Glomerulonephritis Test 5 Flashcards

1
Q

Glomerulonephritis

A

Immunologic process involving the urinary tract predominantly affect the renal glomerulus
-glomerular injury as result of inflammation, affecting both kidneys equally

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2
Q

Etiology of glomerulonephritis:

A
  • immunological reaction
  • SLE
  • strep infection
  • Vascular injury
  • hypertension
  • Metabolic disease
  • diabetes mellitus
  • Disseminated intravascular coagulation
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3
Q

Glomerulonephritis patho:

A
  • Antigen-antibody complex formation and reaction with glomerular tissue
  • causes inflammation in glomerulous -primary vs. ssecondary-associated with systemic disease-acute, chronic, idiopathic or may occur as a complication of other diseases-rapidly progressive (loss of fx in days/weeks)
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4
Q

Attacks the glomerular basement membrane which-

A

becomes more porous

  • proteinuria, hematuria, azotemia
  • decreased glomerular filtration
  • retention of metabolic waste
  • retention of water and sodium
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5
Q

Early S/S of glomerulonephritis:

A
  • proteinuria and hematuria: early sign
  • bacteria neg in the U/A
  • Azotemia: elevated BUN and Creatinine early sign
  • Increased urine specific gravity
  • Elevated antistreptolysin O titer/
  • Elevated Sed rate
  • Metabolic acidosis d/t impaired glomerular filtration causing retention of waste products
  • Oliguria
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6
Q

S/S of glomerulonephritis early/late:

A
  • Anemia
  • Fatigue
  • Anuria
  • HA
  • Malaise
  • mild fever
  • anorexia
  • flank pain or CVA tenderness
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7
Q

S/S of glomerulonephritis (late):

A
  • Increased B/P r/t fluid overload
  • Edema
  • JVD
  • Periorbital edema
  • End stage renal failure
  • irreversible renal failure occurs in less than 1% of patients
  • Circulatory congestion
  • dyspnea
  • CHF
  • Complications r/t fluid overload
  • CHF
  • encephalopothy
  • pulmonary edema
  • sepsis from infection
  • end stage renal failure
  • *Irreversible renal failure occurs in less than 1% of patients
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8
Q

Glomerulonephritis Diagnostic studies:

A
  • Urinalysis
  • bacteria neg
  • RBC, WBC, and casts
  • urine smoky or rusty in appearance
  • hematuria
  • proteinuria
  • Possible decreased urine creatinine clearance
  • Serum BUN/Creatinine
  • ESR
  • Antistreptolysin-O titer (ASO)
  • Chronic
  • fixed specific gravity
  • metabolic acidosis
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9
Q

Glomerulonephritis prevention:

A
  • early detection and treatment of respiratory infections to prevent increase antigen/antibody complex formation
  • supportive, symptomatic care
  • diuretics for severe fluid overload
  • antihypertensive therapy (only after fluid control has proven unsuccessful)
  • Rest during acute stage to decrease workload on kidneys
  • decrease the metabolic activity
  • advance activity as symptoms disappear; no protein or blood in the urine
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10
Q

Dietary management:

A
  • Dietary sodium restriction
  • fld volume deficit r/t decrease glomerular filtration rate
  • Potassium restriction
  • if GFR is <10 ml/min
  • hyperkalemia can cause dysrhythmia and neuromuscular symtoms
  • protein restriction
  • 1-1.2 g/day when BUN/Creatinine is elevated
  • to decrease metabolic waste products and decrease stress on the kidney
  • Sufficient dietary carbohydrates
  • carb prevention protein being used as energy, leading to muscle wasting and nitrogen imbalances
  • 2500-3500 calories/day
  • monitor pt for weight loss
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11
Q

Chronic Glomerulonephritis:

A
  • reflects the end stage of glomerular inflammatory disease from progressive destruction of the glomeruli
  • Leads to gradual loss of renal function from tubular atrophy, chronic interstitial inflammation and arteriosclerosis
  • Extremely variable
  • Insidious or rapid
  • May follow AGN but often there is no hx of infection
  • Treatment mirrors AGN and is supportive and symptomatic
  • No specific therapy to arrest or reverse the disease process
  • Treatment of renal failure begins when illness progress to end stage
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12
Q

S/S

A
  • U/A- foamy dark smokey color, protein and blood will decrease as the fewer nephrons are intact. Urine specific gravity will become fix same as the plasma. Casts in the urine
  • Metabolic Acidosis- r/t impaired glomerular filtration.
  • HA especially in morning
  • HTN- d/t activation of renin-angiotensin aldosterone system.
  • dyspnea on exertion
  • blurred vision
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13
Q

S/S continued

A
  • Lassitude
  • weakness
  • fatigue
  • edema
  • nocturia
  • effects on the GI:
  • anorexia
  • weight loss
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