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Medsurg > Renal & Urinary Disorders > Flashcards

Renal & Urinary Disorders Flashcards

Exam 2

1
Q

Assessment: History

A

Demographics and personal data
Personal and family health history
Medication use
Renal and urinary assessment

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2
Q

Physical Examination:

A

Inspection

Palpation

Percussion

Auscultation

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3
Q

What should you be auscultating?

A

Auscultation of renal vessels.

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4
Q

What should not be heard if renal vessels are auscultated? What may it indicate?

A

If a bruit is heard, it may indicate altered blood flow to the kidneys.

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5
Q

What should be palpated? How?

A

Palpation of the kidneys; position one hand under the patient’s flank between the rib cage and the iliac crest. Position the other hand over the abdomen, just below the rib cage. Ask the patient to take a deep breath, and use your lower hand to raise the flank while the upper hand palpates.

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6
Q

What should be percussed?

A

Percussing for costovertebral angle tenderness.

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7
Q

When percussing, what is pain or tenderness indicative of?

A

Pain or tenderness is suggestive of kidney inflammation or infection.

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8
Q

Diagnostic Studies:

Labs

A

Blood tests

Urine tests

Imaging studies

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9
Q

Diagnostic Studies:

Blood tests include:

A

BUN

Creatinine

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10
Q

Diagnostic Studies:

Urine tests include:

A

(proteins, glucose, blood and ketones)

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11
Q

DIAGNOSTIC STUDIES:

Imaging studies

A

Bedside sonography
X-ray
Intravenous urography
Renal ultrasound
CT scan
MRI

Renography (kidney scan)
Renal biopsy
Cystoscopy

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12
Q

What is one of the most common genetic disorders?

A

POLYCYSTIC KIDNEY DISEASE

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13
Q

POLYCYSTIC KIDNEY DISEASE:

Epidemiology: What are the two forms of PKD?

A

2 forms of PKD are childhood and adult

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14
Q

POLYCYSTIC KIDNEY DISEASE:

Pathophysiology

A

Genetic disorder that manifests in the cortex and medulla of both kidneys

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15
Q

POLYCYSTIC KIDNEY DISEASE:

Pathophysiology: How does it appear?

A

Appears as large, thin-walled, fluid-filled cysts

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16
Q

POLYCYSTIC KIDNEY DISEASE:

Pathophysiology: How does it range?

A

Ranging from millimeters to centimeters in diameter

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17
Q

POLYCYSTIC KIDNEY DISEASE :

Clinical Manifestations: What are the early signs and what is the first symptom?

A

No early signs, hypertension is first symptom

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18
Q

POLYCYSTIC KIDNEY DISEASE :

Clinical Manifestations: Other signs?

A

Hematuria, lower back pain, headaches, or abdominal pain

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19
Q

POLYCYSTIC KIDNEY DISEASE:

Management: How is diagnosis made?

A

Diagnosis on basis of clinical signs and history

Laboratory and diagnostic tests

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20
Q

POLYCYSTIC KIDNEY DISEASE:

Management: What are treatments?

A

Hemodialysis or peritoneal dialysis

Renal transplant

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21
Q

PYELONEPHRITIS: Epidemiology
Who is most effected?

A

Young women most often affected by sexual activity

22
Q

What is one of the most common renal diseases?

A

PYELONEPHRITIS

23
Q

PYELONEPHRITIS: Pathophysiology

A

Inflammation of the renal parenchyma and urinary collecting system

24
Q

PYELONEPHRITIS: Pathophysiology

What is a common cause?

A

Common cause is a bacterial infection

25
Q

PYELONEPHRITIS:

Clinical manifestations:

A

Signs of infection and back/flank pain

26
Q

PYELONEPHRITIS : Management

How is it diagnosed?

A

Diagnosed by history and physical exam with laboratory results

27
Q

PYELONEPHRITIS : Management

How may it need to be treated?

A

Hospitalization
Antibiotics and fluid replacement

28
Q

PYELONEPHRITIS: Management

What can recurrent infections lead to?

A

Recurrent infections can lead to scarring, chronic kidney disease, or permanent damage

29
Q

What is the third leading cause of renal failure?

A

ACUTE GLOMERULONEPHRITIS

30
Q

ACUTE GLOMERULONEPHRITIS:
Epidemiology: How is it classified?

A

Classified as acute or chronic

31
Q

ACUTE GLOMERULONEPHRITIS:

Pathophysiology:

A

Inflammation of the glomeruli triggered by an immunological mechanism

32
Q

ACUTE GLOMERULONEPHRITIS:

Pathophysiology:

What affects the glomeruli?

A

2 types of antibody-induced immunological conditions affecting the glomerulus

33
Q

ACUTE GLOMERULO-NEPHRITIS:

Clinical manifestations:

A

Patients present edematous, with decreased urine output and hypertension

34
Q

ACUTE GLOMERULO-NEPHRITIS :

Management: What is done?

A

Medical history, physical exam, and laboratory tests

35
Q

ACUTE GLOMERULO-NEPHRITIS:

Management: What medications are given?

A

Medications focus on antibiotic treatment

36
Q

ACUTE KIDNEY INJURY:

Epidemiology: How many new cases annually?

A

2,000 to 3,000 cases annually

37
Q

ACUTE KIDNEY INJURY:

Epidemiology: Who is most vulnerable?

A

Elderly are more vulnerable

38
Q

ACUTE KIDNEY INJURY:

Pathophysiology: What happens with renal function?

A

Acute, rapid loss of renal function

39
Q

ACUTE KIDNEY INJURY:

Pathophysiology: What may be present?

A

Oliguria may be present
Uremia may be present

40
Q

ACUTE KIDNEY INJURY:

Clinical manifestations: What are clinical manifestations related to?

A

Clinical manifestations related to decreased G F R, fluid overload, and impaired clearance of electrolytes

41
Q

ACUTE KIDNEY INJURY:

Management:

A

Eliminate cause, prevent complications, and assist recovery

42
Q

ACUTE KIDNEY INJURY:

Management: What kind of therapy is done?

A

Diuretic therapy and nutritional therapy

43
Q

ACUTE KIDNEY INJURY:

Management: What kind of treatment may be considered?

A

Dialysis may need to be considered

44
Q

CHRONIC KIDNEY DISEASE

Epidemiology: What group of people have high rates?

A

Rates higher in African Americans and Native Americans

Higher in men than in women

45
Q

CHRONIC KIDNEY DISEASE

Pathophysiology:

What occurs?

A

Progressive, irreversible loss of kidney function

46
Q

CHRONIC KIDNEY DISEASE

Pathophysiology: What are the most common causes?

A

Most common causes are diabetes and hypertension

47
Q

CHRONIC KIDNEY DISEASE
Pathophysiology: What is it characterized in?

A

Characterized in 5 stages delineated by GFR

48
Q

CHRONIC KIDNEY DISEASE:

Clinical manifestations:

A

Devastating effect on every body system

49
Q

CHRONIC KIDNEY DISEASE:

Management:

A

Renal replacement therapies

Renal transplantation

50
Q

CHRONIC KIDNEY DISEASE:

Management: What kind of imbalances need to be handled?

A

Hyperkalemia, hypertension, renal osteodystrophy, hypocalcemia, hyperparathyroidism, anemia, and dyslipidemia

Medsurg (21 decks)

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