Term
| list names of infections in urinary system (4) types of UTIs |
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Definition
| cystitis, pyelonephritis, glomerulonephritis, nephrotic syndrome aka nephrosis |
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Term
| second most common bacterial disease |
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Definition
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Definition
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Term
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Definition
| UTI of kidney and renal pelvis |
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Term
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Definition
| UTI of bladder usually from bacterial infection |
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Term
| risk factors for developing UTIs |
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Definition
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Term
| bacteria that commonly causes UTIs |
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Definition
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Term
| cystitis in men and women |
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Definition
| women have short urethras; men have BPH...organisms usually ascend from urethra |
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Term
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Definition
frequency,urgency,dysuria, maybe hematuria
****suprapubic pain, foul smelling urine, pyuria=BAD UTI |
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Term
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Definition
| pus in urine=wbc in urine |
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Term
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Definition
| eldery do not usually have symptoms...change from baseline can be a clue they have a UTI..nonspecific symptoms |
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Term
| nonspecific symptoms elderly experience in UTI |
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Definition
| cognitive changes,, sudden incontinence, fatigue, anorexia |
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Term
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Definition
urine dipstick and microscopic + for WBC
positive urine cultures
CCMS |
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Term
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Definition
| =clean catch midstream best method to obtain urine |
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Term
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Definition
antibiotics (single dose to longterm)
analgesics
antispasmodics |
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Term
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Definition
*pyridium
stains urine
*urised-bluegreen |
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Definition
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Definition
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Term
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Definition
kidney infection; MO ascent from lower tract into renal pelvis
*inflamed areas become necrotic & absceses can form-> scar tissue
*wbc and edema |
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Term
| CM of acute pyelonoephritis |
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Definition
dysuria, frequency
**FEVER, CHILLS, N/V, FLANK PAIN, COSTOVERTEBRAL TENDERNESS |
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Term
| CM of acute pyelonephritis in elderly can just be.... |
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Definition
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Term
| diagnostic studies in acute pyleonephritis |
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Definition
elevated WBC with shift to the left
UA with bacteria, wbc, rbc, wbc casts
pos urine culture
pos blood culture |
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Term
| treatment for acute pyelonephritis |
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Definition
will require more than dose of simple antibiotics
IV antibioticss |
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Term
| how long is antibiotic treatment for acute pyelonephritis |
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Definition
| 2-3 wks or longer, may receive prophylactic treatment if they continue to have infections |
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Term
| patient teaching for acute pyelonephritis |
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Definition
must have urine culture and must come back for another
s/s of pyelonephritis
take all antibiotics |
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Term
| signifigicance of having acute pyelonephritis while pregnant |
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Definition
| can cause preterm labor or adult repiratory distress syndrome=fluid in lungs->respiratory failure |
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Term
| complication of acute pyelonephritis |
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Definition
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Term
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Definition
repeated infectious episodes that were not successfully treated created scar tissue so eventually pt develops chronic renal disease
*can lead to ESRD |
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Term
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Definition
| IMMUNOLOGICAL disorder that causes inflammation in glomerulus |
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Term
| common cause of glomerulonephritis |
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Definition
| group a strep infection (skin or respiratory) |
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Term
| what do most cases of glomerulonephritis result from |
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Definition
| trapping of circulating antigen-antibody complexes |
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Term
| in glomerulonephritis, pt will have a hx of... |
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Definition
| recent infection, immunization, autoimmune disease...remember it is immunological |
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Term
| do children with strep a glomerulonephritis recover? |
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Definition
| 95% recover fully...can develop ESRD years later |
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Term
| adults with glomerulonephritis |
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Definition
| 15% of adults develop chronic glomerulonephritis and can develop CKD |
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Term
| what happens during glomerulonephritis?? |
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Definition
| the inflammation impedes filtration in the glomerulus which causes changes in the nephron =no filtration |
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Term
| glomerulonephritis looks like... |
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Definition
| arf but with blood and protein in urine |
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Term
| CM of acute glomerulonephritis |
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Definition
sudden hematuria (smoky cola colored on psagn)
RBC casts are indicitave of AGN
generalized edema
HTN, HA, CHF, pleural effusions-> fluid build up
oliguria
abd or flank pain |
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Term
| what cm is indicatie of AGN |
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Definition
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Term
| diagnostic studies of glomerulonephritis |
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Definition
protein and blood in urine
low urine specific gravity=not filtering
creatinine and BUN serum elevated
creatinine clearance low
biopsy reveals inflamed glomeruli |
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Term
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Definition
High calorie, Low protein, low sodium, retricted fluids
anorexia and nv may need intervention |
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Term
| acute glomuleronephritis and fatigue |
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Definition
| direct correlation between activity and amt of blood and protein in urine |
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Term
| if blood and protein in urine,... |
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Definition
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Term
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Definition
| diuretics and antihypertenives for bp |
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Term
| ex. of antibiotic for strep infection |
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Definition
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Term
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Definition
aka nephrosis
a s et of cm arising from PROTEIN WASTING s/t diffuse glomerular damage |
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Term
| precipitating factors of nephrotic syndrome |
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Definition
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Term
| most common cause of nephrotic syndrome/nephrosis |
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Definition
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Term
| what happens during nephrosis? |
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Definition
immunological process causes glomerular basement membrane to become permeable to protein, especially albumin
PLASMA LEVELS of albumin depleted->alters oncotic pressure->3rd spacing, FVE, dehydration |
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Term
| what will you see with nephrosis????? |
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Definition
*massive proteinuria 4-30 g/day
*severe hypoalbuminemia can drop to 1-2.5 g/dL
*massive edema BIGGEST PROBLEM
*hyperlipidemia, anorexia, malaise, irritability |
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Term
| most serious complication of nephrosis |
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Definition
| thrombus formation (PE, renal thrombosis) long term anticoagulant therapy-->vessels are dehydrated |
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Term
| how do pts with nephrosis lose weight? |
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Definition
| from protein loss not fluid loss |
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Term
| nursing diagnosis of nephrosis |
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Definition
| fluid volume excess? don't restrict fluids but its not in vascular space(dehydrated)...may need BP meds and albumin |
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Term
| what meds help to stop inflammation in glomeruli during nephrosis? |
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Definition
| corticosteroids and cytotoxic meds |
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Term
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Definition
Low protein protects nephrons, high protein to prevent catabolism LOOK AT PROTEIN LOSS
low sodium for edema
high carbs for energy |
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Term
| minimal change nephrotic syndrome seen in |
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Definition
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Term
| minimal change nephrotic syndrome |
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Definition
cant see change in glomeruli
triggered by childhood infections
80% get better over time and no residual effects |
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Term
| treatment for minimal change nephrotic syndrome |
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Definition
| prednisone 7-21 days; start tx agai if relapse |
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Term
| chronic glomerulonephritis |
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Definition
develops over decades as immune reponse destroys basement membrane
*can be seen after agn or nephrosis
often detect on routine UA OR HTN workup |
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Term
| chronic glomerulonephritis cgn can lead to... |
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Definition
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Term
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Definition
| mild proteinuria, mild hematuria, HTN, edema |
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Term
| three types of renal trauma |
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Definition
| minor,major, pedicle(vascular) |
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Term
| findings with renal trauma |
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Definition
hematuria (gross or microscopic)
flank pain
bruises over flank and lower back
grey & turners signs |
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Term
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Definition
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Term
| find what in urine with renal damage? |
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Definition
| urinary casts...RBC cats if tubular damage |
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Term
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Definition
| contusions, small lacerations, hematuria r/t damaged vessels |
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Term
| minor renal trauma usually caused by |
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Definition
| blunt trauma (car, motorcycle accident, sports, pedestrian injury |
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Term
| treatment for minor renal injury |
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Definition
WAIT AND WATCH
adequate hydration
if gross hematuria, placed on bedrest |
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Term
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Definition
lacerations to cortex, medulla
fractured kidney |
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Term
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Definition
| penetrating trauma, abd, flank or back wounds, bleed a lot |
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Term
| treatments for major trauma |
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Definition
surgical repair (partial/total nephrectomy)
bench surgery
try to save as much as possible*** |
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Term
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Definition
| remove,repair,replace kidney |
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Term
| pedicle (vascular) injuries |
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Definition
damage to renal blood supply
CAN DIE QUICKLY->rapid hemorrhage
laceration or disruption of artery or vein |
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Term
| causes of pedicle injuries |
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Definition
| accidents that propel person into air |
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Term
| treatment for pedicle injuries |
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Definition
emergency fluid resuscitation with vasoactive colloids, plasma
TRY TO KEEP PT ALIVE SO CAN REPAIR VESSELS |
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Term
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Definition
| blunt or penetrating injury to bladder that can cause reputure |
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Term
| most common cause of bladder trauma |
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Definition
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Term
| another cause of bladder trauma (2) |
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Definition
| sexual assault and seatbelts especially with full bladder |
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Term
| assessment findings in bladder trauma |
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Definition
| pain low in abd; hematuria, anuria or difficulty voiding |
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Term
| what does blood coming from the meatus mean? |
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Definition
| urethral disruption. DO NOT CATHETERIZE until you determine if disruption exists |
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Term
| why is cathing the bladder imp in bladder trauma |
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Definition
| remove urine and keep bladder empty until it heals |
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Term
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Definition
| shows bladder emptying, used with bladder trauma |
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Term
| treatment for bladder trauma |
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Definition
if greater than simple contusion, surgery required
will have cath until bladder healed
if posterior repair, will have suprapubic |
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