Topic 9: Chronic Pyelonephritis & Chronic Glomerulonephritis

Question 1

Chronic Pyelonephritis

Answer 1

the kidneys become inflamed, develop fibrosis (scarring) leading to loss of renal function and can atrophy (shrink), this can progress to ESRD.

Question 2

Chronic glomerulonephritis

Answer 2

a syndrome of permanent and progressive renal fibrosis, can progress to ESRD

Question 3

Clinical Manifestations of Pyelonephritis

Answer 3

· Same as UT but MUCH WORSE
· Costovertebral tenderness
· Dull flank pain
· Extending toward the umbilicus

Question 4

Clinical Manifestations of Glomerular Nephritis

Answer 4

· Hematuria
· WBCs & casts in urine
· Proteinuria
· S/S of uremia
· Elevated BUN & Creatinine
· History of: drug use, Lupus, Scleroderma

Question 5

Diagnosis for Pyelonephritis

Answer 5

· Radiologic imaging

Question 6

Diagnostic Tests for Glomerular Nephritis

Answer 6

· Kidney Biopsy
· Ultrasound
· CT
· CBC, CMP

Question 7

risk factors for bladder cancer

Answer 7

· Half of bladder cancers are related to SMOKING
· Exposure to dyes
· Indwelling catheters for long periods

Question 8

bladder cancer is more common in

Answer 8

men than women and in whites thanks blacks and Hispanics

Question 9

bladder cancer clinical manifestations

Answer 9

· Painless hematuria
· Irritable bladder
· Frequency
· Dysuria
· Urgency

Question 10

bladder cancer diagnostics

Answer 10

· Urinalysis
· Urine cytology studies
· Cystoscopy with biopsy
· CT
Ultrasound

Question 11

Transurethral resection with fulguration

Answer 11

wire look inserted through cystoscope to remove the tumor and tissue; fulguration burns the base of the tumor to kill cancer cells

Question 12

Cystectomy

Answer 12

segmental only part of bladder wall containing the tumor is removed; radical cystectomy involves removal of the bladder, prostate, and seminal vesicles in men and bladder urethra, cervix, ureters, anterior vagina and ovaries in women

Question 13

Intravesical therapy

Answer 13

drug is instilled in patient’s bladder and retained for 2 hours

Question 14

Intravesical therapy management

Answer 14

o Bladder must be empty before instillation
o Patient change position every 15 minutes during instillation for maximum contact in all areas of the bladder

Question 15

Post-op Instructions for any procedures (bladder cancer)

Answer 15

· Drink large volume of fluid the first week after procedure
· Teach patient to monitor color and consistency of urine

Question 16

after any bladder surgery urine is…

Answer 16

o Pink for the first several days after procedure is normal
Should NOT be bright red or contain blood clots

Question 17

patients teaching/ health promotion for bladder cancer

Answer 17

Increase fluid and quit smoking