renal system Flashcards
functions of kidneys
acid base balance water balance electrolyte balance toxin removal blood pressure control erythropoietin vitamin d metabolism
oliguria
urine output less than <400 ml/day
anuria
urine output <40 ml/day
GFR range
90-120 ml/min
creatinine clearance for males and females
females: 85-125
males: 95-140
acute glomerulonephritis (post streptococcal) s/s
** patho = untreated strep then antibodies are created and get lodged in the glomeruli -> inflammation and scarring ---> DECR GFR S/S - hematuria - azotemia *tea colored urine* *excessive nitrogenous waste* - malaise - h/a - proteinuria - hypoalbuminea - edema - incr BP, retaining sodium - incr USG - incr BUN/creatinine
acute glomerulonephritis (post streptococcal) interventions
- fix cause (strep)
- diet modifications –> fluid restriction, sodium restriction, decrease protein, provide high carb diet
- monitor I&O, daily weight
- bed rest
- monitor BP
ANTIHYPERTENSIVES
DIURETICS
Acute kidney injury 3 parts to failure and 4 phases
- sudden renal damage… leads to the build up of waste, fluid and electrolyte imbalance… can be reversible
prerenal failure AKI S/S
Decreased vol/perfusion to the kidneys
- cardiac damage… impaired CO
- vasodilation
- hemorrhage (hypovolemia)
- burns
- GI losses (vomitting/diarrhea)
intrarenal failure AKI S/S
- prolonged ischemia
- myoglobinuria
- hemoglobinura
- rhabdomyolysis
- nephotoxic drugs (NSAIDS, antibiotics, chemo drugs, contrast dyes)
- infections glomerulonephritis
postrenal failure AKI S/S
- obstruction/blockage in UT
- renal calculi
- blood clots
- BPH
- tumors
- neuro damage (stroke)
phases of AKI - oh oh darn rena
onset - triggering event –> correct underlying cause
oliguria - decr UO <400 mL/24 hrs, decr GFR –> diet changes, strict IO, monitor EKG/labs, watch for hyperkalemia… may need dialysis
diuretic - cause of AKI is corrected, gradual incr in UO –> large amounts of dilute urine with electrolytes, monitor pt for dehydration and hypokalemia
recovery - incr kidney function, may take up to 6-12 months –> some pts never recover –> CKD
Nephrotic syndrome causes and s/s
damage to glomerular membrane, loss of protein –> hypoalbuminemia = hyperlipidemia, generalized edema, possible thrombosis (albumin helps to prevent clot formation) and incr risk for infection
causes: bacterial/viral infection, cancer, genetic, systemic disease (lupus, diabetes), NSAIDs
s/s –> hypoalbumenia and proteinuria
nephrotic syndrome interventions
- monitor fluid status
- diet modifications moderate protein intake
- decrease cholesterol, sat fats
MEDS: diuretics, statins, predinsone (to decr inflammation), antineoplastic agent, immunosuppressant
- monitor for s/s of infection and BCs
chronic kidney disease causes
progressive and irreversible loss of kidney function
untreated AKI DM HTN fam hx recurrent infections autoimmune disorder
IN END STAGES ALMOST ALL BODY SYSTEMS ARE NEG AFFECTED
