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med/surg
UA alterations
| Hint | Answer |
|---|---|
| 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
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