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