Problems of Urinary Function: Renal and Urological Flashcards
What is the functions of the kidney?
- Urine formation
- Excretion of waste products
- Regulation of electrolytes
- Regulation of acid-base balance
- Control of water balance
- Control of blood pressure
- Renal clearance
- Regulation of red blood cell production
- Synthesis of vitamin D
- Secretion of prostaglandins
What is a UTI?
inflammation of the urinary tract
What is the most common pathogen if bacterial?
e-coli
What is acute pyelonephritis?
Inflammation of the renal parenchyma and collecting system
Most common cause is bacterial infection
What is glomerulonephritis?
- Immune-related inflammation of the glomeruli
- Characterized by proteinuria, ↑ BUN and Creatinine, hematuria, ↓ urine production, edema
What post-streptococcal glomerulonephritis (APSGN)?
Develops 5-21 days after an infection of the pharynx or skin
- most common in children and young adults
What is the signs and symptoms of post-streptococcal glomerulonephritis (APSGN)?
generalized edema, periorbital edema, hypertension, oliguria, hematuria (cola-coloured urine), proteinuria, abd or flank pain, sometimes no symptoms
What is the diagnosis and treatment of post-streptococcal glomerulonephritis (APSGN)?
- Elevated BUN and Creatinine
- supportive care and dietary modifications (sodium & protein restriction)
What is the two types of glomerulonephritis?
- post-streptococcal glomerulonephritis (APSGN)
- chronic glomerulonephritis
What is chronic glomerulonephritis?
- may be discovered during a routine eye exam
- May be discovered with hypertension or ↑BUN and creatinine
- some patients are asymptomatic for years; as glomerular damage increases, signs and symptoms of renal insufficiency and renal failure
What is the signs and symptoms of chronic glomerulonephritis?
- Nosebleed, stroke, seizure - may be related with disease.
- Headaches, dizziness, and digestive disturbances are common.
- Loss of weight and strength, increasing irritability, increased need to urinate at night.
What is the diagnosis and treatment of chronic glomerulonephritis?
Diagnosis: renal biopsy, u/s, CT scan
Abnormal laboratory tests: Hyperkalemia, anemia, ↑serum phosphorus, decreased serum calcium, hypermagnesemia, urine with fixed specific gravity, casts, and proteinuria; and hypoalbuminemia, elevated bun and creatinine
Treatment: hypertension and UTI’s should be treated vigorously, protein and phosphate restrictions
what is the management of acute glomerulonephritis?
- Early Dx and Tx of sore throats/skin lesions
- Focus on symptom relief
- Rest
- I/O – strict measurement and documentation.
- Fluid and dietary restrictions
- Protein intake restriction
- Antibiotics – strep infection
- Patient education
- Follow-up care
What is the management of chronic glomerulonephritis?
- Potential fluid and electrolyte imbalances
- Signs and symptoms of deterioration of renal function.
- Emotional support
- Teaching self-care
- Daily weights and diuretics as needed.
- Adequate calories, proteins of high biologic value (dairy products, eggs, meats) promote good nutritional status.
- Dialysis may be considered early in the course of disease.
What is the nephrotic syndrome?
Any condition that seriously damages the glomerular membrane and results in increased permeability to plasma proteins
What is the signs and symptoms of nephrotic syndrome?
- peripheral edema, proteinuria, dyslipidemia, hypoalbuminemia (ascites)
- abnormal lab tests: ↓ albumin, ↓ serum protein, ↑ cholesterol
What is the medical management of nephrotic syndrome?
symptomatic, relieve edema (salt restriction), thiazide or loop diuretics, lipid-lowering angents, corticosteroids
What is urolithiasis?
Presence of calculi in the urinary tract
What is the etiology and pathophysiology
- Metabolic, dietary, genetic, climate, lifestyle & occupational influences
- Crystals unite to form a stone, calculus
What is the clinical management of urinary tract calculi?
- Usually asymptomatic until passed into lower urinary tract, causing excruciating pain from muscle spasms (renal colic).
- Pain when stone is moving, or urine flow is blocked
- Pallor, flank pain & diaphoresis often accompany pain.
- Hematuria may be present, nausea, vomiting, fever, chills
What is the collaborative care for urinary tract calculi?
- Manage acute attack and evaluate cause of stone formation, prevention
- Surgical therapy
- Nutritional therapy
What is nephrolithiasis?
kidney stones
- renal calculi
What is the diagnosis of urolithiasis?
- KUB (Kidneys, ureters, bladder x-ray)
- Ultrasound, CT scan
- IVP (intravenous pyelogram)
- Keep pt NPO in case taken to OR after
What is the treatment of urolithiasis?
- Do not over hydrate in initial phase to ease passage (decrease urine pushing).
- Strain urine, send stones to lab for analysis.
- Analgesics, antispasmotics.
- Stent insertion - tube to facilitate passage inserted in OR.
What is lithotripsy?
Extracorporeal shock wave lithotripsy (ESWL) - shock waves used to disintegrate stone
- when a kidney stone is too large to pass on its own
What is polycystic kidney disease?
Cortex and medulla filled with thin-walled cysts that enlarge and destroy surrounding tissue by compression
Two forms: adult and child
What is the signs and symptoms of polycystic kidney disease?
Abdominal pain, enlarged kidneys, hematuria, UTI, hypertension
What is the collaborative care of polycystic kidney disease?
No specific treatment; aim is to prevent UTIs
What is the postoperative nursing management for renal and ureteral surgery?
Assessment: include all body systems, pain, fluid, and electrolyte status; patency and adequacy of urinary drainage system
Diagnoses: ineffective airway clearance, ineffective breathing pattern, acute pain, fear and anxiety, impaired urinary elimination, and risk for fluid imbalance
Complications: bleeding, pneumonia, infection, and DVT
What is the interventions for renal and ureteral surgery?
-Encourage leg exercises, early ambulation, and monitor for signs of DVT
- watch for bleeding, promote airway clearance and effective breathing coughing
What is the patient teaching for renal and ureteral surgery?
- Instruct both patient and family
- Care of drainage system
- Strategies to prevent complications
- Signs and symptoms
- Follow-up care
- Fluid intake
- Health promotion and health screening
What is the treatment for acute pyelonephritis?
antibiotics
What is the signs and symptoms of acute pyelonephritis?
mild fatigue to sudden onset of chills, fever, vomiting, malaise, flank pain
