Ch 70 Renal Disorders

Question 1

Polycystic kidney disease (PKD)

Answer 1

Inherited

Fluid-filled cysts develop in nephrons

Question 2

Early manifestations of PKD

Answer 2

Abdominal or flank pain

Nocturia

Question 3

Manifestations of PKD

Answer 3

HTN (very common)
Dysuria
> abd girth
constipation
bloody/cloudy urine
kidney stones

Question 4

Results of urinalysis with PKD

Answer 4

+ proteinuria
+ hematuria
Possible + bacteria

Question 5

Medications for pain management

Answer 5

Do not use ASA due to bleeding risk

NSAIDs are used cautiously because they reduce renal blood flow

Question 6

Top nursing priority in PKD

Answer 6

control BP

Question 7

Pyelonephritis

Answer 7

bacterial infection in the kidney and renal pelvis (upper urinary tract)

Question 8

Populations in which pyelonephritis is common

Answer 8

Frequent catheterizations
DM (due to reduced bladder tone)
Chronic renal stones
Overuse of analgesics

Question 9

Manifestations of acute pyelonephritis

Answer 9

fever/chills
tachycardia
flank/back/loin pain
N/V
Fatigue
burning, urgency or frequency
Nocturia

Question 10

Manifestations of chronic pyelonephritis

Answer 10

HTN
Inability to conserve Na+
< urine concentration 
tendency to develop hyperkalemia and acidosis
low grade fever

Question 11

Pyelonephritis urinalysis

Answer 11

+ for leukocyte, WBC and bacteria

Question 12

Fluid intake with pyelonephritis

Answer 12

at least 2-3 L/day

Question 13

Acute glomerulonephritis manifestations

Answer 13

Edema/fluid overload
dark urine
HTN
fatigue
N/V

Question 14

Acute glomerulonephritis lab results

Answer 14

hematuria & proteinuria
< GFR (50mL/hr)
> BUN
< serum albumin due to protein lost in the urine

Question 15

Acute glomerulonephritis interventions

Answer 15

Antibiotics
Na/ H2O restriction/ antihypertensives
Possible K+ and protein restriction

Question 16

Rapidly progressive glomerulonephritis

Answer 16

type of nephritis where crescent shaped cells are present in the bowman’s capsule

Question 17

Rapidly progressive glomerulonephritis timeframe

Answer 17

weeks to months

Question 18

Rapidly progressive glomerulonephritis sx

Answer 18

causes loss of kidney function

sx of renal failure (fluid volume excess, htn, oliguria, electrolyte imbalances, and uemic symptoms)

Question 19

Chronic glomerular nephritis time line

Answer 19

develops over 20-30 years

Question 20

Chronic glomerular nephritis sx

Answer 20

Mild proteinuria, hematirua, hypertension, fatigue, and occasional edema

Question 21

Chronic glomerular nephritis labs

Answer 21

Creatanine >6 and up to 30
BUN 100-200
Acidosis

Question 22

Nephritic syndrome

Answer 22

increased glomerular permeability

causes proteinuria

Question 23

Nephritic syndrome features

Answer 23

severe proteinuria
low albumin
high lipids
edema
HTN

Question 24

Nephritic syndrome treatments

Answer 24

immunosuppresants
ACE inhibitors to < proteinuria
Anti-lipids
high protein diet
mild diuretics