Digestive, Reproductive, and Urinary Disorders Flashcards
Common manifestations of disorders
Anorexia, nausea, and vomiting
Emesis definition
forceful expulsion of chyme (food and digestive juices) from the stomach
Signs and symptoms of emesis
often associated with increase salivation, pallor, and sweating. May be preceded by retching/dry heaves
Hematemesis
presence of blood in vomit
coffee-grounds
old brown, partially digested blood
frank blood
obvious blood; large amount, new (red) hemorrhage
yellow or green vomit
bile from duodenum
Treatment for emesis
Zorfran (anti emetic) and fluids
Cause of diarrhea Large Volume
secretory or osmotic diarrhea related to infection, short transit time, lactose intolerance
Cause of small volume diarrhea
associated with inflammatory bowel disease, stool may contain blood/mucus/pus, and may be accompanied by abdominal cramps
Steatorrhea cause
fatty particles associated with malabsorption syndromes, frequent bulky greasy loose stools. A lot of CF patients have this
Constipation Acute cause
inadequate dietary fiber, inadequate fluid intake, failure to respond to defecation reflex, muscle weakness/inactivity, drugs that slow peristalsis, mechanical obstruction
What types of drugs that slow peristalsis
opiates (morphine), anticholinergics
Chronic constipation cause
hemorrhoids, diverticulitis and severe constipation
Cause of fluid and electrolyte imbalance
loss of fluid via vomiting and diarrhea, ions lost with fluid, acid-base imbalance due to lost hydrochloric acid and bicarb
Main forms of fluid and electrolyte cause
dehydration, overhydration ( rare and not usually a problem for normal kidney), water intake must balance water loss, drinking too much is usually better than too little,
Water is absorbed primarily by what?
digestive tract
during dehydration water is lost by what?
kidney excretion depending on bodys needs
During evaporation water is lost how?
through the skin and exhalation of the lungs, profuse sweating, exercise, fever, hot weather, loss of fluid via vomiting and diarrhea
Signs and Symptoms of dehydration
thrist, dry sticky mouth, dizziness/tiredness, dec.urine output, dry skin, rapid heartbeat and breathing
Treatment for dehydration
drink more water, electrolyte and carbohydrate rich solutions, dec.sodium intake, and avoid caffeinated beverages
Cleft lip/palate
developmental abnormality of mouth and face, arises in 2nd or 3rd month of gestation and be inherited/enviromental
Cleft lip cause
failure to fuse in weeks 4-8 of fetal development. Can be unilateral or bilateral
Cleft palate cause
failure of hard and soft palates to fuse, opening between oral and nasal cavities, causing feeding problems in infants
Treatment for cleft palate and cleft lip
surgical repair, speech therapy, orthodontia
Oral Candidiasis
Thrush, candida albicans in normal oral flora, opportunistic infection.
Symptoms of thrush
red swollen patches on oral mucosa, makes eating and drinking painful
How to treat with thrush
topical antifungal agent (Nystatin, Mycostatin)
Dysphagia
difficulty swallowing
Cause of dysphagia
neurologic deficit with cranial nerves (V, VII, IX, X, XII), brain damage, achalais (failure to lower/open esophageal sphincter)
Muscular disorders
muscular dystrophy, ALS
Mechanical obstruction that cause dysphagia
congenital atresia, stenosis, esophageal diverticula, and tumors
Gastro Esophageal Reflux Disease (GERD) cause
At the lower end of the esophagus, where it joins the stomach, there is a circular ring of muscles called the lower esophageal sphincter, after swallowing the LES relaxes and allows food to enter stomach and then contracts to prevent food back up. The LES becomes weak or relaxed when the stomach is distended, which allows liquids in the stomach to go back into esophagus
Acid Reflux becomes GERD when?
it causes bothersome symptoms or injury to esophagus
Signs and symptoms of GERD
stomach pain, non-burning chest pain, difficulty swallowing, painful swallowing, persistent laryngitis/hoarseness, persisten laryngitis/hoarseness, persistant sore throat, chronic cough, new onset asthma, or asthma wheeze only at night
Acid reflux complications
ulcers, stricture, lung and throat problems, esophageal cancer, Barretts esophagus
Barretts esophagus is what?
esphageal cells are replaced with intestinal cells due to repeated acid exposure
Diagnostic tests of GERD
endoscopy, 24 hour esophageal pH study, esophageal manometry (involves swallowing a tube that measures the muscle contractions of the esophagus)
Treatment for GERD
weight loss, head of bed raised 6=8 inches, avoid acid reflux inducing foods, avoid large and late meals, proton pump inhibitors, histamine H-2 blockers, surgery
Hiatal Hernia cause
protrusion of a portion of stomach through esophageal hiatus into thoracic cavity
Sliding hernia most common slides up when?
when the person is supine, it returns to normal when standing
Paraesophageal hernia more likely to ulcerate due to what?
compressed vessels
Chronic esophagitis may cause what?
fibrosis and stricture
Symptoms of a hernia
seen in conjunction with GERD, heart burn, sour taste in mouth, increased discomfort when lying down or bending over
Treatment of a hernia
frequent small meals, avoid lying down after meals, avoid restrictive clothing around waist, elevate head of bed, antacids, if severe surgery
Gastroenteritis cause
usually due to infection (e coli, salmonella, contaminated food/water), may be allergic reaction to foods or drugs, inflammation of stomach (vomiting), inflammation of intestines (diarrhea)
E coli
some strains extremely virulent, present in cows, release toxins that damage intestinal mucosa and blood vessels, can cause bloody diarrhea and acute renal failure, may cause death in kids, elderly or those with low immunity
Treatment of a gastroenteritis
usually self limiting, provide adequate fluids and electrolytes, antibiotics in persistent/severe cases of E. coli
Prevention of gastroenteritis
hand washing, properly cook food
Peptic ulcers (PUD) found where?
most common in proximal duodenum, also found in antrum of stomach and lower esophagus, genetic predisposition is questioned
Peptic ulcers are more common in who?
men, elderly, type O blood
peptic ulcers are caused by?
increased acid pepsin secretion, breakdown of gastric mucosal barrier
Precipitating factors of peptic ulcers
inc. acid pepsin secretion due to ingestion of alcohol, NSAIDS, ceffeine, certain foods and abnormal feedback mechanism, breakdown of mucosal barrier due to heliobacter pylori, inadequate blood supply, excessive glococorticoids, ulcerogenic substances
Heliobacter pylori
present in 50% of people; most have no complications
Complications of peptic ulcers
bleeding, perforation, obstruction
Treatment of peptic ulcers
difficult to heal due to stomach acids irritates lesions, antibiotics, meds to reduce acid secretion, remove exacerbating factors
Cholelithiasis
formation of gallstones
Cholecystitis
inflammation of the gallbladder and cystic ducts
Cholangitis
inflammation of bile ducts due to infection
Cause of gallbladder disorders related to gallstones
inflammation in biliary structures may provide focus for stone formation, stones initially form in bile ducts, gallbladder, cystic duct
Cholesterol gallstones are more common in who?
women especially associated with obesity, inc. cholesterol intake, giving birth multiple times, oral contraceptives/estrogen supplements
Bile pigment stones associated with what?
hemolytic anemia, alcoholic cirrhosis, biliary tract infections
Signs and symptoms of gallbladder disorders
frequently asymptomatic, if large stone obstructs duct may become biliary colic, pain in upper right quadrant, pain often radiates to back and right shoulder, nausea/vomiting, fever and leukocytosis
Treatment of gallbladder
surgical removal via laproscopic cholecystectomy, long term medication use to dissolve stones
Hepatitis A
transmission via oral fecal route, 2-6 week incubation period, fecal shedding of virus weeks before onset of signs, acute, self-limiting infection (not chronic/ not carriers)
Hepatitis B
transmission via blood and body fluids, 1-6 month incubation period, may be asymptomatic carrier or develop acute infection
Hepatitis C
originally referred to as non A non B, proven existence in 1989, transmitted via blood and body fluids, 2-6 week incubation period, may be carrier or develop chronic infection
Hepatitis D
requires presence of Hep B for replication, increase severity of Hep B infection
Hepatitis E
similar to Hep A, oral fecal transmission, 2-9 week incubation, no carrier/chronic state
Researchers questions the existence of hepatitis what?
F and G
Signs and symptoms of Hepatitis
preicteric stage- general systemic signs of infection, mild upper right quadrant discomfort, elevated liver enzymes in serum. Icteric stage- jaundice, dark urine, hepatomegaly with tenderness, may be prolonged clotting times. Posticteric stage- slow recovery
Treatment of Hepatitis
supportive measures, anti viral drugs
Cirrhosis cause
the 3 general causes are alcoholic liver disease (most common), biliary cirrhosis due to obstructed bile flow, postnecrotic cirrhosis (due to chronic hepatitis or long term exposure to toxic agents)
Signs and Symptoms of cirrhosis
ascites (fluid in peritoneal cavity), generalized edema, esophageal varices (due to portal hypertension), anemia and increased bleeding, jaundice, and hepatic encephaolopathy
Treatment of Cirrhosis
supportive measures, emergency treatment of reptured esophageal varcies, portocaval shunt, liver transplant, make end life decisions
Acute pancreatitis causes
alcohol abuse, gallstones, viral infection, drug reaction
Signs and symptoms of acute pancreatitis
severe epigastric and abdominal pain that radiates to back, shock, fever, abdominal distention, and decreased bowel sounds
Treatment of acute pancreatitis
20% mortality rate, nothing by mouth/orally, analgesics (not morphine), treat shock and electrolyte imbalance, monitor all other vitals
Structural abnormalities in female reproductive system
changes in uterine position
Normal anatomical position in females
Antevered (tipped forward) Anteflexed (bent foward over bladder)
Retroversion
tipped backward (1st-3rd degree) could compress colon
Retroflexion
Bent back towards rectum, could also impress colon
Anteflexion
bent forward toward bladder
cause of positional abnormalities in female reproductive system
congenital anatomic variation, childbirth, pathologic conditions (scar tissue/tumor)
Supporting structures for uterus, bladder, rectum become weakened due to?
multiple/difficult childbirths, trauma, aging, effects appear from menopause
Signs and symptoms of positional abnormalities in females?
often asymptomatic, may be infertile due to poor positioning of the cervix.
Symptoms associated with 3rd degree retroversion
back pain, dysmenorrhea (heavy/difficult menstration), dyspareuma (painful intercourse)
Prevention of positional abnormalities in females
kegel exercises
Uterine prolapse 1st degree
cervix drops into vagina
uterine prolapse 2nd degree
uterine body drops into vagina
uterine prolapse 3rd degree
cervix and uterus outside of vagina
treatment of uterine prolapse
pessary X 6 weeks, surgery
Cystocele
protrusion of bladder into anterior vaginal wall, bladder doesnt completely empty
Treatment of cystocele
surgery if severe
Rectocele
protrusion of rectum into posterior wall of vagina, interferes with defecation
Treatment of rectocele
surgery if severe
Primary amenorrhea
absence of menarche after age 16 years, has gone through other normal changes that occur during puberty
Cause of primary amenorrhea
chromosome abnormality, congenital absence/hypoplasis of uterus, defect of hypothalamus, anorexia, chronic illness, infections that occur in the womb or after birth, turmors
treatment of primary amenorrhea
hormone therapy, weight management, meds for tumor removal, surgery, treatment for systemic illness
Secondary amenorrhea
absence of menstruation for 6 months or greater, in women who previously had regular menstrual cycles without the presence of birth control, menopause, or pregnancy
Cause of secondary amenorrhea
suppression of hypothalamus/pituitary, stress, sudden weight loss, low % body fat, obesity, anemia, chemo, and ovarian tumors
Treatment for secondary amenorrhea
treat underlying cause, may require hormone therapy, weight management
Endometriosis
very common but not well understood, a problem that affects a woman’s uterus.
Cause of endometriosis
endometrial tissue established at ectopic sites via migration up fallopian tubes, development from embryonic tissue at other sites, spread through blood or lymph systems, transplantation during surgery. Ectopic tissue responds to hormone cycle proliferation, degeneration, and bleeding
Signs and symptoms of endometriosis
may be asymptomatic, abdominal pain, dysmenorrhea, inflammation at ectopic site, dyspareunia, infertility
Treatment of endometriosis
hormone therapy, laparoscopy to lyse adhesions/remove ectopic tissue, total hysterectomy
Pelvic inflammatory disease
the most common preventable cause of infertility in the US. May be acute or chronic
Cause of PID
majority arise from STDs, may follow childbirth/insertion of IUD, usually originates as vaginitis/cervicitis.
Signs and symptoms of PID
lower abdominal pain, pain increases with walking, purulent foul smelling vaginal discharge, systemic signs of infection (Fever)
Treatment of PID
appropriate antibiotics, treat sexual partners
Uterine Leiomyoma
fibroids, can vary in size and number and may be accompanied by infertility, miscarriage, and early onset of labor
Cause of Uterine leiomyoma
cause may be unknown, benign tumor of myometrium, common in women during reproductive years, usually occurs as multiple/well defined masses
Signs and symptoms of uterine leiomyoma
frequently asymptomatic, menorrhagia, urinary frequency, constipation, heavy sensation of lower abdomen, may cause infertility
Treatment of uterine leiomyoma
depends of severity of symptoms and desire to have kids, surgery to remove tumors, and hysterectomy
Ovarian cysts (benign) cause
cause unknown, usually multiple or large fluid filled sacs
Signs and symptoms of ovarian cysts
abdominal discomfort, urinary retention due to compression, tortion of ovary if cyst is mobile, and bleeding into peritoneal cavity
Treatment of ovarian cysts
may disappear spontaneously, birth control, surgery
Epispadias
urethral opening on dorsal surface of penis, may cause repeated infections
Hypospadias
urethral opening on ventral surface of penis, often associated with cryptorchidism
Treatment to both epispadias and hypospadias
surgery to provide normal urinary flow and normal sexual function
Cryptorchidism
testes fail to descend into scrotum, may remain in abdominal cavity or inguinal cavity
Possible causes of Cryptorchidism
hormonal abnormalities, short spermatic cord, small inguinal ring
If cyrptorchidism is left untreated what can happen?
impaired spermatogenesis and increased risk of testicular cancer
treatment of cyrptorchidism
surgical repair before age 2/ may have spontaneous decent before age 1
Hydrocele
excessive fluid collection in tunica vaginalis
Tunica
serous membranes surrounding testicles
Vaginalis
between the parietal and visceral layer of the scrotal sac
Hydrocele may be due to what?
congenital form associated with inguinal hernia, acquired form may be due to infection, injury, tumor or unknown
Varicocele
varicose veins, dilated vein in spermatic cord usually on left side, develops after puberty
Treatment of varicocele
if mild treat with jockstrap, if extensive it requires surgery
Torsion of the testes
testis rotates on spermatic cord, frequently occurs during puberty, compresses arteries and veins
Treatment of torsion of testes
may first try to manual manipulation to restore blood flow, usually requires surgery
Acute bacterial prostatitis cause
usually associated with UTI, primarily caused by E coli, sometimes associated with STDs
Signs and symptoms of acute bacterial prostatitis
dysuria, urinary frequency and urgency, low back pain, systemic signs of infection, severe inflammation, prostrate enlarged and tender
Treatment of acute bacterial prostatitis
antibiotics (Cipro/Ciprofloxacin)
Benign Prostatic Hypertrophy cause
hyperplasia of prostrate tissue, associated with aging, enlarged glands compresses urethra
Signs and symptoms of prostatic hypertrophy
decreased force of uninary stream, incomplete bladder emptying, enlarged prostrate on rectal exam
Treatment of prostatic hypertrophy
meds to shrink prostrate, transurethral resection, thermo ablation
Chlamydia
only grows intracellulary, spread via vaginal/rectal intercourse, may be spread by oral-genital contact
how can babies be infected by chlamydia?
vaginal delivery
Signs and symptoms of chlamydia in a female
often asymptomatic, urethritis, purulent discharge, and may spread to fallopian tubes
Signs and symptoms of chlamydia in a male
urethritis, dysuria, itching/whitish discharge, painful/swollen scrotum
Treatment of chlamydia
antibiotics for affected person and sexual partner(s), Azithromycin (single dose) or Doxycycline (BID for 7 days)
Cause of Gonorrhea
gram -, diplococcus/gonococcus, spread during sexual contact, vaginal delivery can infect newborn
Signs and symptoms of gonorrhea female
may be asymptomatic, greenish/yellowish purulent discharge, dysuria (itching/burning), pelvic pain
Signs and symptoms of gonorrhea male
purulent discharge, dysuria, may lead to epididymitis (swelling of scrotum)
In addition to genital infections Gonorrhea can also cause other infections by way of diverse sexual contact like what?
oral and pharyngeal infections, rectal infections, ocular and periocular infections, gonococcal arthitis
Treatment of Gonorrhea
Antibiotics (more due to eloborate MDR strains) Ceftriaxone IM once pluse Azithromycin PO once, or Doxcycline PO BID for 7 days
Syphilis cause
transmitters by directed contact with infected lesion (chancre is name of lesion), may be transmitted by contact with infected body fluid
Signs and symptoms of primary syphilis
3 week incubation period, chancre develops at point of contact, chancre heals spontaneously in several weeks
Signs and symptoms of secondary syphilis
if primary is not treated, macular/papular rash, systemic signs of infections, symptoms end in a few weeks
Signs and symptoms of latent syphilis
may last for years, usually asymptomatic
Signs and symptoms of tertiary syphilis
Begins 2-7 years after initial infection, gumma develops, destruction in multiple organs
Treatment of syphilis
Antibiotics (primary is Penecillin)
Genital Herpes cause
HSV-1 usually causes cold sores although may cause genital outbreaks, transmitted by direct contact with secretions, infants infected during vaginal delivery
Signs and symptoms of genital herpes acute stage
tingling sensation precedes lesion, vesicle blister surrounded by erythematous area, vesicle ruptures after several days –> ulcer, crust forms and ulcer heals, initial episode sometimes mild
Signs and symptoms of genital herpes latent stage
virus migrates to dorsal root ganglion (low spine) viruses may linger in body secretions after lesions heal
Signs and symptoms of genital herpes reactivation (active stage)
may be trigged by decrease in host resistance, virus migrates back to mucosa and skin, replicates in cells to form new vesicles
Treatment of genital herpes
no cure, one can transmit the virus even though there is no outbreak (latent shedding), acyclovir to lessen acute symptoms, Valtrex once oral daily administration (reduces # of outbreaks and reduces risk of spreading virus), improved dietary supplements
Genital warts cause
elevated flesh colored lesions (papillomas) fibrous tissue over growth usually seen on the external genitalia or peri anal area, 90% caued by HPV types 6 and 11
Transmission of genital warts
spread by sexual activity involving genital contact does not have to be intercourse, Common STD, may cause PAP smear abnormalities. CDC estimates 20 million people in US had HPV in 2005
Treatment of genital warts
topical meds, carbon dioxide laser treatment, cryosurgery (freeze off), electrocautery (burn off), debridement, interferon injections
Prevention of genital warts
avoid sexual contact with infected individuals, vaccination (GARDISAL for types 6 and 11 and HPV Types 16 and 18) this causes 70% of cervical cancer, topical cream (Aldara)
Trichomoniasis cause
is a protozal infestation of the urethra, vagina, or prostate, single unit protozoan flagellate, transmitted by sexual intercourse affects 10-15% of the sexually active. Women may increase their risk by vaginal sprays or douches
Signs and symptoms of Trichomoniasis Female
10-25% of females asymptomatic. Acute vaginitis strong smelling, greenish/yellowish frothy discharge, itching swelling, dyspareunia, and dysuria
Signs and symptoms of Trichomoniasis Males
usually asymptomatic, if present urethritis, dysuria
Treatment of Trichomoniasis
Flagyl (antibiotic), Bactericidal, Trichomonacidal, Amebicidal
Erythropoiesis definition
is used to describe the process of RBC formation or production
What organ produces erythropoitin?
kidneys
The kidneys can detect low levels of what in the blood?
oxygen
The kidney is responsible for what?
turning of the faucet of RBC production is the kidney
Urinalysis
urinate in a sterile cup and then test it
What should urine usually look like?
usually clear, straw colored or amber, depends on the concentration or dilution
pH of urine
4.5-8.0, low the pH the more acidic it is
Specific gravity increases when urine is what?
concentrated/dehydrated
Specific gravity decreases when urine is what?
diluted/hydrated
What should not be in the urine?
WBCs, RBCs, protein, bacteria, pus
Blood urea nitrogen test
BUN, a metabolite; this will inc. due to a dec. in glomerolo-filtrate rate
Electrolyte test
Na+ K+, there could be an imbalance depending on kidney function
Intravenous pyelogram test IVP
diagnostic test, contrast dye is used via IV, then xrays are taken to look for a problem or blockage
CT, MRI
better clarity
Cystoscope
scope used to look into bladder/lower urinary tract
Urethritis
swelling of the urethra/ureters
Cystitis
inflammation of bladder
Pyelonephritis
very painful infection in the kidneys, may affect one or both, may be from bacterial organisms passage from the bladder to the kidneys
Cause of Urinary tract infections
organisms usually ascent urinary tract, usually from perianal area, hygiene is very important, begins in urethra ascending up to the bladder
E coli
most common organisms/associated with lower UTI, organism from the bowel, infection may result from poor hygiene
Benign prostrate hyperplasia
more common in older men, prostate enlargement slows flow of urine, proximity to the anal area/irritation
Honeymooners syndrome
a form of bacterial cystitis, common for individuals who recently became sexually active to experience, bacteria are introduced during frequent or prolonged sexual activity through the urethra
Urinary Catheters
very commonly used in health care (Foley Cath), used during surgeries and for individuals confined to bed, may also be used in individuals with damaged urinary function
Cystitis signs and symptoms
may have systemic signs, inflamed bladder wall and urethra, lower abdominal pain, dysuria, cloudy urine
Pyelonephritis signs and symptoms
same as cystitis, plus dull aching pain in the lower back/flank, systemic signs more pronounced
Treatment of UTIs
antibiotics, better hygiene, urinate frequently, increase fluid intake
Glomerulonephritis/Acute poststreptoccal glomerulonephritis cause
both common 2 weeks after strep infection, type 3 hypersensitivity reaction, inflammation causes decrease in GFR, decreased blood flow in kidneys triggers rennin
Signs and symptoms of UTI
lower back/flank pain, dark cloudy urine, oliguria (dec urine output), facial edema leading to generalized edema, general signs of inflammation, increased blood pressure
Treatment of glomerulonephritis
supportive, diuretics, angiotensis-converting enzyme inhibitors, sodium restriction, antibiotics, bed rest
Urolithiasis cause
kidney stones, build up of mineral salts in kidneys, addition of deposits at site, may be caused by prolonged dehydration, immobilization, infection, excessive calcium in diet, hereditary predispositioin, more common in men
Signs and symptoms of urolithiasis
frequently asymptomatic, back/flank pain, if ureter is obstructed there is extreme abdominal distension, intense spasms of pain, nausea and vomiting, chills/fever, possibly hematuria
Treatment of urolithiasis
inc. fluid intake, analgesics, lithotripsy, urethroscopy, surgery
Adult polycystic kidney disease cause
autosomal dominant, gene defect in chromosome 16, multiple cysts develop in both kidneys, 1st clinical manifestation midlife, develop chronic renal failure, life expectancy is about 10 years from onset
signs and symptoms of adult polycystic kidney disease
back pain, hematuria, enlarged kidneys, hypertenstion
Treatment of adult polycystic kidney disease
treat infections or hypertension, dialysis, transplant
Acute renal failure cause
decrease blood flow to kidney and or inflammation and necrosis, severe prolonged shock can lead to heart failure, free hemoglobin or myoglobin are toxic to the tubules
Signs and symptoms acute renal failure
oliguria, inc. BUN, metabolic acidosis, hyperkalemia, weakness/confusion due to toxins
Treatment of acute renal failure
reverse underlying cause, inc. renal blood flow, short term dialysis until kidneys recover
Chronic renal failure/ESRD cause
gradual irreversible destruction of the kidneys over a long period of time, chronic pyelonephritis, polycystic kidney disease, hypertension, diabetes, long term exposure to nephrotoxins
Early signs and symptoms of chronic renal failure
polyuria, general malaise, anemia, inc. BP
Late signs and symptoms of chronic renal failure
uremic signs approx 90% loss of nephron function, oliguria then anuria (no urine output), pruritic hyperpigmented skin, congestive heart failure/arrhythmias, encephalopathy, osteoporosis, systemic infections
Treatment of late signs and symptoms of chronic renal failure
control systemic effects, Inc, RBCs, dialysis, transplant
What are the 3 stages of chronic renal failure?
Decreased renal reserve, renal insufficiency, end stage
Decreased renal reserve
nephrons lost about 60%, remaining nephrons adapt and increase filtration capacity, GFR is dec. serum creatinine higher than average, yet normal, normal urea
Renal Insufficiency
change in blood chemistry, nephrons lost about 75%, GFR is decreased to 20% or normal, tubule function is decreased, erythropoiesis is dec. ( bone marrow supression)
End stage Renal Failure (LATE)
nephrons lost about 90%, GFR is negligible (none), fluid, wastes, electrolytes are retained in body, ALL systems are affected: osteoporosis, leathery skin, metabolic acidosis, electrolyte imbalance, CHF (arrhythmias), Encephalopathy (mentally confused), oliguria or anuria develop
What are the 3 types of Dialysis
peritoneal dialysis, hemodialysis, continuous renal replacement (CRRT)
Peritoneal dialysis
least invasive, uses the persons own peritoneum as dialyzing membrane. Tube is place in the peritoneum, diffusion of wastes takes place via the clean fluid and membrane, contaminated fluid is drained out/replaced with fresh, patient could do this by his/herself
How ofter is peritoneal dialysis done?
3 weeks
How long is peritoneal dialysis done?
5-8 hours
Hemodialysis
blood is drawn out of the body and filtered through an artificial kidney and then blood is returned to the persons circulation. Needs and access (permacath or central venous line), most patients have to go to Dialysis center but some can do this at home
How often is hemodialysis done?
3-4 times per week
How long does hemodialysis take?
3-5 hours
CRRT
continuous, utilized for clinically unstable patients for days, an extremely porous blood filter containing a semi permeable membrane is used in all methods
Kidney transplant
need a match or donor, chance of rejection, immunosuppressive drugs indefinitely, life can be normal if there is no rejection, sometimes the underlying disease that destroyed the original kidneys will destroy the new ones.
