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pathopharm > renal > Flashcards

renal Flashcards

1
Q

kidney filters how many gallons of blood daily? how many full blood filters is that?

A

45 gallons of blood; filters all of blood 30x per day

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2
Q

how many nephrons are in each kidney

A

~1 million

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3
Q

functions of the kidney

A

filtration + detoxification; BP regulation; erythropoietin release; acid/base balance; regulating vit. D and Ca+ formation (impacts multiple systems)

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4
Q

values used to measure kidney function

A

serum creatinine and blood urea nitrogen (BUN)

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5
Q

normal serum creatinine

A

men: 0.9-1.3
women: 0.6-1.1

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6
Q

normal BUN

A

8-20

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7
Q

acute kidney injury (AKI)

A

sudden, short term loss of renal function caused by obstruction, poor circulation or kidney disease; usually reversible with proper treatment (can take up to a year for full recovery); 3 types

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8
Q

types of acute kidney injury (AKI)

A

prerenal, intrarenal, postrenal

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9
Q

prerenal AKI

A

AKI due to reduction in blood flow to kidney (hypoperfusion); could be caused by hypovolemia, hypotension, vasoconstriction, inadequate CO, or a clot; treatment: restore hydration and perfusion

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10
Q

intrarenal AKI

A

also called acute tubular necrosis(ATN); AKI due to damage to the filtering structures of the kidney; more serious than prerenal; caused by infections, autoimmune disease, or nephrotoxic medications; diagnosis: creatinine >1.3; remove underlying cause

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11
Q

nephrotoxic medications

A

NSAIDS, CT contrast dye (make sure to stay hydrated); antibiotics (ending in -mysin)

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12
Q

postrenal AKI

A

bilateral obstruction of urine outflow; caused by prostatic hyperplasia, renal calculi (stones), strictures(narrowing ureter/urethra), or tumors; look for obstructions through x-ray, ultra sound, and CT w/o dye

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13
Q

clinical manifestations of AKI

A

dec. urine output, edema, nausea, fatigue, SOB, hyperkalemia (can cause arrhythmias, MI, cardiac arrest)

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14
Q

AKI nursing care

A

IV fluids, take input+outputs; review labs, avoid nephrotoxic meds, monitor for dysrhythmias, weigh daily, assess urine flow

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15
Q

factors leading to AKI

A

nephrotoxic meds, chronic NSAID use; opioid abuse, older age, procedures requiring fasting or bowel prep

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16
Q

chronic kidney disease risk factors

A

acute kidney injury, diabetes (infection risk + inc. protein excretion), nephrotoxic meds, HTN, recurrent infections (like UTIs), smoking (dec. perfusion), obesity, high cholesterol

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17
Q

symptoms of chronic kidney disease

A

hypervolemia (dec. fluid excretion), peripheral edema, hyperphosphatemia, hyperkalemia, hypocalcemia, metabolic acidosis, anemia (low erythropoietin), peripheral neuropathy (waste product build up)

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18
Q

chronic kidney disease

A

progressive, irreversible kidney disease; 5 stages

19
Q

chronic kidney disease stage 1

A

at risk pt., kidney function normal; educate and screen for risk factors

20
Q

chronic kidney disease stage 2

A

mild chronic kidney disease; renal function begins to be impaired; testing indicates kidney disease

21
Q

chronic kidney disease stage 3

A

moderate chronic kidney disease; renal function impaired; interventions to slow development of disease (manage causes of disease)

22
Q

chronic kidney disease stage 4

A

severe chronic kidney disease, renal function severely impaired; manage complications, educate ab options

23
Q

chronic kidney disease stage 5

A

end stage kidney disease (ESKD); can’t maintain homeostasis, waste elimination severely impaired; educate pt. on options (dialysis, transplant, etc.)

24
Q

chronic kidney disease treatment

A

meds to manage symptoms: diuretics, vit. C, Ca+ reducer, erythropoietin; dialysis in stage 4+5; kidney transplant

25
Q

benign prostatic hyperplasia (BPH)

A

enlarged prostate gland; puts pressure on urethra, impeding urine flow; can be partial or complete; most common benign tumor in men

26
Q

benign prostatic hyperplasia pathophysiology

A

prostate cells inc. in # and form large nodules narrowing urethra; enzyme 5 a reductase converts testosterone to dihydrotestosterone (DHT), which induces growth factors that inc. prostate growth

27
Q

benign prostatic hyperplasia symptoms

A

nocturia, dribbling at end of stream, incontinence, urine urgency, painful urination(dysuria), hematuria, straining, incomplete bladder emptying, slow or delayed stream

28
Q

BPH treatment

A

alpha1 adrenergic blocker, 5 alpha reductase inhibitors; usually combo of both

29
Q

alpha1 adrenergic blocking agents

A

tamsulosin (flowmax); treat BPH; blocks alpha receptors in prostate-> smooth muscle relaxation in bladder and prostate

30
Q

tamsulosin (flowmax)

A

alpha1 adrenergic blocking agents; smooth muscle relaxation in bladder and prostate; may cause sleepiness, weakness, back pain, diarrhea; monitor BP (fluids), priapism; start low and word up; take 30 mins after the same meal everyday

31
Q

5-alpha reductase inhibitors

A

block conversion of testosterone to DHT to stop prostate hyperplasia

32
Q

finasteride

A

5-alpha reductase inhibitor; treat benign prostatic hyperplasia; may cause impotence, decreased libito, abd. upset, gynecomastia(breast tissue); wear gloves when giving

33
Q

transurethral resection of the prostate (TURP)

A

go through the urethra and debulk prostate; may only be a temporary fix

34
Q

renal calculi predisposing factors

A

dehydration, infection, obesity, exercise, prolonged diuretic therapy, immobility, urinary rentention

35
Q

renal calculi symptoms

A

flank pain, NV, hematuria, dysuria, urinary frequency

36
Q

most common kidney stone type

A

caldium oxalate

37
Q

renal calculi treatment

A

vigorous fluids to pass stone; diuretics (lower Ca+), analgesics

38
Q

urinary tract infection (UTI)

A

can occur anywhere in the urinary tract; most are acute, but can be chronic (can cause kidney damage); diabetes inc. risk (sugar feeds bacteria); pt. w/ catheter; women 4x as likely; e. coli is most common cause

39
Q

UTI symptoms

A

frequent, painful urination; red, dark, milky or cloudy urine; foul smelling urine; kidney pain (back); pelvic pressure; fever, fatigue, altered mental status; confusion in older adults

40
Q

sulfamethoxazole/trimethoprim (bactrim)

A

antibacterial used to treat UTIs; may cause NV, anorexia; watch for superinfection; hydrate to prevent renal calculi; take on full stomach

41
Q

nitrofurantoin (macrobid)

A

antibacterial used to treat UTIs; may interfere w/ bacterial cell wall formation of bacterial enzyme systems; monitor for pulmonary sensitivity; may cause asthma attack; may cause dark yellow or brown urine

42
Q

ciprofloxacin (cipro)

A

antibacterial used to treat UTIs; more aggressive antibiotic; may cause ND; monitor I&O; do not take with milk

43
Q

phenazopyridine (pyridium)

A

analgesic to relieve UTI pain; stops spasm; can turn urine orange or red (normal); only take for <2 days; take after meal; still need an antibiotic

pathopharm (7 decks)

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