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Nursing Theory IV A- Cindy'S Class > Problems of Urinary Function: Renal and Urological > Flashcards

Problems of Urinary Function: Renal and Urological Flashcards

1
Q

What is the functions of the kidney?

A
  • 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
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2
Q

What is a UTI?

A

inflammation of the urinary tract

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3
Q

What is the most common pathogen if bacterial?

A

e-coli

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4
Q

What is acute pyelonephritis?

A

Inflammation of the renal parenchyma and collecting system
Most common cause is bacterial infection

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5
Q

What is glomerulonephritis?

A
  • Immune-related inflammation of the glomeruli
  • Characterized by proteinuria, ↑ BUN and Creatinine, hematuria, ↓ urine production, edema
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6
Q

What post-streptococcal glomerulonephritis (APSGN)?

A

Develops 5-21 days after an infection of the pharynx or skin
- most common in children and young adults

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7
Q

What is the signs and symptoms of post-streptococcal glomerulonephritis (APSGN)?

A

generalized edema, periorbital edema, hypertension, oliguria, hematuria (cola-coloured urine), proteinuria, abd or flank pain, sometimes no symptoms

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8
Q

What is the diagnosis and treatment of post-streptococcal glomerulonephritis (APSGN)?

A
  • Elevated BUN and Creatinine
  • supportive care and dietary modifications (sodium & protein restriction)
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9
Q

What is the two types of glomerulonephritis?

A
  1. post-streptococcal glomerulonephritis (APSGN)
  2. chronic glomerulonephritis
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10
Q

What is chronic glomerulonephritis?

A
  • 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
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11
Q

What is the signs and symptoms of chronic glomerulonephritis?

A
  • 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.
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12
Q

What is the diagnosis and treatment of chronic glomerulonephritis?

A

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

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13
Q

what is the management of acute glomerulonephritis?

A
  • 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
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14
Q

What is the management of chronic glomerulonephritis?

A
  • 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.
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15
Q

What is the nephrotic syndrome?

A

Any condition that seriously damages the glomerular membrane and results in increased permeability to plasma proteins

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16
Q

What is the signs and symptoms of nephrotic syndrome?

A
  • peripheral edema, proteinuria, dyslipidemia, hypoalbuminemia (ascites)
  • abnormal lab tests: ↓ albumin, ↓ serum protein, ↑ cholesterol
17
Q

What is the medical management of nephrotic syndrome?

A

symptomatic, relieve edema (salt restriction), thiazide or loop diuretics, lipid-lowering angents, corticosteroids

18
Q

What is urolithiasis?

A

Presence of calculi in the urinary tract

19
Q

What is the etiology and pathophysiology

A
  • Metabolic, dietary, genetic, climate, lifestyle & occupational influences
  • Crystals unite to form a stone, calculus
20
Q

What is the clinical management of urinary tract calculi?

A
  • 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
21
Q

What is the collaborative care for urinary tract calculi?

A
  • Manage acute attack and evaluate cause of stone formation, prevention
  • Surgical therapy
  • Nutritional therapy
22
Q

What is nephrolithiasis?

A

kidney stones
- renal calculi

23
Q

What is the diagnosis of urolithiasis?

A
  • KUB (Kidneys, ureters, bladder x-ray)
  • Ultrasound, CT scan
  • IVP (intravenous pyelogram)
  • Keep pt NPO in case taken to OR after
24
Q

What is the treatment of urolithiasis?

A
  • 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.
25
Q

What is lithotripsy?

A

Extracorporeal shock wave lithotripsy (ESWL) - shock waves used to disintegrate stone
- when a kidney stone is too large to pass on its own

26
Q

What is polycystic kidney disease?

A

Cortex and medulla filled with thin-walled cysts that enlarge and destroy surrounding tissue by compression
Two forms: adult and child

27
Q

What is the signs and symptoms of polycystic kidney disease?

A

Abdominal pain, enlarged kidneys, hematuria, UTI, hypertension

28
Q

What is the collaborative care of polycystic kidney disease?

A

No specific treatment; aim is to prevent UTIs

29
Q

What is the postoperative nursing management for renal and ureteral surgery?

A

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

30
Q

What is the interventions for renal and ureteral surgery?

A

-Encourage leg exercises, early ambulation, and monitor for signs of DVT
- watch for bleeding, promote airway clearance and effective breathing coughing

31
Q

What is the patient teaching for renal and ureteral surgery?

A
  • 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
32
Q

What is the treatment for acute pyelonephritis?

A

antibiotics

33
Q

What is the signs and symptoms of acute pyelonephritis?

A

mild fatigue to sudden onset of chills, fever, vomiting, malaise, flank pain

Nursing Theory IV A- Cindy'S Class (17 decks)

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