysis
Nephrotic syndrome set of clinical manifestations caused by protein wasting secondary to diffuse glomerular damage
manifestations of nephrotic syndrome proteinuria, hypoalbuminemia, anasarca, retention of sodium and water, hyperlipidemia, anemia, hematuria
causes of nephroctic syndrome glomerularnephritis, DM, lupus, HepB, carcinoma, preeclampsia, allergic reaction, sickle cell, HF
complications of nephrotic syndrome edema, renal failure, hypovolemia, thromboembolism, abnormal thyroid function, increased susceptibility to infection
manifestations of nephrotic syndrome hematuria, fever/chills, edema, HTN, abd/flank pain, anemia, mental confusion, proteinuria, N/V, anorexia, oliguria, HA, irritabilty, malaise may progess to resp and cardiac sx
onset of nephroctic syndrome insidious or sudden
dx of nephrotic syndrome UA, labs, periorbital edema, anasarca, HTN, history, renal biopsy
medical mngmt of nephrotic syndrome antibiotics, fluids/electrolytes, steriods, anticoagulants, diuretics, restricted diet, ACEs, plasmaphoresis, strict control of pre-existing conditions
nursing mngmt of nephrotic syndrome H&P, UA &labs, teaching (risk for infection), support
Created by: rsg175