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Pathophysiology and Pharmacology 2 > Week 7 > Flashcards

Week 7 Flashcards

1
Q

What are the functions of a normal kidney?

A
  • Filtration of the blood
  • Production of erythropoietin which regulates red blood cell production
  • Aids in calcium absorption by activating vitamin D
  • Control of blood pressure - renin-angiotensin II mechanism
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2
Q

How does glomerular filtration work if the afferent arteriole is constricted?

A
  • Decreases blood flow
  • Decreases glomerular filtration pressure
  • Decreases glomerular filtration = decreases urine output
  • May be due to shock, vasoconstriction
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3
Q

How does glomerular filtration work if the efferent arteriole is constricted?

A
  • Increases resistance to outflow from the glomerulus
  • Increases glomerular pressure
  • Increases glomerular filtration = increases urine output
  • May be due to vasoconstriction effect of Angiotensin II
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4
Q

What does the acidity (pH) in a urinalysis indicate?

What would an abnormal pH indicate?

A

Indicates the amount of acid in the urine.

An abnormal pH would indicate a kidney or urinary disorder

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5
Q

What does a specific gravity urinalysis indicate?

A

Shows how concentrated particles are in the urine.

Higher than normal concentration often is a result of not drinking enough fluids

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6
Q

Describe Renal Calculi.

A

The most common cause of obstruction.
Usually starts in the kidney.
Made up of materials normally excreted in the urine

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7
Q

What are the causes of renal calculi?

A
  • High levels of calcium in blood and urine
  • Crystallisation
  • Alteration in anatomy of the urinary tract
  • Metabolic disorders
  • Recurrent UTIs
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8
Q

What are the signs and symptoms of renal calculi?

A
  • Severe colicky pain
  • Some urgency and frequency
  • May be haematuria
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9
Q

What nursing management is associated renal calculi?

A
  • Pain relief
  • Collect all urine for straining to collect stones
  • Urinalysis to check for infection
  • Encourage fluids
  • Pre and post procedure care
  • Education on any dietary changes and fluid intake
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10
Q

What are some causes of renal obstructive disorders?

A
  • Renal calculi
  • Strictures form scarring
  • Tumours
  • Congenital disorders
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11
Q

What are the signs and symptoms of renal obstructive disorders?

A
  • Recurrent UTIs
  • Pain either from distended kidney or a stone
  • Hypertension can be due to enhanced renin-secretion due to decrease flow
  • If blockage complete may lead to
    >Anuria
    >Oliguria
    >Renal Failure
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12
Q

Describe Urinary Tract Infections

A
  • The colonisation of a pathogen to a point where it overwhelms the host inherent defence mechanisms and causes inflammation of the urinary tract
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13
Q

What are the causes/risks of UTIs?

A
  • Age and gender
  • Poor hygiene
  • Bacteria
  • Indwelling Catheter
  • Diabetes
  • Dehydration and urinary stasis
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14
Q

List the signs and symptoms of UTIs.

A
  • Dysuria
  • Frequency and urgency
  • Haematuria
  • Suprapubic or lower back discomfort
  • Offensive smelling urine
  • Elevated body temperature
  • Confusion of the elderly
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15
Q

What nursing care is needed for UTIs?

A
  • Pain relief as ordered
  • Monitor TPR
  • Encourage fluids
  • Give antibiotics as ordered
  • Educate patient on use of antibiotics
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16
Q

Describe acute pyelonephritis

A
  • An infection of the renal pelvis
  • Usually caused by bacteria
  • May be due to obstruction
  • Reflux from the bladder causing an ascending infection
  • Rarely causes renal failure
17
Q

What are the signs and symptoms of acute pyelonephritis?

A
  • Fever and chills
  • Flank/groin pain
  • Frequency and dysuria
  • Confusion in elderly
  • Cloudy foul smelling urine
  • Pyuria and haematuria
  • Nausea and vomiting
18
Q

Discuss the nursing care/treatment of acute pyelonephritis?

A
  • Causes found and treated to prevent recurrence
  • Give and encourage antibiotics as ordered
  • Encourage fluids
  • Monitor TPR
  • Provide pain relief as ordered
19
Q

Describe chronic pyelonephritis

A
  • Persistent, recurrent infections
  • Usually associated with obstruction or reflux
  • Causes progressive inflammation and damage to the renal pelvis and the renal tubules
  • Because of the diffuse scarring the kidneys are no longer able to concentrate urine as well
20
Q

List the signs and symptoms of chronic pyelonephritis

A
  • Hypertension
  • Frequency and urgency
  • Flank pain
  • May be changes in urine output if the disease has progressed
21
Q

Describe Nephrotic Syndrome

A
  • A condition of the kidneys
  • Usually caused by one of the diseases that damage the kidneys filtering system = results in an increase in permeability of the capillary walls of the glomerulus
  • This allows albumin to be filtered into the urine
22
Q

What is the aetiology of diabetic nephropathy?

A
  • Glomerulosclerosis = scarring

- Damage occurs to the capillary network of the glomerulus by the long term effects of high BGLs

23
Q

List signs and symptoms of diabetic nephropathy.

A
  • First sign = protein in the urine
  • May be a rise in blood pressure
  • Their cholesterol and triglycerides may show at elevated levels in blood tests
24
Q

Describe polycystic kidney disease

A
  • Genetic disorder where cysts grow in the kidneys

- Can enlarge and replace normal kidney tissue = decrease kidney function

25
Q

List the signs and symptoms of polycystic kidney disease

A
  • UTIs
  • Haematuria
  • Increased BP
  • Back and flank pain
  • Headaches
  • Decreased output as kidney function declines
26
Q

Describe acute renal failure

A

Sudden and remarkable loss of renal function.
Can be a serious threat to life, causing death.
Sudden onset of oliguria, due to decreased renal function

27
Q

Describe pre-renal acute renal failure

A 
1. Pre Renal
Problem occurring in blood supply to the kidney.
Can be due to:
- Severe vasoconstriction
- Hypotension
- Hypovolaemic shock
- Surgical mishap to blood vessels
28
Q

Describe intrarenal acute renal failure

A
  1. Intrarenal
    Problem occurring inside the kidney.
    Can be due to:
    - Tubular necrosis or ischaemia due to prerenal causes
    - Toxic insult from drugs, heavy metals or contrasts
    - Infection and sepsis
    - Transfusion reaction
29
Q

Describe post-renal acute renal failure

A
  1. Post-renal
    Problem occurring in the drainage system of the kidney
    - Bilateral obstruction due to tumours, stones, prostate
    - Blocked IDC
30
Q

What treatment is used for acute renal failure?

A
  • Treat the underlying cause
  • Monitor fluid balance
  • Correct any fluid or electrolyte disturbances
  • May require dialysis to treat uraemic syndrome
31
Q

Describe chronic renal failure

A

Progressive and irreversible loss of functioning nephrons.
Usually caused by
- Diabetes mellitus
- Chronic recurrent infections and scarring
- Hypertension

32
Q

List the signs and symptoms of chronic renal failure.

A
  • Hypertension
  • Anaemia
  • Oedema
  • Fatigue
  • Pruritis
  • Changes in urine output
33
Q

What is stage 1 of renal failure?

A

Stage 1

Normal GPR despite kidney damage

34
Q

What is stage 2 of renal failure?

A

Stage 2

Mild changes to GFR

35
Q

What is stage 3 of renal failure?

A

Stage 3

Moderate loss in kidney function

36
Q

What is stage 4 of renal failure?

A

Stage 4

Severe loss of function

37
Q

What is stage 5 of renal failure?

A

Stage 5

ESRD usually <10% function remaining

38
Q

Treatment for chronic renal failure

A
  • Dialysis - either haemadialysis or peritoneal dialysis
  • Transplant
  • Manage BP
  • Maintain fluid balance through fluid and salt restriction
  • Maintain nutrition levels

Pathophysiology and Pharmacology 2 (12 decks)

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