lewis ch 45 (renal and urologic problems) Flashcards
Amount of blood filtered each minute by the glomeruli
GFR
functional unit of kidney
nephron
S+S of lower urinary tract infection (4)
- burning/painful urination
- constant urge to urinate
- cloudy urine
- foul odor
2 classifications of lower UTI
cystitis
urethritis
1 classification of upper UTI
pyelonephritis
2 contributing factors to UTIs
sex
catheter
what 2 bacteria can cause CAUTI
pseudomonas
e coli
S+S of upper urinary tract infection (3)
- flank pain (CVA tenderness)
- chills
- fever
2 diagnostic tests to diagnose UTI
- dipstick urinalysis for nitrates, WBCs, and leukocyte esterase
- urine culture/sensitivity (clean catch)
systemic infection from urologic source
urosepsis
Inflammation of renal parenchyma and collecting system, including renal pelvis
pyelonephritis
what is one of the most important risk factors for pyelonephritis
pregnancy -induced changes
diagnostic studies for pyelonephritis (5)
- urinalysis culture and sensitivity
- blood cultures
- ultrasound
- CT scan (preferred imaging study)
- decreased kidney function test
Kidneys inflamed; resulting in scarring; loss of renal
function and atrophy
-Result from anatomic abnormalities or recurrent
infections of upper urinary tract
chronic pyelonephritis
diagnostic studies for chronic pyelonephritis (2)
radiologic imaging
biopsy
inflammation of the urethra due to bacterial or viral infection
urethritis
how do you treat urethritis (2)
sitz baths
antimicrobials
chronic, painful, inflammatory disease of the
bladder; can cause painful bladder syndrome
interstitial cystitis
bladder irritants (4)
- caffeine
- alcohol
- some acidic fruits
- spicy foods
Inflammation of the glomeruli
glomerulonephritis
S+S acute strep glomerulonephritis (6)
- edema
- hypertension
- oliguria
- hematuria
- proteinuria
- smokey urine
how to treat acute glomerulonephritis (5)
- rest
- diuretics
- restrict salt and fluids
- restrict proteins
- antibiotics
S+S chronic glomerulonephritis (4)
- hematuria
- proteinuria
- RBCs, WBCs, and casts in urine
- increased BUN and creatinine
Autoimmune disease—antibodies attack glomerular and
basement membranes
goodpasture syndrome
Glomerular disease with glomerular crescent formations; loss of renal function in days to weeks
rapidly progressing glomerulonephritis
causes urinary calculi (3)
- low or high urinary pH
- obstruction
- infection
how to treat urinary calculi (2)
increase hydration
avoid vitamin c and calcium supplements
type of urinary calculi:
- small
- more common in men
- can easily get trapped in ureter
- most common type
calcium oxalate
type of urinary calculi:
- mixed stones with struvite or oxalate stones
- from alkaline urine or hyperparathyroidism
calcium phosphate
type of urinary calculi:
- genetic autosomal recessive defect
- defective absorption of cystine in GI tract and kidneys
- from acidic urine
cystine
type of urinary calculi:
- more common in women
- always associated with UTI
- large staghorn type
struvite
type of urinary calculi:
- predominant in men (high incidence in jewish men)
- from acidic urine, gout, or inherited condition
uric acid
S+S urinary calculi (4)
- sudden severe pain
- flank pain
- N/V
- fever and chills
4 diagnostic studies for urinary calculi
- CT scan
- ultrasound
- urinalysis
- 24 hr urine collection
treatment of urinary calculi (5)
- adequate hydration
- sodium restriction
- dietary changes
- may need drugs to correct urine pH
- antibiotics and possible surgery for struvite stones
procedure for kidney stone: remove stone in bladder
cystoscopy
procedure for kidney stone: large stones broken up with
lithotrite (stone crusher)
Cystolitholapaxy
procedure for kidney stone: ultrasonic waves break
stones
Cystoscopic lithotripsy
complications of procedures to remove kidney stones (3)
- hemorrhage
- retained stone fragments
- infection
what amount of water intake would be recommended for someone with kidney stones
3 L/day
what are some dietary changes recommended for someone with kidney stones (3)
- restrict purines
- restrict salt intake
- limit soda, coffee, and tea
Fibrosis or inflammation of urethral lumen leads to narrowing
and compromised opening and closing with bladder filling and
voiding
urethral stricture
manifestation of renal trauma (1)
hematuria
diagnostic studies for renal trauma (5)
- urinalysis
- ultrasound
- CT
- MRI
- renal arteriogram
treatment for renal trauma (4)
- rest
- fluids
- pain meds
- possible surgery to repair or remove
- Cortex and medulla filled with thin-walled cysts that destroy surrounding tissue by compression
- Cysts are filled with fluid; may have blood or pus
polycystic kidney disease
S+S polycystic kidney disease (4)
- hematuria
- hypertension
- back/side/abdomen pain
- UTI/kidney stones
2 diagnostic studies for polycystic kidney disease
CT
ultrasound
pathophysiology of urinary incontinence (DRIP)
D: delirium, dehydration, depression
R: restricted mobility, rectal impaction
I: infection, inflammation
P: polyuria, polypharmacy
most common heathcare associated illness/infection
CAUTI
