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MS2 Exam 1 > Renal Disease > Flashcards

Renal Disease Flashcards

1
Q

Primary Functions of the Kidneys

A
  • Maintain acid-base balance
  • Filter and excrete waste products of body metabolism
  • Control fluid and electrolyte balance
  • Regulate BP
  • EXCRETE bacterial toxins, water soluble drugs and drug metabolites (the wastes you dont need, when working properly)
  • SECRETE renin and erythropoietin
  • Synthesize Vit D
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2
Q

Blood urea nitrogen

A
  • end product of protein metabolism
  • what level of protein is being left in the blood and not being excreted
  • will tell you if there may be renal problems OR dehydration, high protein diet, infection and stress, steroid use, GI bleed, anything that causes muscle breakdown
  • 8 to 20 mg/dL
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3
Q

Serum creatinine level

A
  • End product of muscle cell metabolism
  • only affected by renal disease
  • 0.7 to 1.4 mg/dL
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4
Q

Creatinine clearance test

A

-evaluates how well kidneys remove creatinine from the blood

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5
Q

Uric acid test

A
  • 24 hour collection to diagnose gout and kidney disease

- 2.5 to 8.0 mg/dL

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6
Q

KUB

A

kidneys, ureters, bladder

-xray to detect urinary calculi

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7
Q

Bladder ultrasonography

A
  • noninvasive method to measure volume of urine in bladder

- bladder scanning is a form of this

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8
Q

Intravenous pyelogram

A

to visualize and identify abnormalities in the renal system

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9
Q

Renal angiography

A

to examine the renal blood vessels and renal arterial supply

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10
Q

Renal scanning

A

visual imaging of renal blood flow, glomerular filtration, tubular function and excretion

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11
Q

Cystoscopy and biopsy of the bladder

A

Mucosa examined for inflammation, calculi, tumors

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12
Q

Renal biopsy

A

needle sample of tissue for examination

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13
Q

urinalysis

A

test for evaluation of renal system and renal disease

-can be done as a dip stick test

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14
Q

specific gravity

A

measures the ability of kidneys to concentrate urine

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15
Q

The BUN can have inaccurate results based on a patients hydration status

TRUE OR FALSE?

A

True

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16
Q

Glomerular Filtration Rate

A
  • Strong determinant of renal function
  • Measures the plasma volume that can be cleared of any given substance within a certain time frame

N: 125 mL/min

-GFR formula derived from plasma creatinine, BUN, BP, gender, and age much more specific

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17
Q

UTI

A

Urinary Tract Infection

  • 2nd most common bacterial disease
  • Highest in women
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18
Q

Two Classifications of UTIs

A
  1. Upper and lower UTI

2. Complicated or uncomplicated

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19
Q

Upper and Lower UTI Classifications

A
  • Pyelonephritis (upper)
  • Cystitis and urethritis (lower)
  • May lead to urosepsis
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20
Q

Complicated or uncomplicated UTI

A
  • involves only the bladder (uncomplicated)

- involves coexisting conditions (complicated)

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21
Q

Antibiotics for UTI

A
  • Trimethoprim/sulfamethazaxole
  • Nitrofurantoid/Macrodantin
  • Fluoroquinolones (Cipro, Levequin, Floxin)
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22
Q

Trimethoprim/sulfamethazaxole

A
  • Bactrim, TMP
  • uncomplicated or initial infection
  • inexpensive
  • BID
23
Q

Nitrofurantoid/Macrodantin

A

-3 to 4 times a day

24
Q

Fluoroquinolones (Cipro, Levequin, Floxin)

A

complicated UTI’s

25
Urinary analgesia
- used in conjuction with antibiotics - soothing effect on urinary tract - pyridium - urised
26
pyridium
- stains urine reddish orange | - OTC
27
urised
-preparations with methylene blue tint urine blue or green
28
Upper UTIs
- renal parenchyma, pelvis, ureters - typically causes fever, chills, flank pain - pyelonephritis
29
Lower UTIs
- LUTS (Lower Urinary Tract Symptoms) * Emptying symptoms * Storage symptoms
30
Emptying symptoms
- hesitancy - intermittency - post void dribble - pain on urination
31
Storage symptoms
- urinary frequency - urgency - incontinence - nocturia
32
Acute Pylonephritis
- commonly starts in renal medulla and spreads to adjacent cortex (Upper UTI) - mild fatigue to chills, fever, vomitting - urinalysis, C and S, CBC, Blood culture - IVP, CT - Broad spectrum antibiotics then sensitivity guided therapy - Fluorquinolones
33
Chronic Pyelonephritis
- kidneys small, atrophic, shrunken, decreased function due to scarring or fibrosis - AKA reflux nephropathy (backward flow), chronic atrophic - Often progresses to end-stage renal failure
34
Lower UTI's
- inflammation of the bladder wall (cystitis) - inflammation of the urethra (urethritis) - major source of nosocomial infections (40-45%)
35
urethritis
- bacterial or viral - Trichomonas, monilial infection, chlamydial infection, gonorrhea - STDs
36
Obstructive Uropathies
- Urinary Tract Calculi - Strictures - Renal Trauma
37
Glomerulonephritis
- immunological disorder - 3rd leading cause of renal failure - multiple types and classifications "something happens and then you get it..."
38
Urolithiasis
***kidney stones - caused by urinary stagnation or super-saturation of urine with poorly soluble crystalloids - most stones originate in the kidney and move distally before becoming lodged in narrow areas
39
Clinical Manifestations of glomerulonephritis
- HA - high BP - facial/periorbital edema - lethargic - low grade fever - weight gain (edema) - proteinuria - hematuria - oliguria - dysuria
40
Types of Kidney Stones
- Calcium - Struvite - Uric Acid - Cystine
41
Calcium kidney stones
associated with increased Ca+ intake, hyperparathyroidism, hyperuricosuria, hypomagnesuria
42
Struvite
due to increased ammonia levels found in renal failure, chronic UTI, urine PH >7
43
Uric Acid
found with gout and malignancies with rapid cell turnover
44
Cystine
renal tubule reabsorption of sulfur containing amino acids
45
Nursing Indications for kidney stones
- Flank Pain - hematuria - N/V - dysuria - urinary frequency - Increase hydration - dietary changes - treat underlying causes - antimicrobial agents - alkalinize urine (endourologic, lithotripsy, surgery)
46
Nursing Goals for UTIs
- symptomatic relief | - teaching and prevention
47
Teaching and Prevention of UTIs
- showers better than baths - perineal cleansing front to back - voiding after intercourse - anti-microbial therapy - no scented toilet paper - no perfumes to perineal area - empty bladder regularly
48
Manifestations for Cystitis
- frequency - urgency - suprapubic Pain - dysuria - hematuria - fever - confusion in OA
49
Manifestations of Pyelonephritis
- flank pain - dysuria - pain at costovertebral angle - same S/S as cystitis
50
Tx for UTIs
- anti-microbials - increase fluid intake - prevention
51
Fluorquinolones
- cipro - floxin - noroxin - tequin
52
Cystitis
inflammation of the bladder wall
53
Sx of the urinary tract
- nephrectomy - urinary diversion (incontinent and continent) - orthotopic bladder reconstruction

MS2 Exam 1 (13 decks)

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