Ch. 25 & 27 Disorders of Renal Function Flashcards
What are the most common cause of obstruction which develop in the kidneys and are excreted un urine?
Urinary Calculi/urolithiasis (Renal Calculi)
What are the manifestations of renal calculi?
- PAIN
- Hematuria
What type of pain does renal calculi cause?
- Acute, intermitting, excruciating
- Flank, upper and outer abdominal quadrant
- Worsens with increase of fluid intake
Which pain medication is a wonder drug for renal calculi?
Toradol
Renal calculi can be passed in urine if it is what size?
<5mm
To treat renal calculi what should be encouraged?
Fluid intake (or IV)
What is one of the number one causes of UTI?
E.coli from vaginal or perianal areas
What is a nosocomial infection?
An infection the people providing care caused.
What is urethrovesical?
urine from urethra moves into bladder (UTI)
What is vesicoureteral?
urine from bladder moves into ureters
What is the problem with UTI obstruction?
Urine remains in urinary tract and acts as a medium for bacterial growth
What are UTI manifestations?
- Frequency
- Urgency
- Dysuria
- Lower abdominal/back discomfort
- cloudy/foul smelling urine
How can a UTI be diagnosed?
- U/A
- Culture and sensitivity
- leukocytes
What is the treatment for a UTI?
- Antibiotics 3-7 days
- Cranberry juice
- Increase fluid intake
What is the leading sign of a UTI in the elderly?
AMS
Acute Pyelonephritis (kidney infection) is what type of disorder?
Tubulointerstitial
Infection and inflammation of the tubules is what?
Acute Pyelonephritis
Bacteria ascending from the lower urinary tract causes what?
Acute Pyelonephritis
Does acute pyelonephritis cause fever and chills?
Yes
Does acute pyelonephritis cause headache, flank pain, and CVA (costovertebral) tenderness?
Yes
Similarly to a UTI does acute pyelonephritis also cause dysuria, frequency, and urgency?
Yes
Does acute pyelonephritis cause malaise?
Yes
What is the treatment for acute pyelonephritis?
- Antibiotics (typically IV)
- Fluids (oral or IV)
- Tylenol for fever
Chronic Pyelonephritis (progressive) is what type of disorder?
Tubulointerstitial
What is the most common cause of Chronic Pyelonephritis?
Reflux
Inflammation, scarring, deformation of renal chalices and pelvis is caused by what tubulointerstitial disorder?
Chronic Pyelonephritis
What is Chronic Pyelonephritis?
A bacterial infection with obstructive abnormality or reflux.
Chronic pyelonephritis can have s/s of an acute infection or what else?
Can be insidious
What are the manifestations of chronic pyelonephritis?
- Polyuria
- Nocturia
- Mild proteinuria
Chronic Pyelonephritis is the cause of 10-20% of what?
Renal failure patients
What is glomerulonephritis?
Inflammatory injury to the glomerulus.
An acute glomerulonephritis infection occurs when?
2-3 weeks after streptococcal infection
A chronic glomerulonephritis infection occurs when?
after acute phase or slowly over time
Periorbital and facial edema is a manifestation of what type of infection?
Glomerulonephritis
Anorexia, pallor, lethargy, and hypertension are manifestation of what type of infection?
Glomerulonephritis
What type of urinary related manifestations are seen in glomerulonephritis?
- Decreased urinary output
- Proteinuria
- Cloudy, smoky, brown colored urine (hematuria)
An increased BUN, increased creatinine and proteinuria are diagnostic test to determine what?
Glomerulonephritis
What are complications of glomerulonephritis?
- Renal failure
- Hypertensive encephalopathy
- Pulmonary edema
- heart failure
What are interventions for glomerulonephritis?
- Daily weight
- Sodium and water restriction
- Administer diuretics
A 10-year old with glomerulonephritis reports a headache and blurred vision. What should the nurse do immediately?
Obtain the child’s BP
What syndrome is caused by protein wasting caused from diffuse glomerular damage?
Nephrotic Syndrome (Fluid volume overload)
What is the hallmark sign of nephrotic syndrome?
Generalized edema
What is the most important intervention for a patient with nephrotic syndrome?
Daily Weights!
The nurse determines that interventions for decreasing fluid retention have been effective when the child with nephrotic syndrome demonstrated evidence of what?
Decreased abdominal girth
What is the most important thing to do if a Wilms Tumor is suspected?
Avoid palpating the abdomen.
What is one of the most common childhood tumors of the abdomen and the most common type of kidney tumor?
Wilms Tumor
What are the manifestations of a Wilms Tumor?
- *Swelling in abdomen
- Abdominal pain
- Blood in urine (not as common)
A client seen in the Emergency Department reports dysuria, frequency, and urgency. What condition would the nurse suspect?
Cystitis (UTI/bladder infection)
As compared to younger adults, older adults who experience UTIs tend to exhibit the following primary manifestations?
Cognitive impairment and anorexia
