Med Flashcards
Radiologic study to evaluate structure, function of KUB
Using radiographs and radiopaque dye
Force fluids after to excrete dye
Intravenous pyelography
Visualization of complete ureter, renal pelvis needed.
Performed during cystoscopy
Carries risk of sepsis, severe UTI
Retrograde pyelography
Evaluates the bladder structure abnormalities, filling.
Cystogram
Rapid series of x rays while voiding
Contradicted in UTI
Voiding cystourethrography
Evaluate bladder, renal function, assess cause of reduced urinary flow, urinary retention or incontinence.
Uroflowmetry, cystometrography
Urodynamic studies
BUN normal range
7-20
GFR normal range
90 or greater
Inflammation in glomeruli believed to be from antigen antibody stimulation in the glomerular membrane which changes the membrane permeability. More common in males
More common in children and young adults.
Proceeded by strep or viral inf
Acute glomerulonephriris/ Bright’s disease
Hematuria and proteinuria is a S/S of
Acute glomerularnephritis/Brights disease
How do you dx acute glomerularnephritis/brights disease
Proteinuria
Elevated ASO titer
Percutaneous renal biopsy
Tx for acute glomerularnephritis/Bright’s disease
Tx SS
Bed rest until BUN decreases and hematuria decreases
Low sodium diet and dec fluids if needed
Diuretics/ antihypertensives/ steroids
i&O and weights
Nursing care for acute glomerularnephritis/ Bright’s disease
Inc urine output and dec wt means patient is improving.
VS monitor BP
Sodium and protein diet restriction
BR
Pt not cured till urine free of protein and RBC for 6 mo
Causes of ____ ____ causes are autoimmune connective tissue disorders (lupus) resulting in scar tissue that replaces nephrons and may progress in renal failure
Slow progressive disease in which there is inflammation of the glomeruli that causes irreversible damage to nephrons
Chronic glomerulonephritis
S/S of ___ ___ may not have SS for years
Anasarca- which is caused by a fluid shift and protein (albumin) is lost in urine.
Ss of renal failure
DX- dec RBC
Azotemia- nitrogenous waste in blood
Protein and casts in urine
Early stages percutaneous kidney bx
TX: symptomatic
Dec edema, and bp
Prevent CHF, correct fluid and electrolyte prob, eliminate UTI
May eventually require dialysis or kidney transplant
Chronic glomerulonephritis
___ ___ ___ inherited as autosomal dominant trait, infantile (rare) and adult forms, formation of multiple bilateral kidney cysts. They cause kidneys to greatly enlarge as cysts accumulate fluids
*hypertension, pain, colic. Hematuria, renal stones
Dx findings:
Abd US, CT, MRI, IVP, labs
Tx- no cure, tx HTN, *avoid all nephrotoxic meds-nsaids/cephalosporins
Surgical removal of kidney, dialysis, transplant
Monitor BP, I&O and labs
Polycystic renal disease
Stones in urinary tract
Urolithiasis
Stone in kidneys
Nephrolithiasis
Stones in ureters
Ureterlithiasis
Chronic ureteral stone formation; compressive congenital anomalies of conditions
S/S flank pain or discomfort, tenderness
DX: voiding cystourethrogram, ultrasonography
Tx: dilation ureteroplasty(remove narrow section of ureter and put good parts together)
Typical post op care, I&O, assess for shock pain SS of UTI
Ureteral stricture
___ ___ are typically malignant
*painless hematuria, flank pain, palpable mass.
Tumor cells often metastasize to *lungs, bone, lymph, liver, and brain by way of renal vein and vena cavae
Dx finding/ PE, radiography, IVP, cystoscopy w retrograde pyleogram, ultrasonography, MRI, CT, renal angiography
Med management: nephrectomy; radiation therapy; chemotherapy, palliative tx for metastases
*wilms rumor in children do not palpate
Kidney tumors
Nurse care: discourage laying on operative side, monitor I&O, pain, bleeding. Encourage fluids, irrigate tubes/catheter or ordered
___ ___ is the inability of nephrons in kidneys to maintain fluid/electrolyte & acid base balance: excrete waste products and to perform their regulation of body
Acute: ARF, sudden, rapid decrease in renal function
Chronic: CRF, progressive, irreversible, takes years to develop
Renal failure
__ ___ ___ develops due to prerenal, intrarenal, and post renal disorders.
Acute renal failure
___ ___ ___ usuAlly is caused by intrarenal conditions or systemic diseases
ESRD- less than 10% of kidney function and pt require dialysis. GFR less than 15
Damage to nephrons is slow and often do not notice declining renal function.
Uremia, hyponatremia, electrolyte imbalances-metabolic acidosis, uremic frost-skin acts as excretory organ and precipitation-irritation of skin and smells bad.
Chronic renal failure
SS H/A blurred vision, Tiredness Inability to concentrate Inc BP Dec urine output Facial puffiness Dry itchy skin Odor of urine
Dx of chronic renal failure
Inc BUN, creatine, K, MG, Ph Dec GFR Dec CA, RBC, h&h, GFR blood ph is acidotic Renal Bx
Tx: prevention
ARF promptly tx cause
Hemodialysis/peritoneal dialysis
Kidney transplant
Medical TX
IV fluids, vasodilator, diuretic, dopamine, temp hemodialysis while tubules regenerate, protein K, NA, ph restriction.
-protein restriction helps decrease urea build up in body. NA polystyrene sulfonate (po/rectal)
IV glucose and insulin to move K back into the cells
Epogen inj- inc o2 compacity of RBC
