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Renal / Urinary
Renal System Complications
26
Nursing
Undergraduate 4
01/14/2010

Additional Nursing Flashcards

 


 

Cards

Term
Neurogenic Bladder
Definition

Results from a lesion of the nervous sysytem

Two Types: Spastic (upper lesion); Flaccid (lower lesion)

no perception of bladder fullness

Can result in possible kidney damage

 

Interventions: Urocholine administration, Crede's method, voiding programs, catherterization

 

Term
Hydronephrosis
Definition

Distention of renal pelvis due to obstruction

Ache in back or flank, chills, tenderness, pyuria, hematuria

 

Interventions: Correct the obstruction, monitor for post obstructive diuresis

Term
Acute Pyelonephritis
Definition

Infection of renal pelvis

dysuria, fever, chills, CVA tenderness

Urine is cloudy and foul-smelling; hematuria

Urine cultures must be obtained

 

 

Term
Acute Pyelonephritis Interventions
Definition

Encourage adequate fluids (8 glasses/day)

Rest

Antibiotics for 14-21 days

NSAIDS

Sitz Baths/heating pads for pain

Teach manifestations of reoccurance

Follow up urine culture in 2 weeks

Term
Chronic Pyelonephritis
Definition

Kidney losses function

Repeated bouts of acute pyelonephritis

 

Fatigue, headache, polyuria, anorexia

Diagnosed by radiologic imagine and histologic testing

Can progress to end-stage renal disease

Term
Chronic Pyelonephritis Interventions
Definition

Bedrest during acute phase

adequate fluid intake (3-4 liters/day)

Antibiotics

NSAIDS

If BUN elevated, restrict protein; High calorie diet

Follow up urine culture in 2 weeks

Term
Acute Glomerulonephritis
Definition

Inflammation of the glomerulus

Typically caused by group A strep (throat infection)

Symptoms occur 2-3 weeks after infection

Decrease in GFR resulting in:

Hematuria, proteinuria, elevated BUN / Creatinine

Headache, malaise, periorbital edema, flank pain, HTN, CVA tenderness

Term
Acute Glomerulonephritis Interventions
Definition

Antibiotics (if strep is present)

Rest

Restrict Na, and fluid intake; diuretics (Edema)

Restrict protein; High calorie diet (elevated BUN)

Antihypertensive drugs (HTN)

 

Term
Chronic Glomerulonephritis
Definition

Kidneys shrink in size and become fibrous

Causes severe damage resulting in ESRD

May be asymptomatic

 

HTN, elevated BUN/ creatinine, proteinuria, hematuria, peripheral edema, nocturia, dizziness, weight loss,

Term
Chronic Glomerulonephritis Interventions
Definition

Rest

Restrict Na, protein, and fluid intake; diuretics (edema)

Antihypertensive drugs (HTN)

Dialysis (fluid/electrolyte balance)

Emotional support

 

Term
Nephrotic Syndrome
Definition

Glomerulus becomes permeable to plasma proteins

Decreased oncotic pressure

Peripheral edema, proteinuria, hypoalbuminemia, HTN, hyperlipidemia

Hypocalcemia may occur

Hypercoaguability (possible thromboembolism)

 

Term
Nephrotic Syndrome Interventions
Definition

Steriods (Prednisone; Cytoxan; Imuran)

Low Na diet (2-3 g/day); High calorie diet

Low protein diet (0.5-0.6 g/kg/day); Diuretics

Bedrest until edema subsides

Proper exercise to decrease protein breakdown

Avoid ACE-inhibitors and NSAIDS

 

 

If urine protein excedes 10g/day, supplement may be needed

Term
Acute Renal Failure
Definition

Abrupt loss of kidney function

 

Oliguria (output less than 400-500ml/day)

Azotemia (uremic toxins)

Elevated BUN/ creatinine/ K+

Term

Acute Renal Failure

 

PRERENAL

 

Causes / Interventions

Definition

(Patient will have high specific gravity/ low urine Na)

 Decreased cardiac output; hemorrhage

Hypovolemic shock

Dehydration

Vascular obstruction (calculi, BPH, strictures)

 Maintain BP at normal levels

Catheterize

MONITOR FOR POST OBSTRUCTIVE DIURESIS-

Input restrictions should = output + 600ml/day

 

Term

Acute Renal Failure

 

POSTRENAL

Definition
Term

Acute Renal Failure

 

INTRARENAL

 

Causes

Definition

Prolonged prerenal ischemia (acute tubular necrosis)

Nephrotoxic injury

 Drugs; Hemorrhage; Burns;

Pulmonary emboli; Allergies 

Infections; Malignant HTN

Chemical exposure (lead, arsenic)

Term

Acute Renal Failure

 

POSTRENAL

 

Causes

Definition

Mechanical obstruction of urinary flow causing urine reflux into the kidneys, impairing function

 

BPH ; Calculi; Trauma; Extrarenal tumors

Term

Acute Renal Failure

 

Neurological Manifestations

Definition

Nitrogenous waste products accumulate in the brain

 

Decreased alertness, energy, and thought processes

Decreased LOC that leads to coma

Seizures

Itching, tingling, numbness, twitching of extremeties

 

Term

Acute Renal Failure

 

Cardiovascular Manifestations

Definition

Volume overload

Heart failure

Hypotension (early)

Hypertension / Cardiac arrythmias

 

Term

Acute Renal Failure

 

Respiratory Manifestations

Definition

Pulmonary Edema

Kussmaul Respirations

Pleural Effusion

 

Findings on Assessment:

adventitous breath sounds

thick secretions

Term

Acute Renal Failure

 

GI Manifestations

Definition

Weight loss / Anorexia

Positive guaiac stool tests (bleeding)

Nausea/ Vomiting

Constipation or diarrhea

 

Term

Acute Renal Failure

 

Hematopoetic Manifestations

Definition

Anemia (impaired erythropoietin production)

Increased susceptability to infection

Leukocytosis

 

Findings on Assessment:

pale mucous membranes

fatigue, weakness

Term

Acute Renal Failure

 

Integumentary Manifestations

Definition

Pale, dry, dull, yellow skin

Uremic frost

Bruising

Pruritus

Thin, brittle hair

Thick nails

Term

Acute Renal Failure

 

Fluid and Electrolyte Balance

Definition

K+= hyperkalemia

ECG will show peaked T waves, wide QRS complex, and ST segment depression 

Na= hyponatremia

Ca= hypocalcemia (from decreased GI absorption)

Phos= hyperphosphatemia

Mg= hypermagnesemia

 

Metabolic acidosis from decreased excretion of H+ ions

Decreased production of buffers (bicarbonate)

 

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