Renal Flashcards
1
Q
involuntary urination in children >4yo
A
enuresis
2
Q
high BUN & creatinine
A
azotemia
3
Q
swelling of one or both kidneys
A
hydronephrosis
4
Q
GFR requiring adjustment of med dosages
GFR requiring dialysis
A
60
10-15
5
Q
URINARY TRACT OBSTRUCTION
explanation
etiology
s/s
dx test
A
- Blockage that inhibits flow of urine through normal pathway
- Etiology - urolithiasis; BPH; tumor
- s/s - fever; n/v; flank pain; difficulty starting stream; limited urine; hydronephrosis
- Blunt percussion to the kidney causing pain indicates hydronephrosis
6
Q
RENAL CALCULI
explanation
etiology & types
r/f
s/s
complication
A
- Urolithiasis - usually made of calcium or uric acid (also struvite, crystalline) - form inside kidney & can travel through UT
- Etiology - varies on type
- Struvite - infection
- Uric acid - gout
- r/f - dietary; infection; ↑ uric acid; genetics
- s/s - hydronephrosis; unilateral flank pain; n/v; retching with waves of pain; dysuria; hematuria; frequency with small voids; hesitancy
- More painful & complicated if stone gets stuck in ureter
7
Q
CYSTITIS
etiology
r/f
s/s
A
- “UTI” or “bladder infection”
- Etiology - usually E. coli
- r/f - aging (loss of estrogen, skin changes around vulva); young girls; female; Foley; incontinence; sexual activity
- s/s - dysuria; frequency; hematuria; cloudy urine; malodorous urine; confusion in older pts
8
Q
PYELONEPHRITIS
etiology
r/f
s/s
A
- “Kidney infection”
- Etiology - often ascends from bladder; usually E. coli
- r/f - frequent UTI; reflux; catheter use; enlarged prostate; CKD; kidney stones; DM; immunocompromise
- s/s - systemic - fever; n/v; malaise; colicky flank pain, waves of nausea; chills; dysuria (burning with urination); malodorous urine; hematuria; urgency; frequency; pyuria
9
Q
STRESS INCONTINENCE
explanation
etiology
r/f
s/s
A
- Physical activity puts pressure on bladder
- Etiology - sphincter & pelvic muscles are stretched out and weak
- r/f - pregnancy; childbirth; obesity
- s/s - loss of urine with standing up, laughing, coughing, sneezing, lifting, sex, exercise
10
Q
OVERFLOW INCONTINENCE
explanation
etiology
r/f
s/s
A
- Overfull bladder
- Etiology - nerve damage affecting ability to sense fullness; blockage in urinary tract; weak detrusor muscle; medications
- r/f - enlarged prostate; kidney stones; neurological damage; tumors; DM; MS; trauma
- s/s - leaking urine without sensation of fullness__, with full bladder
11
Q
URINARY RETENTION
explanation
etiology
r/f
s/s
A
- Inability to completely empty bladder
- Etiology - nerve damage affecting ability to sense fullness; blockage in urinary tract; weak detrusor muscle
- r/f - recent surgery, especially to bladder; neurological damage; blockage; structural
- s/s - inability to empty bladder despite fullness
12
Q
NEPHROTIC SYNDROME
explanation
etiology
r/f
s/s
A
- Too much protein excretion
- Etiology - damage to basement membrane - ↑ permeability of capillary wall
- r/f - infection; CKD; DM; lupus; medications
- s/s - proteinuria; edema; foamy urine; wt gain, ascites, puffy face (fluid leaving vascular compartment); fatigue; loss of appetite; hypoalbuminemia; HLD (liver’s response to hypoalbuminemia); ↓ antithrombin 3 (hypercoagulative state)
13
Q
GLOMERULONEPHRITIS - NEPHRITIC SYNDROME
explanation
etiology
r/f
s/s
A
- Inflammation of glomerulus; Damage to basement membrane - larger molecules (RBCs, WBCs) able to enter filtrate
- Etiology - autoimmune, type 3 hypersensitivity - complexes get stuck in glomerulus & cause damage
- r/f - infection; immune disease; vasculitis; DM; HTN
- s/s - severe hematuria (cola colored)__; pyuria__; proteinuria; edema; HTN; oliguria
14
Q
3 types of acute kidney injury
A
- Prerenal - blood flow to kidney
- Intrarenal - within kidney
- Postrenal - ureters, bladder, urethra
15
Q
PRERENAL AKI
etiology
r/f
s/s
A
- Sudden renal hypoperfusion
- r/f - hemorrhage/blood loss__; HF; sepsis; severe dehydration; severe burns; pancreatitis; hepatitis; blood loss in surgery, injury
- s/s - hypovolemia; thirst; ↓ urine; dizziness; ortho hypotension; v/d; hemorrhage
33
Q
HEMODIALYSIS
function
accessed how?
performed when?
A
- Filters wastes and water from blood
- Helps control BP, balance K, Na, Ca
- Vascular access - ONLY use for dialysis
- Arteriovenous (AV) fistula
- AV graft
- Catheter
- 3x/week for 4 hours
34
Q
PERITONEAL DIALYSIS
uses what?
how to use?
accessed how?
A
- Uses peritoneum to filter blood
- Must empty used solution & refill with fresh solution 4-6x/day
- Surgical catheter placement
