Nephritis Flashcards
The functioning unit of the kidneys is…
Nephrons
Inflammation of the kidneys is called…
Nephritis
The inflammation of the glomerular capillary membrane is…
Glomerulonephritis
This type of nephritis is caused by a response to a streptococcal infection such as strep throat, and impetigo. Other infections include: staph, pneumococcus, and coxsackie virus
Acute post-infectious glomerulonephritis (APIGN)
With APIGN the patient will have an abrupt onset of….
Hematuria, Proteinuria, azotemia, salt and water retention, periorbital edema, HTN
In APIGN the onset usually occurs around _______ days after the initial infection.
The patients urine will be
10-14 days
Tea/coca-cola colored
This form of nephritis is an abrupt result of an immune complex reaction in the glomerular capillary wall.
Acute Proliferative glomerulonephritis
APGN has antibody-antigen complexes that lodge in glomeruli leading to….
Inflammation/obstruction
Vascular permeability is decreased leading to leaking of protein and RBC’s
This form of glomerulonephritis is considered “end stage”
Chronic glomerulonephritis
Chronic glomerulonephritis is usually seen in what other conditions?
RPGN, Lupus Nephritis, and diabetic neuropathy
In chronic glomerulonephritis the patient will have a ____ decline in renal fx. The kidneys will be _____ symmetrically and surfaces become _____.
This disease is not often recognized until ____ develops
reduced (small)
rough
renal failure
____ nephritis is caused by a patients disorder of SLE. This happens due to the autoimmune attacks on the kidney. This is one of the more severe consequences of SLE.
Lupus
Manifestations of Lupus nephritis are:
Hematuria, and proteinuria
Progression of Lupus nephritis may be ___ or ____ with a rapid development of renal failure.
Acute/Chronic
This type of nephritis is caused by a rare autoimmune disorder characterized by a formation of antibodies to the glomerular basement membrane.
Goodpasture Syndrome
In a person with goodpasture syndrome, if the basement membrane gets damaged this causes damage to the ____ which leads to ____ _____
alveoli
Pulmonary hemorrhage
Goodpasture syndrome is seen in what ages?
And is more prevalent in….
20-30, and 60 years
White males
Manifestations of goodpasture syndrome include:
Hematuria, proteinuria, edema
In goodpasture syndrome progression to ___ is rapid.
ARF (acute renal failure)
This type of nephritis is caused by injury to the renal tubules and interstitium, secondary to glomerular damage.
Tubulointerstitial Nephritis
Tubulointerstitial nephritis can be caused by
drugs, toxins, radiation, or renovascular disease
RF for Nephritis are:
HTN, SLE, DM, Infections, OTC meds such as NSAIDS,
Trauma, Sickle cell, AIDS, CHF, Anemia.
Nephritis can be prevented by:
Washing hands
Controlling BP and diabetes
Not smoking
Maintaining healthy weight (exercise)
Glomerulonephritis is usually asymptomatic. It may also have manifestations of
fever, mild periorbital edema, hematuria, oliguria
What pulmonary signs of edema will the nurse see in a person with glomerulonephritis?
pleural effusion, dyspnea, cough, and crackles
diagnostic tests include:
- -Throat/skin culture (group A strep)
- -ASO titer- (+)
- -ESR (inflammation)- increased with APIGN, and lupus nephritis
- -KUB- rule out other causes (acute-kidneys enlarged, chronic- small)
- -Biopsy- most reliable (Tell type of nephritis, prognosis, and tx. needed)
- -GFR- reduced (#1 indicator)
- -BUN-increased (up to 50- mild azotemia, >100- severe renal impairment)
- -Creatinine-increased (level >4 = impaired renal fx.)
- -serum electrolytes (increased K+)
- -albumin (low)
- -UA (check for RBC, and protein in urine)
This med can be given to manage HTN and edema by pulling fluids.
furosemide
These can be given to eradicate any bacteria causing agents, that can cause APIGN, SLE, Goodpasture
Antibiotics
This med can be given to reduce inflammation.
corticosteroid (prednisone)
Given in large doses (1mg/kg)
These drugs can be given to suppress the immune system so it doesn’t attack itself (SLE)
Immunosuppressants (cyclophosphamide, azathioprine, mycophenolate)
This drug must be avoided with APIGN because it may worsen the condition.
Corticosteroids
These meds can help reduce protein loss and slow the progression of nephritis
ACE inhibitors, and ARBS
These meds can be given to help with HTN
Antihypertensives (lol drugs)
Non pharm tx. for Glomerulonephritis are:
- -Bed rest (acute)
- -Fluid restrictions
- -dietary restrictions (reduce Na+, K+ intake)
If a patient has azotemia this may need to be limited in their diet
Protein
Examples of complete proteins are:
milk, eggs, cheese, meats, poultry, fish, soy
Examples of incomplete proteins are:
breads, cereals, grains, legumes, seeds, nuts
This procedure can be done in combination with immunotherapy to treat RPGN, and Goodpasture. It is done by removing damaging antibodies from the plasma.
Plasmapheresis
Three nursing Dx. for a person with glomerulonephritis can be…
- -Risk for infection
- -Fluid volume overload
- -Imbalanced nutrition
The nurse must monitor the patients…
- -VS
- -UOP (color. clarity, smell)
- -daily weight
Normal urinary output is…
A patient with glomerulonephritis should have a UOP of at least….
- -1 ml/kg/hr
- -0.5 mL/kg/hr
What care should the nurse implement when caring for a patient with glomerulonephritis?
- -fluid restriction
- -Q2 turns if immobile
- -Pad bony areas
- -promote nutritional balance
- -prevent fatigue
- -Promote self esteem
The nurse should prevent infection by…
- -Washing hands
- -avoiding invasive procedures
- -use a closed drainage system for urinary catheter
- -limit visitors
when a person is on a low Na+ diet they should be informed not to use ____. These products contain KCl and can cause salt to go up.
Salt substitutes
If a pt. has salt and water retention. they may present with HTN, hematuria, mild/moderate edema. The nurse should provide what clinical therapies?
- -Diuretics
- -Antihypertensives
- -Na+ restriction
- -Low protein diet
If a pt. has severe HTN they will present with extremely high BP with cerebral dysfunction. What is the clinical therapy for this pt?
–emergency care that includes IV diazoxide, hydralazine, or labetalol
If patient presents with an infection. They will have a fever, edema, and malaise. What is the clinical therapy the nurse can perform?
- -antibiotics
- -bed rest
- -low Na+ diet
- -antipyretics
