Exam #1 Flashcards
Physiologic (functional)
Changes in body related to disease process
Homeostasis
Maintenance of a relatively stable internal environment regardless of external changes
Maintain=good health
Not maintained= disease
Factors that might alter what is considered “normal”?
Age, gender, genetics, environment, activity level
Seven steps for health
- Tabacoo and vape:do not smoke, causes cancer, damages lungs vast constricts bloodvessels = heart squeezes harder and wearsheart out by increasing heart size, avoid second-hand smoke
- Nutrition:diet, healthy options,heavy infruirs and veggies non processed foods, lean meats, heathy fats, eat 5-10 servings of fruits and veggies a day, nigh fiber foods, limit alcohol intake
- Physical activity: 30 minutes a day 15 days a week,moderate activity, strength training to help bones,helps with heart and lungs
- Protection from the sun
- Follow cancer screening guidelines
- Doctor ordentist visit if any changes in the normal state of health
7.follow health and safety guidelines at home and at work when using, storing, and disposing of hazardous materials
Disease prevention Stages 1-3
Primary: protect people from disease or injury in the first place
Secondary: after diagnosis, or identification of risk factor, stop in early stages,limit long-term disability,prevent recurrent injury Tertiary:helping people manage chronic illness, prevent further deterioration, maximize quality of life
Screenings are what in disease process?
Secondary
Healthy lifestyle and vaccines are what in disease process?
Primary
Post acute episode, rehab are what in disease process?
Tertiary
All of the following are part of the seven steps to health, except:
A. Follow cancer screening guidelines
B. Use of sunblock agents whenever expose.
C. choose high fiber, your fat foods.
D. Participate in strenuous exercise on a regular daily basis.
D. Participate in strenuous exercise on a regular daily basis.
Gross level
In total
Biopsy
Excision, removal of small amounts of living tissue
Autopsy
Examination of the body and organs afterdeath
Diagnosis
Identification of a disease
Etiology
Causes of factors in a disease
Idiopathic
Unknown causes of a disease
Iatrogenic
Error treatment/procedure may cause the disease
Ex. Folly, central line
Predisposing factors
Age, gender, inherited factors, environment
Ex. Smoking
Prophylaxis
Preserve heath; prevent spread of disease
Prevention
Vaccinations, diet, etc.
Pathogenesis
Development of a disease
Onset: insidious
Gradual onset; mild symptoms
Onset:sudden example
Ex. Heart attack
Acute
Short term
Chronic
Long term
Subclinical state
Early stages of the disease
Latent incubation period
Caught the infection but has not started
Ex. Covid
Prodromal period
Nonspecific sings, feeling off
Clinical manifestations
Signs and symptoms
Syndrome
Collection of signs and symptoms
Remission
Period of time where signs and symptoms calm down
Exacerbation
Time where signs and symptoms flair up
Precipitating factors
Triggers
Sequelae
- Sometimes that happened because of an acute event
- potential unwanted outcome
Convalescence
Recovery getting back to the wanted state
What’s the following would be the most likely cause of a error iatrogenic disease?
A. An inherited disorder.
B. And unwanted affects of a prescribed drug.
C. Prolonged exposure to toxic chemicals in the environment.
D. A combination of specific etiology logical factors.
B. And unwanted affects of a prescribed drug.
The manifestations of a disease are best defined as the
A. Subjective feeling of discomfort during a chronic illness.
B. Signs and symptoms of the disease.
C. Factors that precipitate in acute episode of chronic illness.
D. early indicators of the prodromal stage of infection.
B. Signs and symptoms of a disease
Prognosis
A predicted outcome or likelihood of recovery from a specific dose
Morbidity
Disease rates within a group
Mortality
Number of deaths resulting from a disease
Epidemiology
- tracking the pattern or occurrence of the disease
- major data collection centers: WHO and CDC
Epidemiology: incidence
Number of new cases in a given population within a given time period
Epidemiology: prevalence
Number of old, or existing case within a given population and time period
Epidemiology: epidemic
Higher-than-expected number of cases of an infectious disease within a given area
Epidemiology: pandemic
Higher number of infectious diseases on global level
Prognosis: communicable disease
Infectious disease that can spread from one person to another
Ex. STD, MRSA,measles -
Prognosis: noticeable or reportable disease
Must report by the physician to authorities
Authorities very with local jurisdiction
Reporting is to prevent further spread of the disease
Ex. STD, COVID
The best definition of the term prognosis is the:
A.precipitating factors causing an acute episode.
B.number of remissions to be expected during the course of a chronic illness
C. Predicted outcome or likelihood of recovery from a specific disease
D. Exacerbation occurring during chronic illness
C. Predicted outcome or likelihood of recovery from a specific disease
A situation when there is a higher-than- expected number of cases of an infectious disease within a given area is called a/ an
A. Epidemic
B. Pandemic
C. Exacerbation
D. Outbreak
A. Epidemic
Atrophy:
Decrease in tissue mass
Ex. Broken arm
Hyperplasia
Increase number of cells enlargement of tissue mass
Ex. Pregnancy
Hypertrophy
Muscle mass
Ex. Body builder
Metaplasia
Replaced normal cells that should not be there
Ev. Lung - chronic smoker
Byplasia
Abnormally shaped cells
Neoplasia
New cell growth, also known as a tumor, new and uncontrolled growth
Ex. Papsmire
Cell damage cause x6
- physical damage: excessive heat or cold exposure.
- Mechanical damage: pressure or tearing of tissue
- Chemical toxins: exogenous- from environment,,,, endogenous: from inside the body
- Microorganisms: bacteria, virus, and fungi
- Abnormal metabolites:genetic disorders, inborn errors of metabolism
- Imbalance of fluids or electrolytes
Cell damage: apoptosis
Refer to programmed cell death
Normal occurrence in the body
Cell damage: ischemia
Deficit of oxygen in the cells
Cell damage: hypoxia
Reduced oxygen in the tissue
Cell damage
Nutritional defects
Pyroptosis
Results in lysis causing nearby inflammation
Necrosis, infarction
Area of dead cells as a result of oxygen deprivation
Necrosis
Dying cells cause further cell damage due to cellular disintegration
Gangrene
Area of necrotic tissue that has been invaded by bacteria:wet, dry, gas
Liquefaction necrosis
Dead cells liquefy of release of cell enzymes
Coagulate necrosis
Cell proteins are altered or denatured- coagulation
Caseous necrosis
Form of coagulation necrosis and thick, yellowish, “cheesey” substance forms
A change in a tissue marked by cells that vary in size and shape and show increased mitotic figures would be called:
A. Dysplasia
B. Metaplasia
C. Hyperplasia
D. Neoplasia
A.dysplasia
When prolonged ischemic occurs to an area of the heart, the resulting damage is referred to as:
A. Atrophy
B. Liquefactive necrosis
C. Apoptosis
D. Infarction
D. Infarction
First line defense
Nonspecific general defense
Second line
Inflammatory response (nonspecific)
Third line
Immune response (specific)
Inflammation goal
Localize and remove an injurious agent
Inflammation goal
Localize and remove an injurious agent
Infamination signs X5
Pain, heat, redness, swelling, loss of function
Steps of inflammation
Chemical mediators-histamine-bradykinin- increased blood flow and capillary permeability
Why do we want to increase blood flow and capillary permeability?
Increase flow of blood to the area to heal it and get rid of it and start the healing process and fight off whatever it is… Vasodialate
How do these steps cause the five cardinal signs of inflammation?
- Swelling: influx of blood and fluid in the area to try and fight it off
- And 3. Heart redness: increase blood flow
- Pain: pressing on a nerve
- Loss of function: super swollen and loss of movement
Chemotaxis
Movement of messenger to the rest of the body help = warning signs of chemical messengers
Steps of inflammation X5
- damage cells release their content and break in skin allows bacteria to enter the tissue.
- Chemotaxis
- Draws neutrophils and monocytes to the site of injury.
- Neutrophils, phagocytosis bacteria
- Monocytes in macrophages, enter tissue from blood and phagocytosis microbes
Steps of inflammation: vascular response
Blood flow, vasodilation, and capillary permeability
- may also have an immune response and or clotting response depending on type of injury
Steps of inflammation: cellular response
Chemotaxis, drawing in cells to affected area
- may also have an immune response and or clotting response depending on type of injury
What to see at site of injury?
Heat, redness, pain, loss of movement, swelling, exudate, allergies, burns, fibirnous-thick, sticky, increase risk for scaring pus, bacteria,abscess in solid tissue
Systemic effects x5
- Mild pyrexia=low grade fever
- Malaise-feeling of unwellness
3.fatigue = more tired than usual - Headache
- Anorexia-loss of appetite
Leukocytosis
WBC - white blood cells
Example of indicator of inflammation- nonspecific
CPR and ESR
Shift to the left
Body is working overtime to pump WBC to fight infection
Eosinophils
Allergies
what is Increased plasma protein doing?
Creating more cells
Chronic inflammation exacerbation
May have periodic exacerbation with acute inflammation
Worse before they get better
What do aspirin and NSAIDs do?
Decrease prostaglandin synthesis
Stomach irritation and ulcers
Interfere with blood clotting
What does corticosteroids do?
- Decrease capillary permeability, reduce number of leukocytes and must cells, block immune response
Osteoporosis
Delayed healing and growth
High blood pressure, edema, and sugar
Risk of infection
Adrenal crisis-must taper off slowly
Rice
R: rest
I: ice
C: Compress
E: elevate
Types of healing x3 r’S
- Resolution: minimal tissue damage; short healing time
- Regeneration: damage to tissue, cells are capable of mitosis
- Extensive tissue damage: cells are in capable of mitosis
-Fill the gap only
- not normal, functional tissue
Intention Healing
First intention: small wounds and clean wounds
Second intention: large wounds, debris, present, bottom up, healing, more scarring, longer time to heal, greater risk for infection
Stages of healing x3
- Inflammation
- Proliferation
- Remodeling: scar formation
Complications R/T Scarring
Loss of function, contractors, and obstructions, adhesions, hypertrophy of scar tissue, ulceration
Types of burns X6
Thermal, chemical, radiation, electricity, light, friction
Severity of the burn depends on
Cause, temperature, extent of the burn surface, site of the injury
1st degree burn
Epididymis, upper dermis, only, red, painful, heal without scarring, sunburn, mild scalp
2nd degree burn
epidermis and dermis, red, swollen, blistered, painful, waxy with reddened margin, risk for infection, scarring
3rd degree burn
All layers of skin, charge, skin, eschar, painless, required skin graft
4th degree burn
Effect muscle and bone, all layers of skin, painless, charred skin, skin graft
Percentage of body surface are burns
https://www.openanesthesia.org/wp-content/uploads/2023/01/12/Burn-Injuries_Initial-Evaluation-and-Management_figure-2-04zyb4-e1673546848838.jpg
Classification for major burns
Burns to hand, feet, face, ears, or genitalia
Inhalation affecting airway
10% for elderly
20% for adults
30% for children
Electrical injuries affect everything it’s touched and causes cardiac dysrhythmias
Emergency treatment for burns
Cover the burn area by soaking it with cool or timid water slightly above body temperature
Use sterile gauze to cover loosely
For a chemical burn, remove any affected clothing and flush the burn area well with cold water, then cover it with a clean cloth
Burn and shock treatment
Treat with fluids
Burn and respiratory problems treatment
treat with oxygen and watch respiratory status closely
Burn an infection treatment
barriers down, decreased perfusion, may lead to septic shock, treat with antibiotics cleansing of wound
Burn and increase, metabolic demand treatment
lots of proteins at exudate, stress response, increase tissue demand for healing, treat with increase protein carbs and caloric intake
Point of tenderness
Push on that area and it is going to hurt
Periosteum
Outside/lining of the bone
Fractures
Initiate an inflammatory response and homeostasis
Edema causes stretching of periosteum and swelling of soft tissue causing severe pain
Fracture Healing X8
- Hematoma: fibrin formed
- phagocytes cells: clean
- Fibroblast: lay down callagen fibers
- Chondroblast: new fiber formed
- Format noon of procallus
- Osteoblast: new bone
- Procallus: replace Old money callus
- Remodeling of bone-use
Fracture affecting healing
- Presence of material or infection
- blood supply to fracture site ‘smoking, cirrulation)
Potential factor complications
Muscle spasms, infection ischemia fat emboli, nerve damage, failure to heal residual effects
Compartment syndrome
Edema within one area, the compartment of the limb that is between layers of dense connective tissue
Compressed arterial supply = less perfusion
Ischemia and infarction of tissues may occur
A tight cast can cause compartment syndrome
Treatment for fracture
Check pulse in Century function distal to the fracture
Dislocation clinical manifestations
Deformity of the joint
Limited range of motion
Pain, swelling, tenderness
Sprain
Tear in the ligament
Strain
Tear in a tendon
Muscle tear treatment
Apply cold to help reduce the internal bleeding
Compression bandage
Fat emboli
Fat Gobles released into the bloodstream
Common and femur fractures
Osteoporosis
Decreasing bone density and mass
Diagnosis is bones density scan
Osteoporosis patho
Phone reabsorption exceeds formation
Result in loss of compact bone
Thin, fragile, bones, more liable for fractures
Compression fractures of vertebrae, wrist or hip
Can lead to kyphosis and scoliosis
Osteoporosis predisposing factors
Age 50 and older
Decreasing mobility sedentary lifestyle
Small white bone structures
Hormone factors
Deficits of calcium, vitamin D, or protein
Cigarette smoking
Excessive caffeine intake
Osteoporosis manifestations
Nerve, back, or neck pain
Kyphosis, lordosis, scoliosis
Lots of height
Stooped posture
Spontaneous fractures
Poor fracture healing
Osteoporosis treatment
Dietary supplement: calcium and vitamin D
Weight-bearing exercises
Hormone replacement increases the risk for cancer
Bisphosphonales
Fluoride supplementes
Calcitonin
Rickets
Leads to weak bones and other skeletal deformities
In children
Results from deficient of vitamin D, and phosphate
Causes: dietary deficiency, malabsorption, intake of phenobarbital, lack of sun exposure
Osteomalacia
Adults
Soft bones = compression fractures
Causes: dietary deficiency, malabsorption, intake of phenobarbital, lack of sun exposure
Paget disease
40+
Replacement a bone by fibrous tissue, an abnormal bone
Pathological fractures are common
Elevated calcium levels
Invertebrate = kyphosis
In skull= increased pressure = headaches compression of cranial nerves = severe pain
Large weak bones
An older adult female has a bone density test that reveals severe osteoporosis. What does the nurse understand? Can be a problem for this client due to the G Crescent bone mass and density?
A. Diabetes.
B. Hypertension
C. Compression fractures
D. Cardiac disease
c. Compression fractures
The nurse is planning an education program for women of childbearing years. What does the nurse recognizes the primary prevention of osteoporosis?
A. Engaging in non-weight-bearing exercises daily
B. Ensuring adequate calcium and vitamin D intake
C. Undergoing assessment of serum calcium levels every year.
D. Having a DXA beginning at age 35 years.
B. Ensuring adequate calcium and vitamin D intake
Osteomyelitis
Bone infection caused by bacteria and fungi
Treatment: antibiotics possible surgery
Types of curved spines X3
Lordosis: curving inward at the lower back
Kyphosis, hunchback, or humpback
Scoliosis: S or C-shaped spine
Lordosis cause
Achondroplasia, obesity, dicitis, something forward of the vertebrae
Kyphosis causes
Poor posture, spina bifida, cognitive defects, spinal tumor, infections
Ewing sarcoma
Common and adolescence, and usually in the shaft of long bones likes to go to lungs
Osteosarcoma
Most common primary neoplasm of bone
Bone pain at rest is a warning sign for cancer
Long bone in both legs
A nurse is caring for a client who has a cute osteomyelitis. Which of the following interventions is the nurses priority?
A. Provide the client was antipyretic therapy
B. Administer antibiotics to the client.
C. increase the clients protein intake
D. Teach relaxation breathing to reduce the clients pain
B. Administer antibiotics to the client.
Muscular dystrophy
Genetic disorders
Deficit of dystrophin leads to the degeneration and necrosis of the cell
Duchenne in the most common type and affects young boys
Manifestations of muscular dystrophy
Early motor weakness
Struggle with GOW ER maneuver, pushing up to erect positions
Cardiomyopathy
No cure!!!
Fibromyalgia
Group of disorders, characterized by pain and stiffness of muscles and surrounding soft tissues
No obvious signs of inflammation or degeneration
Unknown cause
Clinical manifestations of fibromyalgia
Muscle fatigue generalize chronic aching pain
Diagnosis of fibromyalgia
Presence of pain in at least 12 to 18 tender points
Treatment of fibromyalgia
Stress, avoidance, or reduction
Low-dose antidepressant
Regular exercise in the morning
Pease activity and rest as needed
Analgesic drugs
Applications of heat or massage
Osteoarthritis
Degenerative wear and tear joint disease
Primary form is weight-bearing, obesity, aging, smoking
Secondary form follows, trauma, repetitive use
Genetic factors thought to play a role
Weight-bearing joints, most frequently affected but finger joints also involved
Patho of osteoarthritis
Articular Cartlidge is damaged
Surfless Cartlidge becomes worn
Pain with weight-bearing use
Inflammation
Manifestations of osteoarthritis
Aching joint pain with weight-bearing a movement
Limited range of motion
May be a symmetric
Crepitus
No systemic signs
Rheumatoid arthritis
Considered an auto immune disorder
Causes chronic systemic, inflammatory disease
Patho of rheumatoid arthritis
Synovitis inflammation of synovial membranes, Mark, inflammation, cell proliferation
Pannus formation
Cartilage erosion
Fibrosis
Ankylosis
Rheumatoid arthritis manifestations
Symmetrical joints affected
Joint stiffness occurs at Russ, improved with movement
Elite joint deformity
Rheumatoid or subcutaneous, nodules can form on tuna ulna, pleura, heart valves, or eyes
Juvenile rheumatoid arthritis JRA
Onset is more acute than adults
Systemic affects or more March, but rheumatoid nodules are absent
A nurse is teaching a client about risk factors for osteoarthritis, which of the following factors should the nurse include in the teaching? (select all that apply)
A. Bacteria.
B. Diuretics.
C. Aging
D. Obesity.
E. Smoking
C. aging
D. Obesity.
E. Smoking
A nurse is in a providers office in assessing a client who has rheumatoid arthritis. Which of the following findings is a late manifestation of this condition?
A. Anorexia.
B. Knuckle deformity.
C. Low-grade fever.
D. Weight loss
B. Knuckle deformity
Infectious (septic) arthritis
Develops in single joint
Joint is red, swollen painful with decreased movement
Cause:
Direct introduction of bacteria into joint
Treatment:
With antimicrobial over sustained; Often requires IV administration.
Gout
Results from deposit of uric acid,, and crystals and joint, causing inflammation
Often affects a single joint, such as the big toe
Formation of tophus large hard nodule of your urare Crystal
Gout, diet modifications
Avoid alcohol
Red meats
Lamb
pork
Seafood
High sugars
Ice cream
A nurse is caring for a patient diagnosed with gout, who is being educated about appropriate meal selections. Which meal option should the nurse recommend to the patient to help manage gout effectively?
A. Grilled chicken salad with mixed greens, cherry, tomatoes, cucumbers, lowfat vinaigrette.
B. Spaghetti Bolognese made with lean ground beef, whole wheat, pasta, and a tomato based sauce.
C. Fried shrimp served with mashed potatoes and steamed broccoli on the side.
D. Cheeseburger with fries and a soft drink.
A. Grilled chicken salad with mixed greens, cherry, tomatoes, cucumbers, and a low fat vinaigrette.
Patient with a history of girl is planning a meal with their family. What does our options to the nurse advise the patient to avoid due to its potential to a trigger gout attack.
A. Fresh fruit, salad with strawberries, blueberries, and watermelon.
B. Chocolate cake with whipped cream frosting
C. Frozen yogurt with mixed nuts and honey drizzle.
D. Vanilla, ice cream, topped with caramel sauce, and sprinkles.
D. Vanilla, ice cream topped with caramel sauce and sprinkles.
A nurse is completing discharge instructions with a client following an acute onset of gout. Which of the following client statements indicates an understanding of the treatment regimen?
A. I will closely follow a High Perrine diet.
B. I will limit my fluid intake to 1 L per day.
C. I will take one aspirin every day.
D. I will limit my alcohol intake.
D I will limit my alcohol intake
A nurse is teaching a client who has a new diagnosis of acute bursitis in her right shoulder. Which of the following self-care strategies should the nurse recommend?
A. Range of motion exercises
B. Intermittent ice and heat.
C. Elevation of the right arm.
D. Cortical steroid therapy.
B. Intermittent ice and heat.
Ankylosing spondylitis
Chronic, progressive, inflammatory disorder of the vertebral joints that lead to a rigid spine
Ankylosing spondylitis patho
‘Vertebral joints become inflamed
Fibrosis and calcification of fusion of the joints
Loss mobility
Inflammation in lower back
Osteoporosis is common
Ankylosis, spondylitis, manifestations, and treatment
Manifestations:
Spine becomes more rigid with impaired flexion, extension and rotation
Stiffness in the morning
Lower back pain
Treatment:
Sleep in a supine position
NSAIDs
Bursitis
Inflammation of the bursa
Most common cause is repetitive on a particular joint
SYNOVITIS
Information of the synovial membranes
Movement of the joint is restricted and painful
Tendinitis
Irritation of the tendon
To treat rest, apply ice
Osteocytes
Mature, bone cell
Osteoblast
Bone producing cell
Osteoclast
Bone reabsorbing cell
Fracture types and classifications
See notes
Urinalysis
Straw-colored with mild odor
Normal urine specific gravity is 1.010-1.050
Cloudy: large amounts of bacteria, puss, blood
Dark colored = dehydration: hematuria, excessive, bilirubin, or highly concentrated urine
Unpleasant or unusual color: infection from certain dietary components or medication
Urinalysis: abnormal findings
Blood hematuria
Elevator protein level proteinuria and albuminuria
Bacteria bacteriuria
Urinary cast : indicate inflammation of kidney tubules
Specific gravity
Glucose and ketones
Blood test
GFR: renal function
Bun and CRE: elevated serum Andrea and serum creatinine levels: failure to excrete, nitrogen waste, decrease in GFR
Metabolic acidosis: failure to control acid base, balance, and decrease in GFR
Anemia : decrease in erythroprotein, secretion, and bone marrow depression
Electrolytes antibody level
Elevated rain in levels: indicates kidney as a cause of hypertension
More urine test
Culture and sensitivity: what organism and help select appropriate antibiotics
Cystoscope: To see inside lower urinary track
Radiologic test: see inside
Diuretic drugs
Used to remove excess, sodium ions and water from the body
Reduces the fluid volume and tissue in blood
Increase excretion of water through the kidneys
Educate patient taking the morning
Adverse effect is hypokalemia
Loss of electrolytes in muscle weakness, causing cardiac arrhythmias
Take potassium
Dialysis
Sustain life, but not a cure
Provides filtration and reabsorption does the job for the kidneys
Hemodialysis
In hospital dialysis or at home with equipment
Removes patient’s blood from an implanted, shine or catheter in the artery to machine
Frequency: usually require three times a week
Potential complications: infection at access site, blood clots
Peritoneal dialysis
Outpatient
Personal membrane serves as the semipermeable membrane
Abdominal administration site
Takes longer than 3 to 4 hours
Major complication is infection, resulting in peritonitis
Retention in incontinence
Retention: inability to empty bladder, may follow anesthesia
Incontinence: loss of voluntary control of the bladder
Incontinent x3
Stress incontinence: women, pregnancies, coughing, laughing, lifting
Overflow incontinence: older people, weakening of bladder sphincter
Neurological bladder: spinal cord
Urinary tract infections
Lower urinary track infections: cystitis, urethritis
Upper urinary tract infections : pyelonephritis
E. Coli
UTIs continued
More common in women, because shorter urethra interest to anus
Older man Prostatic hypertrophy urinary retention
Congenital abnormalities in children
Retention of urine
Poorly controlled diabetes
Urethritis common cause
STDs
Bladder wall
Cystitis
Urethra
Urethritis
Pyelonephritis
Pruitt accident feels pelvis and calyces
Fills kidney with pus
Signs and symptoms : Dole aching pain in lower back or flank area. Fever urinary cast are now present.
UTI treatment
Lots of fluids and antibiotics
Glomeralonephritis
Follows recent strep, or upper respiratory infection
Starts to develop 10 to 14 days later
Follows strep throat
Signs and symptoms of glomeraulonephritis
Urine, dark and cloudy tea colored
Edema first in the face and periorbital generalized
Elevated blood pressure
Flank or back pain
General signs of inflammation
Decreased urine output
Glomerulonephritis testing
Blood test: bun, cre
Metabolic acidosis
Uranalysis: henauria
Golmerulonephritis treatment
Sodium restrictions
Steroids to reduce inflammation
Protein and fluid intake decrease in severe cases
Nephrotic syndrome
Abnormality in glomerular capillaries increase permeability large amounts of plasma, proteins escape into filtrate
Patho of nephrotic syndrome
Hypoalbuminemia with decreased plasma, osmotic pressure equaling more severe, severe edema
Low protein and blood because you’re peeing it out
Low bread, pressure
High cholesterol, lipid urea fat in urine
Milky, frothy, looking urine
Signs and symptoms of nephrotic syndrome
Massive proteinuria
Frothy urine
Hyperlipidemia hypoalbuminemi
Massive edema
Set an increase in girth
They look like puffy marshmallows
Treatment for nephrotic syndrome
Glacocoricoids: reduce inflammation
ACE INHIBITORS: decreasing protein loss in urine
Antihypertensives
Increase protein
Decrees,  sodium intake
Urolithiasis(calculi). Stones
Can develop anywhere in the urinary track
Stones may be small or a very large
Turn to form with: insufficient fluid intake/dehydration, excessive amount of solute infiltrate, urinary track infection
Manifestations occur with obstruction of urinary flow: may lead to infection, hydronephrosis with dilation of calyes, if location can you or your order and iHeartRalfy of renal tissue
Stone / urolithiasis types x4
Calcium oxalate: bigger, nigh calcium level and high alkaline urine
Uris acid stone: gout, unmet, high praise diets
Struvite and cystine stones
Stone formation depends on predisposing factors
Urolithiasis manifestation
- Stones in kidney or bladder often asymptomatic
~ swing pain, possibly caused by distention of renal capsule - renal colic cause by obstruction of the ureter
~ excruciating pain in flank area with upper outer quadrant
~ in ureter, suck
Treatment urolithiasis
- Small stones eventually passed
- laser lithotripsy
- surgery
- extracorporeal shock wave lithotripsy
- medication
Prevention of urolithiasis
Treat underlying conditions → dietary modification: diet rich in citrus, fruits, legumes, and vegetables, raise ph and produces urine that is more alkaline. A diet nigh in meat and cranberry juice will help the urine acidic → consistent, increase food intake
Hydronephrosis
Secondary problem caused by colon complications of Calcio, tumors, scar tissue in kidney or your order, untreated, prostatic, enlargement, development, and abnormalities, restricting urine flow
Frequently asymptomatic in early stages
Diagnosis: US, CT, or renal scan
Buildup of urine will cause compression of kidney tissue resulting in as ischemia and necrosis
If cause is not removed, chronic renal failure
Urine is blocked from exiting body
Renal cell carcinoma manifestations
-painless hematuria initially
-dull, aching, flank pain
-Unexplained weight loss
-Anemia, or erythrocytosis
- palpable masses
- paraneoplastic syndrome
Bladder cancer
Most bladder tumors are malignant and calmly arise from transitional epithelium of the bladder
Often develop says multiple tumors
Diagnosed by urine, cytology and biopsy
Early signs are painless bloody urine hematuria
Tumor is invasive through wall two adjacent structures: metastasizes to pelvic lymph nodes, liver, and bone
Bladder cancer, predisposing factors
Working with chemicals in laboratories in industries
Cigarette smoking
Recurrent infections
Heavy intake of energetics
Bladder, cancer treatment
Surgical resection of tumor
Chemo and radiation
Photoradiation successful in early cases
Vascular disorders: nephroscoliosis RAAS
Involves vascular changing the kidney: some occur, normally with aging
Thickening in hardening of the walls of arterioles and small arteries
Narrowing a blood vessel lumen
Reduction of blood supply to the kidneys
Stimulation of renin
Increase blood pressure
Continue ischemia
Destruction of renal tissue
Chronic renal failure
Nephrosclerosis
- Can primary lesion developed in kidney
- may be secondary to essential hypertension
- treatment: antihypertensive agents, diabetics, beta blockers, sodium intake reduction
Vesicoureneral reflux
Defective valve in the bladder
Genesis
Failure to develop one kidney
Hypoplasia
Failure to develop to normal size
Ectopic kidney
Kidney and ureter displaced out of normal position
Horseshoe kidney
Fusion of 2 kidneys
Adult polycystic kidney disease
- Genetic disorder: asymptomatic till round 40, autosomal dominant gene on chromosome 16
- multiple cyst develop in both kidneys: pushes on good tissue, renal failure, necrosis, destruction of kidneys, or an, compression and destruction of kidney tissue, chronic renal failure
-Manifestations: no manifestations and children and young adults, first see manifestation around 40, flank pain, signs and symptoms of chronic kidney disease
-Diagnosed by abdominal CT scan or MRI
Wilms’ tumor
-Rare tumor occurring in children
-Defection tumor, suppressor, genes and chromosomes 11
- uni lateral bold from large encapsulated mass asymmetic abdomen
-Pulmonary metastasize may be present at diagnosis
-Do not palpate abdomen if Will limbs is suspected
Acute Renal failure cause
- Acute bilateral kidney disease: glomerulonephritis
- severe, prolonged circulatory shock or heart failure
- nephrotoxius :drugs, chemicals, or toxins
- mechanical obstruction: calcui, blood clots, tumor
Acute renal failure
- sudden onset
- blood rest: elevated bun and creatinine levels, metabolic acidosis, hyperkalemia
- treatment: identify and remove or treat primary problem, dialysis to normalize body fluids, and maintain homeostasis
- minimize risk of necrosis
Chronic renal failure
- Gradual irreversible destruction of the kidneys over a long period of time
- asymptomatic in early stages
- progressive
- may result from: chronic kidney disease, con genital polycystic disease, systemic disorders, low level exposure to nephrotoxic over a sustained period of time
Aliguria
Little urinary output
Anuria
No urinary output
Chronic renal failure stages
Decrease renal reserve ~ 60%
Decrease GFR
Increase serum creatinine
No apparent clinical symptoms
Renal insufficiency ~75%
Excretion of larger volumes of dilute urine
Renal failure is the most common cause of erythropoietin deficiency anemia
Elevated blood pressure
Chronic End stage renal failure
Call electrolytes and waste retain and body
Azotemia, anemia, and acidosis
Marked oliguria or Anuria mean
Regular dialysis or kidney transplant patient to maintain patients life
Chronic renal failure early signs
Bone marrow depression and impaired cell function
General science: anorexia, nausea, animal, fatigue, weight, loss, exercise and tolerance
Increase urinary output
Elevated blood pressure
Lea signs/complete failure chronic renal failure
Oliguria, dry pauritic, hyperpigmented, skin, easy, bruising, peripheral neuropathy, important in men, menstrual irregularities in woman, encephalopathy memory loss), congestive heart failure, dysrhythmias, failure to activate vitamin D, possible uremic frost on skin urine like breath, odor, systemic infections
Diagnostic testing on renal failure
Metabolic acidosis becomes decompensated
Azotemia
Anemia become severe
Serum electric levels may vary, depending on the amount of water, retained by the body, usually hyponatremia and hyperkalemia occur as well as hypocalcemia and hyperphosphatemia
Treatment of renal failure
All body systems are affected
Difficult to maintain homeostasis, homeostasis of fluids and electrolytes in acid base balance is
Drugs to stimulate erythropoiesis
Drugs to treat cardiovascular problems
Dialysis or transplantation
And take a fluid electrolytes proteins must be restricted
