Test 5 (Ch. 18&8 Flashcards
Treatment for Acute Renal Failure include:
Due to the high mortality rate, the major concern of Treatment is to identify and correct the cause
Reverse the primary problem as quickly as possible
Restrict Fluid Intake (Reduce strain on the Kidneys)
Monitor Fluid Intake and Output
Dialysis (Usually continued for 1 - 2 Weeks)
X-ray of the Urinary Tract
Contrast material is introduced directly into the Bladder and Ureters through a Cystoscope
Retrograde Pyelogram
What is the most important factor in determining prognosis?
Tumor Thickness (measured in millimeters)
The Most Common Causative Agent is:
Escherichia coli (E. coli)
Inflammation of the Urinary Bladder is called?
Most Common Site of the UTI
Cystitis
What represent 50% of the Cancers diagnosed in the U.S?
Skin Cancers
True or False
Women are far more susceptible to Ascending Urinary Tract Infections than men due to the fact that the Urethra is shorter
TRUE
Abnormal Constituents (Present in Significant Quantities) GLUCOSE AND KETONES:
Indicates when diabetes mellitus is not well controlled
What are The “ABCD” Signs That a Mole or Nevus May be a Melanoma.
Change in Appearance: “Area of the mole is increased”
Change in Border
Change in Color
Increase in Diameter
Directly introduce bacteria into the Bladder
Cystoscopy
A protective barrier between the Bladder’s Epithelium and Bacteria is called?
Mucin
Signs and symptoms of Pyelonephritis include:
Pyuria: Numerous pus filled Abscesses frequently form and rupture
Bacteruria, Hematuria and Proteinuria
Fever and Chills
Flank or lower back pain
Associated with inflammation and stretching of the Renal Capsule
Frequency or Dysuria: Usually originates as an Ascending Infection
Patients taking the above medications should increase their Fluid Intake to reduce the risk of ____________
Kidney damage
Related to Sun Exposure (UV light)
Malignant Melanoma (Severe, blistering sunburns in early childhood and intense, intermittent sun exposures)
Prostate fluid has antimicrobial properties that would function to do what?
protect the Male’s Urethra from colonization
Inherited disease
Disorder in which normal renal tissue is replaced by grapelike fluid-filled Cysts, causing them to become hugely distended
Polycystic Kidney Disease
Skin cancers that are typically associated with total cumulative UV exposure are?
Basal Cell and Squamous Cell Carcinoma
Diagnostic Tests for Pyelonephritis are:
History & Physical: Note some Tenderness during palpation of abdominal or lumbar regions
Urinalysis with C&S: Presence of bacteria, pus, protein and blood
Urinary (WBC) Casts indicate Pyelonephritis
Not always present in the urine
X-rays: Reveal Hydronephrosis - Enlarged Kidneys
Where does malignant Melanoma originate from?
Melanocytes of the base layer of the Epidermis or from a Nevus (Mole)
Due to an initial change in bicarbonate ion levels
Associated with Renal Failure, Shock, Diabetic Ketoacidosis, Severe Diarrhea. ___________
Metabolic Acidosis
ANTIBODY LEVELS:
A low titer is common in most people since ___________
Stretococcal infection is common
Microscopic Molds of the Tubules are called:
Casts
Elderly and Postmenopausal Women appear to produce
Less Mucin
Malignant Melanoma grow quickly and metastasize first to the regional __________
Lymph Nodes
Skin cancer that is more associated with intense, intermittent exposure is?
Malignant Melanomas
Shock following Operations, including Traumatic Shock
Surgical Shock
Infections are diagnosed by
Culture of specific organisms with counts of 100,000 bacteria/ml of freshly voided urine
Most Malignant Melanomas that are diagnosed clinically measure more than ___ mm in diameter
6
X-ray of the Urinary Tract after the injection of a Radiopaque material into a vein. Allows for visualization of Tumors, Obstructions, and Deformities
Intravenous Pyelogram (IVP) Intravenous Urogram
Result of Hemorrhage or Loss Fluid Volume
Hypovolemic Shock
Why is CRF irreversible?
Result of declining number of functional Nephrons over a long period of time
CRF develops when the Neprhon losses exceed 50 – 70% of the total
What is the survival rate with addition to chemotherapy and radiation therapy?
5-year survival
Abnormal Constituents (Present in Significant Quantities) URINARY CAST (microscopic molds of the tubule consisting of bacteria. protein, etc.):
Indicates inflammation of the kidney tubules
Persons with two of the 6 risk factors have a 3.5-fold increased risk of developing ___________.
Malignant Melanoma
Persons with three or more of the above risk factors have a ____________.
20-fold increased risk
Diagnostic Tests for CRF:
History: Patient history may reveal a previous renal disease
Urinalysis: Proteinurea & low Specific Gravity
Urine is very Dilute
BUN and Creatinine: Elevated
CBC: Anemia becomes severe
KUB; IVP: Done to determine the extent of Renal Damage
Serum pH: Evidence of Decompensated Metabolic Acidosis
pH less than 7.35 in the late stages
T OR F
The tubules are primarily affected but the glomeruli are not.
.True
What is a Staghorn Calculus?
a large stone that takes up more than one branch of the collecting system in the renal pelvis of the kidney.
Etiology: The Causes of Acute Renal Failure are Classified as:
- Bilateral Renal Ischemia
- Nephrotoxic Injury
- Urinary Obstruction
- Acute Bilateral Kidney Infection or Inflammation
Abnormal Constituents (Present in Significant Quantities) BLOOD:
Associated with infection, inflammation or tumors in the urinary tract. Also indicates increased glomerular permeability or hemorrhage in the tract.
Signs and Symptoms:Early Signs and Symptoms of CRF
Polyuria: Excessive water loss dominates during Early Stage Disease because the loss of reabsorptive capacity by the Tubules is greater than the reduction in Filtration in the Glomeruli Nocturia: Excessive urination at night High Blood Pressure Anemia: Caused by: Bone Marrow Depression Decrease in Erythropoietin Decreased Cellular Metabolism
Glomerulonephritis and Pyelonephritis can also cause:
Actute Renal Failure
Treatment for CRF include:
Dialysis
2. Kidney Transplant may be attempted to prolong life
Concern: Drug dosages need to carefully monitored due to poor excretion from the kidneys!
Pelvic and Low Back Pain indicate that the Infection is ____________.
Ascending toward the Kidneys
Diagnostic Tests for Acute Renal Failure include:
Urinalysis: Elevations of Protein, Glucose, Leukocytes and Casts
Decreased Specific Gravity: Earliest manifestation indicating Tubular Damage and the inability to concentrate urine
BUN and Serum Creatinine would be elevated
Electrolytes: Elevated levels of Potassium
KUB or IVP
Diagnostic Tests: Electrolytes
Hyponatremia
Hyperkalemia
Hypocalcemia
Hyperphosphatemia
The more serious Skin Cancer is what?
Malignant Melanoma
Renal Ischemia occurs whenever there is a _____________
A pronounced drop in the Systemic Blood Pressure (Could also be a result of Cardiac Damage)
Both Antistreptolysin (ASO) and Antistreptokinase (ASK) titers are used to make a Diagnosis of __________________.
Postreptococcal Glomerulonephritis
Examples of Nephrotoxins of:
Solvents: Carbon Tetrachloride Heavy Metals: Lead, Arsenic, and Mercury Pesticides Antibiotics: Ampicillin, and Penicillin Analgesics: Aspirin and Acetaminophen
Infections are diagnosed by _________
with counts of _______ bacteria/ml
Culture
100,000
Any type of blockage in the Urinary System will result in back pressure that will cause urine to accumulate into the ____________.
Kidney