Ch 70 Renal Disorders Flashcards
Polycystic kidney disease (PKD)
Inherited
Fluid-filled cysts develop in nephrons
Early manifestations of PKD
Abdominal or flank pain
Nocturia
Manifestations of PKD
HTN (very common) Dysuria > abd girth constipation bloody/cloudy urine kidney stones
Results of urinalysis with PKD
+ proteinuria
+ hematuria
Possible + bacteria
Medications for pain management
Do not use ASA due to bleeding risk
NSAIDs are used cautiously because they reduce renal blood flow
Top nursing priority in PKD
control BP
Pyelonephritis
bacterial infection in the kidney and renal pelvis (upper urinary tract)
Populations in which pyelonephritis is common
Frequent catheterizations
DM (due to reduced bladder tone)
Chronic renal stones
Overuse of analgesics
Manifestations of acute pyelonephritis
fever/chills tachycardia flank/back/loin pain N/V Fatigue burning, urgency or frequency Nocturia
Manifestations of chronic pyelonephritis
HTN Inability to conserve Na+ < urine concentration tendency to develop hyperkalemia and acidosis low grade fever
Pyelonephritis urinalysis
+ for leukocyte, WBC and bacteria
Fluid intake with pyelonephritis
at least 2-3 L/day
Acute glomerulonephritis manifestations
Edema/fluid overload dark urine HTN fatigue N/V
Acute glomerulonephritis lab results
hematuria & proteinuria
< GFR (50mL/hr)
> BUN
< serum albumin due to protein lost in the urine
Acute glomerulonephritis interventions
Antibiotics
Na/ H2O restriction/ antihypertensives
Possible K+ and protein restriction
Rapidly progressive glomerulonephritis
type of nephritis where crescent shaped cells are present in the bowman’s capsule
Rapidly progressive glomerulonephritis timeframe
weeks to months
Rapidly progressive glomerulonephritis sx
causes loss of kidney function
sx of renal failure (fluid volume excess, htn, oliguria, electrolyte imbalances, and uemic symptoms)
Chronic glomerular nephritis time line
develops over 20-30 years
Chronic glomerular nephritis sx
Mild proteinuria, hematirua, hypertension, fatigue, and occasional edema
Chronic glomerular nephritis labs
Creatanine >6 and up to 30
BUN 100-200
Acidosis
Nephritic syndrome
increased glomerular permeability
causes proteinuria
Nephritic syndrome features
severe proteinuria low albumin high lipids edema HTN
Nephritic syndrome treatments
immunosuppresants ACE inhibitors to < proteinuria Anti-lipids high protein diet mild diuretics
