Renal Disorders 2 Flashcards
UTO
interference with flow of urine
causes urine to accumulate behind obstruction leading to damage to organs
backs up into kidneys
where can UTO’s occur
anywhere in UT
kidney stones
masses of crystal and protein
crystals made of stone forming substances
what is the most common cause of UTO
kidney stones
kidneys stones in men
distal- see slower streak, maybe scarring
no significant damage
above prostate, bladder affected
patho of kidney stones
crystals made up of stone forming substances trapped within urinary tract and accumulate other crystals –> stones
contributing factors of kidney stones
pH of urine- affects solubility
high urinary conc. of stone forming substance
types of kidney stones
calcium oxalate or phosphate
struvite
uric acid
calcium oxalate is most common in
men
etiology of calcium oxalate
idiopathic
inc leves of Ca causes formation
people who are immobile- Ca buildup
struvite is most common in
women
precipitated by inf
etiology of uric acid
inc urine acid production in body by diet
high purine diet, high meat, fish, poultry, gout
CM for kidney stones
pain
N/V
hematuria
s&s of UTI
complication of kidney stones
can travel, cause irritation to binary tract. jagged crystals are painful
diagnostic tests for kidney stones
urine pH
xRay of abd., IVP, ultrasound
stone analysis- determines cause
treatment for kidney stones
pain meds anx if inf fluids dec dietary intake of comp. in stone ultrasonography or laser lithotripsy surgery
neurogenic bladder
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
patho of neurogenic bladder
paralysis of bladder interferes with normal flow of urine and emptying of bladder
CM of neurogenic bladder
urgency/frequency
incontinence
dribbling of urine
urine retention
diagnostic tests for neurogenic bladder
ultrasound
cystoscopy
urodynamic studies
treatment for neurogenic bladder
bladder training kegel exercises catheters manual compressions surgery
acute renal failure
rapid decline in kidney “f” leading to azotemia
when azotemia symptomatic= uremia
dec UO < 400 cc/24hrs. (oliguria)
Bun, Cr levels for acute renal failure
high
etiology of acute renal failure
surgery
- prerenal
- intrarenal
- postrenal
prerenal
conditions outside kidneys that impair renal bld flow and cause dec glomerularr perfusion or dec GFR
causes of prerenal
dec VV
dec CO
intravascular pooling of bld/ peripheral vasodilation
inc renal vas. resistance or an obstruction
intrarenal
actual damage to renal tissue
causes of intrarenal
prolonged prerenal problem infection nephrotoxins intravascular hemolysis myoglobinuria
postrenal
mechanical obstruction of urinary outflow
anuria < 200ml/ day
causes of postrenal
calculi formation
prostatic hypertrophy
trauma
patho of acute renal failure
- renal vasoconstriction
- cellular edema
- dec glomerular capillary perm.
- intratubular capillary permeability
- leakage of glomerular filtrate
stages of CM of acute renal failure
oliguric phase
diuretic phase
recovery phase
oliguric phase
UO < 400 ml/24hrs urinary changes fluid vol excess metab. acidosis elyte imbalance
elyte levels in acute renal failure
dec Na
inc K
dec Ca
inc phosphate
diuretic phase
gradual inc output to 1-3 l/day
recovery phase
GFR inc
diagnostic tests for acute renal failure
urinalysis
renal ultrasound
therapeutic management of acute renal failure
treat precipitating cause
correct fluid/elyte disturbances
control symptoms and prevent complications
chronic renal failure
progressive, irreversible destruction of kidneys
nephrons destroyed, replaced with scar tissue
phases of chronic renal failure
- diminished renal reserve: often undiagnosed
- renal insufficiency: GFR < 25% of normal
- end stage renal disease (ESRD) or uremia: GFR < 5-10 % of normal
etiology of CRF
most common:
HTN
diabetes
patho of CRF
adaptive response: depends on location of kidney damage
intact nephron hypothesis: remaining nephrons compensate. leads to hypertrophy of nephrons
CM of CRF
8 types; urinary system metabolic disturbances respiratory cardiovascular gastrointestinal neuromuscular integumentary reproductive
diagnostic tests for CRF
serum BUN, Cr- inc
ultrasound, xRay- shrinkage, nothing bu scar tissue
treatment for CRF
pharmacological: elyte management, HTN, anemia
nutritional: protein restrictions, carb and fats, fluid restrictions, Na restictions, K restrictions
DIALYSIS
indications for dialysis
fluid overload hyperkalemia severe acidosis progressive uremia altered CNS "f" pericarditis
goals of dialysis
remove waste products
maintain safe conc of elytes
correct acidosis
remove excess fluid
