Renal Disorders 2

Question 1

UTO

Answer 1

interference with flow of urine
causes urine to accumulate behind obstruction leading to damage to organs

backs up into kidneys

Question 2

where can UTO’s occur

Answer 2

anywhere in UT

Question 3

kidney stones

Answer 3

masses of crystal and protein

crystals made of stone forming substances

Question 4

what is the most common cause of UTO

Answer 4

kidney stones

Question 5

kidneys stones in men

Answer 5

distal- see slower streak, maybe scarring
no significant damage
above prostate, bladder affected

Question 6

patho of kidney stones

Answer 6

crystals made up of stone forming substances trapped within urinary tract and accumulate other crystals –> stones

Question 7

contributing factors of kidney stones

Answer 7

pH of urine- affects solubility

high urinary conc. of stone forming substance

Question 8

types of kidney stones

Answer 8

calcium oxalate or phosphate
struvite
uric acid

Question 9

calcium oxalate is most common in

Answer 9

men

Question 10

etiology of calcium oxalate

Answer 10

idiopathic
inc leves of Ca causes formation
people who are immobile- Ca buildup

Question 11

struvite is most common in

Answer 11

women

precipitated by inf

Question 12

etiology of uric acid

Answer 12

inc urine acid production in body by diet

high purine diet, high meat, fish, poultry, gout

Question 13

CM for kidney stones

Answer 13

pain
N/V
hematuria
s&s of UTI

Question 14

complication of kidney stones

Answer 14

can travel, cause irritation to binary tract. jagged crystals are painful

Question 15

diagnostic tests for kidney stones

Answer 15

urine pH
xRay of abd., IVP, ultrasound
stone analysis- determines cause

Question 16

treatment for kidney stones

Answer 16

pain meds
anx if inf
fluids
dec dietary intake of comp. in stone
ultrasonography or laser lithotripsy
surgery

Question 17

neurogenic bladder

Answer 17

functional obstructive condition caused by dysfunction in nerve supply to bladder. problem can occur at CNS or at level of spinal cord.

not physical obstruction

Question 18

patho of neurogenic bladder

Answer 18

paralysis of bladder interferes with normal flow of urine and emptying of bladder

Question 19

CM of neurogenic bladder

Answer 19

urgency/frequency
incontinence
dribbling of urine
urine retention

Question 20

diagnostic tests for neurogenic bladder

Answer 20

ultrasound
cystoscopy
urodynamic studies

Question 21

treatment for neurogenic bladder

Answer 21

bladder training
kegel exercises
catheters
manual compressions
surgery

Question 22

acute renal failure

Answer 22

rapid decline in kidney “f” leading to azotemia
when azotemia symptomatic= uremia

dec UO < 400 cc/24hrs. (oliguria)

Question 23

Bun, Cr levels for acute renal failure

Answer 23

high

Question 24

etiology of acute renal failure

Answer 24

surgery

1. prerenal
2. intrarenal
3. postrenal

Question 25

prerenal

Answer 25

conditions outside kidneys that impair renal bld flow and cause dec glomerularr perfusion or dec GFR

Question 26

causes of prerenal

Answer 26

dec VV
dec CO
intravascular pooling of bld/ peripheral vasodilation
inc renal vas. resistance or an obstruction

Question 27

intrarenal

Answer 27

actual damage to renal tissue

Question 28

causes of intrarenal

Answer 28

prolonged prerenal problem
infection
nephrotoxins
intravascular hemolysis
myoglobinuria

Question 29

postrenal

Answer 29

mechanical obstruction of urinary outflow

anuria < 200ml/ day

Question 30

causes of postrenal

Answer 30

calculi formation
prostatic hypertrophy
trauma

Question 31

patho of acute renal failure

Answer 31

1. renal vasoconstriction
2. cellular edema
3. dec glomerular capillary perm.
4. intratubular capillary permeability
5. leakage of glomerular filtrate

Question 32

stages of CM of acute renal failure

Answer 32

oliguric phase
diuretic phase
recovery phase

Question 33

oliguric phase

Answer 33

UO < 400 ml/24hrs
urinary changes
fluid vol excess
metab. acidosis
elyte imbalance

Question 34

elyte levels in acute renal failure

Answer 34

dec Na
inc K
dec Ca
inc phosphate

Question 35

diuretic phase

Answer 35

gradual inc output to 1-3 l/day

Question 36

recovery phase

Answer 36

GFR inc

Question 37

diagnostic tests for acute renal failure

Answer 37

urinalysis

renal ultrasound

Question 38

therapeutic management of acute renal failure

Answer 38

treat precipitating cause
correct fluid/elyte disturbances
control symptoms and prevent complications

Question 39

chronic renal failure

Answer 39

progressive, irreversible destruction of kidneys

nephrons destroyed, replaced with scar tissue

Question 40

phases of chronic renal failure

Answer 40

1. diminished renal reserve: often undiagnosed
2. renal insufficiency: GFR < 25% of normal
3. end stage renal disease (ESRD) or uremia: GFR < 5-10 % of normal

Question 41

etiology of CRF

Answer 41

most common:
HTN
diabetes

Question 42

patho of CRF

Answer 42

adaptive response: depends on location of kidney damage

intact nephron hypothesis: remaining nephrons compensate. leads to hypertrophy of nephrons

Question 43

CM of CRF

Answer 43

8 types;
urinary system
metabolic disturbances
respiratory
cardiovascular
gastrointestinal
neuromuscular
integumentary
reproductive

Question 44

diagnostic tests for CRF

Answer 44

serum BUN, Cr- inc

ultrasound, xRay- shrinkage, nothing bu scar tissue

Question 45

treatment for CRF

Answer 45

pharmacological: elyte management, HTN, anemia
nutritional: protein restrictions, carb and fats, fluid restrictions, Na restictions, K restrictions
DIALYSIS

Question 46

indications for dialysis

Answer 46

fluid overload
hyperkalemia
severe acidosis
progressive uremia
altered CNS "f"
pericarditis

Question 47

goals of dialysis

Answer 47

remove waste products
maintain safe conc of elytes
correct acidosis
remove excess fluid