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NURS 2514 > week 11 patho > Flashcards

week 11 patho Flashcards

1
Q

what are some v basic characteristics of AKI

A

abrupt decline in kidney function, with elevated serum creatinine and reduction in urine output

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2
Q

how high will creatinine be with an AKI

A

1.5 times their baseline

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3
Q

what are the three main patient groups at risk for developing an AKI

A

patients with infections
patients with low BP (because kidneys aren’t being perfused)
patients exposed to nephrotoxins

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4
Q

how does sepsis cause an AKI

A

widespread vasodilation will lower BP, which decreases perfusion to the kidneys, also antibiotics used to treat sepsis are bad for the kidneys

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5
Q

what are the three types of AKI

A

1) pre renal
2) intra renal (intrinsic)
3) post renal

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6
Q

what are three causes of pre renal AKI

A

hypovolemia: decreased perfusion to kidneys
altered peripheral vascular resistance: ex. sepsis, anaphylaxis
cardiac disorders which ultimately lower CO and BP

bacically all have to do with decrease in glomerular filtration and BP

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7
Q

what are 5 causes of intra renal AKI

A

prolonged ischemia
nephrotoxic drugs
organic solvents like ethylene glycol
acute hemolysis or rhabdomyolysis
acute glomerulonephritis (inflammation of glomerulus)

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8
Q

how does acute hemolysis and rhabdomyolysis cause intra renal AKI

A

breakdown of these produces a substance called He which is nephrotoxic

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9
Q

what are the main nephrotoxic drugs

A

ahminoglycosides! anything that ends with -mycin
tobramycin
streptomycin

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10
Q

what are some examples of post renal factors of AKI

A

Kidney stones
enlarged prostate
urethra scarring
basically anything that affects urine leaving the kidneys and going down the urinary tract (gets all clogged up)

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11
Q

what is azotemia

A

less waste excreted in the kidneys

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12
Q

what happens inside the nephron during a pre renal AKI

A
  • decreased blood flow disrupts balance of pressure in glomerulus
  • glomerular hydrostatic pressure is lost as it drops
  • decrease in overall GFR
  • kidney activates raas to compensate, not enough to maintain GFR so you get oliguria and azotemia
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13
Q

what do casts in urine indicate

A

it means cells are dying which indicates intratubular damage

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14
Q

what is happening in the nephron during an intrarenal AKI

A
  • lack of blood flow injures tubules
  • causes inflammation, swelling, and loss of fx
  • when epithelial cells die, they sluff off and get clogged in renal tubules
  • this obstructs movement of filtrate and increases intratubular pressure
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15
Q

what is happening in the nephron during a post renal AKI

A

physical obstruction of outflow of urine leads to increased pressure in glomerulus and overall decreased GFR

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16
Q

what is an early intervention for a pre renal injury AKI

A

normalising BP

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17
Q

what is an early intervention for a post renal AKI

A

removing obstruction

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18
Q

what happens if you don’t intervene for a pre renal or post renal AKI

A

you get an intra renal injury

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19
Q

what are the three phases of an intra renal AKI

A

initiation, maintenance, recovery

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20
Q

what happens during initiation phase of infrarenal AKI
what sx do you see

A

increased Cr and BUN, decreased urine output

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21
Q

what happens during maintenance phase of an intrarenal AKI
- urine output
- body fluid
- acid/base balance
- electrolytes

A

-you see a drop of urine output by 10-14 days
-you see fluid retention which includes hypertension, edema, and weight gain
-you see metabolic acidosis
and electrolyte imbalance (low Na, high K, low Ca, high PO4)
- you see anemia

22
Q

what do you see in the recovery phase of an intra renal AKI

A

Diuretic phase, hyponatremia and hypokalaemia,

23
Q

how long does the kidney typically take to stabilise after an intrarenal AKI

A

12 months

24
Q

what are the top 3 priorities a nurse would have when caring for a patient in the maintenance phase of ATN

A

1) fluid balance, make sure they aren’t hypovolemic
2) monitor acidosis
3) monitor EKG d/t high potassium

25
Q

why would a patient in the recovery phase of ATN be hypovolemic

A

due to fluid loss in the diuretic phase

26
Q

what is glomerulonephritis

A

immune mediated swelling of the urinary tract

27
Q

how does glomerulonephritis affect the urine

A

it causes proteinuria, hematuria, decreased UO and oliguria

28
Q

does acute glomerulonephritis affect both kidneys or just one

A

both

29
Q

what are the 2 types of glomerulonephritis

A

1) acute glomerulonephritis
2) rapidly progressive glomerulonephritis
3) chronic glomerulonephritis (initial illness resolves but inflammation persists)
4) nephrotic syndrome (loss of large amounts of protein in the urine)

30
Q

what is acute poststreptococcal glomerulonephritis?

A

an immune attack on strep infection that causes antibody complexes to form and cause damage to the glomerulus

31
Q

when would you see kidney injury after a strep infection

A

5-21 days after initial infection

32
Q

what symptoms would you see in APG

A

periorbital edema, smoky urine, HTN, increased Ur and Cr

33
Q

why are infecitons most common in the urinary tract

A

because the urinary tract is a very sterile place

34
Q

what is the most common pathogen leading to UTI

A

E. coli

35
Q

what is stasis and why is it a major cause of UTI

A

basically the biggest defence against bacteria is peeing because it flushes all the bacteria out. if you don’t pee pathogens have more of a change to travel up the urinary tract. this is why dehydration is a risk factor

36
Q

what are the 2 main risk factors for UTI

A

Females
urinaty stasis

37
Q

why are women more at risk for UTI

A

because they have a shorter urethra so bacteria won’t travel up as far

38
Q

whats the main difference between cyctitis and pyelonephritis

A

cystitis is a lower UTI issue that stays in the urinary tract and bladder
Pyelonephritis when the infection climbs upwards towards the ureters and kidneys

39
Q

which one can lead to CKD, cystitis or pyelonephritis

A

pyelonephritis

40
Q

whats the biggest difference in urinalysis between cyctitis and pyelonephritis

A

pyelonephritis will have leukocyte casts, indicating damage in tubules whereas cystitis won’t because the infection isn’t in the kidneys yet

41
Q

what is renal calculi aetiology

A

theyre mineral salts in urine that precipitate out and form stones

42
Q

whats the difference between calculus and lethiasis

A

calculus is a stone, lethiasis is just stone formation

43
Q

what is the most common type of kidney stone

A

calcium (phosphate or oxalate)

44
Q

which type of kidney stone comes from recurrent UTI

A

struvite

45
Q

which type of stone is associated with gout

A

uric acid

46
Q

which type of kidney stone is the least common

A

cystine

47
Q

what is the main factor associated with kidney stone formation

A

dehydration

48
Q

what are the 5 symptoms of renal calculi

A
  • abdominal/flank pain
  • renal colic
    hematuria
    fever
    N/V
49
Q

what does renal colic feel like

A

its excruciating pain that comes and goes as body tries to push stones down, radiates toward groin area

50
Q

what is polycystic kidney disease

A

it is basically when the Cortex and medulla become filed with cysts that enlarge and destroy surrounding tissue

NURS 2514 (31 decks)

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