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