Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

NURS 2514 > 4 - Urinary Elimination: Acute Kidney Injury + Urinary Tract Disorders > Flashcards

4 - Urinary Elimination: Acute Kidney Injury + Urinary Tract Disorders Flashcards

(64 cards)

Start Studying
1
Q

What is the main cause of glomerulonephritis?

A

Glomerulonephritis is mainly caused by immune-mediated factors such as:

  • post-infectious disease (streptococci, pneumococci, hep B, mononucleosis, measles, mumps, malaria)
  • sepsis
  • endocarditis
  • lupus
  • rheumatic disease
  • idiopathic
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Describe the common clinical presentation of nephritic syndrome.

A

The common clinical presentation of nephritis syndrome involves:

  • hematuria
  • proteinuria
  • reduced GFR
  • hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the 3 common paths that nephritic syndrome follows?

A
  • acute glomerulonephritis
  • rapidly progressive glomerulonephritis
  • chronic glomerulonephritis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Describe acute glomerulonephritis

A

Abrupt onset of symptoms often result in acute renal failure, followed by a full recovery of renal function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Describe rapidly progressive glomerulonephritis

A

Abrupt onset of symptoms in which recovery from acute renal failure does not occur

Over weeks to months - this disorder progresses to chronic renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Describe chronic glomerulonephritis

A

Acute glomerulonephritis which progresses slowly over a period of years (ex. 5-20) to chronic renal failure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does APSGN stand for?

A

Acute Post-Streptococcal GlomeruloNephtritis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What causes apsgn?

A

APSGN occurs b/c of an immune attack on a streptococcal antigen - results in immune complex + complement deposits in the glomerular capillaries

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When do nephritic manifestations occur in APSGN? When do they usualy resolve?

A

Nephritic manifestations usually occur 7-10 days after the onset of a pharyngeal or cutaneous infection w group A streptococcus (ex - streptococcus pyogenes) and resolve over a period of weeks.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Which population does APSGN usually effect? Is it more common in girls or boys?

A

APSGN usually effects children between ages 3-7 and is more common in boys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Describe the manifestations of APSGN and why they occur

A
  • hematuria + proteinuria occur due to damage to the glomerular capillaries
  • decreased GFR, oliguria and azotemia occur due to the infiltration of inflammatory cells into the glomerulus
  • pain in the flank or lower back due to distension of the renal capsule
  • hypertension + edema (facial + preorbital) as a consequence of fluid and salt overload due to a reduced GFR
  • metabolic acidosis
  • elevation of antibodies to streprococcal antigens
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How do we typically treat nephritic syndrome?

A
  • most cases resolve w a diuretic phase after treatment for the infection
  • may not be as easily resolved in adults and some cases ultimately progress to renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What does nephrotic syndrome result from?

What does it occur secondary to?

A

nephrotic syndrome results from inflammation of the glomerulus w/o the presence of cellular immune cells

nephrotic syndrome occurs secondary to a number of disorders including infection, lupus, exposure to nephrotoxins, neoplasia, diabetic nephropathy and immune-mediated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Identify the side effects of nephrotic syndrome + why they occur.

A
  • commonly presents as: proteinuria, hypoalbuminemia, generalized edema (due to reduced colloid osmotic pressure), hyperlipidemia, and lipid in the urine (milky appearance)
  • third spacing: dependent edema, ascites, effusions + weight gain, due to reduced colloid osmotic pressure
  • hyperlipidemia r/t decreased colloid osmotic pressure (liver increases procution of lipoproteins resulting in elevated LDL + VLDL)
  • hypovolemia which manifests as syncope, circulatory shock, and acute azotemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Why are some cases of nephrotic syndrome are considered to be minimal change diseases?

A

Called minimal change diseases when all manifestations occur as a result of proteinuria and progression to uremia does NOT occur

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe how we typically treat nephrotic syndrome.

A
  • usually treated w/ glucocorticoids to reduce glomerular inflammation
  • Lasix + spironolactone (for fluid + electrolyte control)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the second most common infections seen by HCPs?

A

urinary tract infections

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

T or F: most UTIs are descending infections and arise from microbes entering the urethra

A

false - ascending infections.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the major host defense against ascending infection? What is a major contributing factor of UTIs?

A
  • Major host defense is the flushing effect of urine flow

- Therefore stasis of urine is a major contributing factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Which type of bacteria is the most common cause of UTIs? What is the second most?

A

Opportunistic E. coli infections is the most common cause of UTIs

Second most common is fecal proteus bacteria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Why are females and older males more susceptible to UTIs?

A

Women: anatomical vulnerability (short, wide urethra, close proximity to anus)

Older men: enlarged prostate - retantion of urine (stasis) + frequent UTIs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Why are diabetics at a higher risk of UTIs?

A

Diabetics are at a high risk of developing UTIs due to glucosuria - as it provides an additional energy source for some bacterial strains

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Identify the risk factors that predispose pts to UTIs

A
  • women
  • older males
  • incomplete bladder emptying
  • obstruction of urine flow
  • incontinence
  • pregnancy
  • scar tissue
  • congenital defects of the ureter
  • impaired blood supply to bladder
  • catheterization
  • sexual intercourse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is cystitis?

A

Inflammation of the bladder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What are the 4 clinical manifestations of cystitis?
- PAIN (abdominal + during micturition [peeing]) - frequency + urgency due to reduced bladder capacity r/t swelling + inflammation - systemic signs of infection (fever, malaise, nausea, leukocytosis) - cloudy urine w unusual odour due to bacteriuria, pyuria, microscopic hematuria
26
How do we typically treat cystitis?
- antibiotic therapy w/ increased fluid intake to help eliminate evading organisms - cran + blueberry juice (contain tannins that interfere w the pili of E. coli and prevent the binding to urinary epithelia)
27
What is pyelonephritis? What does the infection often involve? What happens if the infection is severe?
Pyelonephritis (aka a KIDNEY INFECTION) is a type of UTI that generally begins in the urthra, bladder, or sometimes in the blood, and travels to one or both of the kidneys. The infection often involves the renal pelvis and medullary tissue - resulting in inflammation + possibly necrosis If the infection is severe - exudate + pus compress the renal vessels, resulting in ischemia + HTN. Compression of the ureter obstructs urine fow.
28
What are the clinical manifestations of pyelonephritis?
- pain (dull ache in lower back / flank) r/t distension of the renal capsule - systemic signs similar to symptoms of cystitis - on urinalysis: leukocyte + epithelia casts, failure to concentrate urine, bacteriuria - azotemia due to bacterial obstruction - chronic failure if chronic or repeated infections occur
29
What is chronic pyelonephritis?
- Chronic pyelonephritis is a term used to describe a kidney that has become shrunken and has lost function owing to scarring or fibrosis - Usually occurs as the outcome of recurring infections involving the upper urinary tract
30
What is the most common cause of urinary tract obstruction?
Urinary calculi (kidney stones) or nephrolithiasis
31
What is nephrolithiasis?
The process of forming a kidney stone
32
What are the 4 types of stone that can form in the urinary tract?
1) calcium (phosphate or oxalate) 2) struvite (Mg, ammonium, phosphate) 3) uric acid 4) cystine
33
What solute is found in approximately 75% of kidney stones? Why?
Calcium due to idiopathic hypercalcuria (most common), hyperparathyroidism, or immobility
34
Identify the contributing factors towards the development of uric acid kidney stones (10% of all stones).
- hyperuricosuria (excessive uric acid in the urine) - gout - chemotherapy - obesity - diet high in red meats + organ meats - acidic urine
35
Why do struvite stones occur? | Why do cystine stones occur?
primarily because of a chronic or recurrent UTI w urea-metabolizing bacteria + alkaline urine cystine stones are rare - usually result from inherited disorders of amino acid metabolism
36
Why do renal stones occur?
Renal stones occur when organic salts precipitate in the urinary tract. Can result from saturation or due to a change in the solubility of a salt.
37
Identify 3 factors that favour renal stone formation
- Dehydration favours stone formation by increasing urine concentration + decreasing the Ca++ transit time. - High Na+ and high protein diets - HTN
38
What are the clinical manifestations of urinary calculi?
- lower back + flank pain due to impingement of renal capsule - pain can radiate into groin, peritoneum, or scrotum as distension of the ureter occurs - excruciating pain called renal colic - lower abdominal pain occurs as the stone moves into the bladder + urethra - oliguria + hematuria - signs of hydronephrosis + hydroureter
39
What is implied if kidney stones obstruct both kidneys?
Underlying renal disease
40
What will happen if a pt w only one kidney has kidney stones?
post-renal azotemia + anuria will result
41
How do we typically treat kidney stones?
- fluids, bed rest, analgesics - thiazide diuretics for oxolate stones - antibiotics for struvite stones - alkali therapy for oxalate, uric acid, cystine stones - allopurinol treatment for uric acid stones - cellulose phosphate to chelate calcium, cholestyramine to bind oxalate - low sodium + protein intake often prevents stone formation - decreasing calcium isn't v/ helpful - lithotripsy - surgery - nutritional therapy
42
What are the 2 most common causes of urinary obstruction?
renal calculi + prostate disease
43
What are the 2 most damaging effects of urinary obstruction?
stasis of urine - predisposes to infection | increased backpressure - can impair renal blood flow + damage renal tissue
44
Describe how impedance to urinary flow can lead to ischemic damage + necrosis of the kidney
impedance to urinary flow increases the pressure w/in the renal pelvis + calices which can obstruct blood flow to the medulla and cause ischemic damage + necrosis
45
How long does it take for irreversible nephron damage to occur r/t complete urinary obstruction? How long does recovery take once the obstruction is removed?
Irreversible nephron damage can occur w/in a few days of complete obstruction. Recovery can take weeks
46
What is hydroureter? What is hydronephrosis? When do they occur?
hydroureter = dilation of the ureters hydronephrosis = dilation of the renal pelvis both occur w prolonged urinary obstruction
47
Why might abdominal distension and paralytic ileus (intestinal blockage in the absence of an actual physical obstruction) occur as a result of urinary obstruction?
due to disruption of visceral innervation which impairs GI mobility
48
Why is early diagnosis + treatment essential in the case of urinary obstruction?
Failure to restore urine flow can result in permanent renal damage - bilat obstruction can result in renal failure
49
What is benign prostate hyperplasia? What causes it?
non-malignant growth / enlargement of the prostate gland; most common benign tumor found in men cause is unknown; hormonal factors + age play a role
50
What are the 2 categories of symptoms of benign prostate hyperplasia?
- mainly caused by obstruction to urine outflow + bladder dysfunction - fall into 2 categories: irritative + obstructive
51
What causes irritative symptoms of benign prostate hyperplasia? What are these symptoms?
result of bladder hypertrophy + dysfunction - frequency - urgency - nocturia
52
What causes the obstructive symptoms of benign prostate hyperplasia?
results from narrowing of the bladder neck + urethra - difficulty initiating urination - decreased urinary flow - intermittency - hesitancy - dribbling
53
What are the complications associated w benign prostate hyperplasia?
- UTIs - hematuria - post-renal azotemia - chronic renal failure (from bilateral hydroureter + hydronephrosis) - bladder distention + hypertrophy
54
How do we usually treat benign prostate hyperplasia?
- alpha1 blockers - androgen blockade - prostate stents - surgery
55
What is the most common cancer in males?
prostate cancer
56
Identify the risk factors for the development of prostate cancer
- men w first + second degree relatives w prostate cancer are at 8x the risk - more common in men over 50 - occurs earlier in men of african descent - elevated testosterone is believed to be a risk factor - never develops in men who have been castrated - dietary fat + red meat - obesity - inactivity
57
What are the clinical manifestations of prostate cancer? How do we diagnose it?
- most tumors are asymptomatic; depending on the size of the tumor there may be changes in urination similar to BPH - screening is needed for those at risk - elevated PSA in the blood (prostate-specific antigen) - diagnosis confirmed w prosatate biopsy
58
How do we treat prostate cancer?
Surgery, radiotherapy, androgen-deprivation therapy
59
What are the 2 types of hereditary renal diseases?
- polycystic renal disease | - medullary cystic disease
60
What is the primary cause of end stage renal failure in Canada?
diabetic nephropathy
61
Describe kidney cancer in terms of its occurrence rate in men and women and its % of all cancer deaths
kidney cancer is the 5th most common cancer in men + 11th in women responsible for 2.5% of cancer deaths
62
Describe bladder cancer in terms of its occurrence rate in men and women and its % cancer deaths in men + women
bladder cancer is the 4th most common cancer in men and the 11th most common in women responsible for 4% of cancer deaths in men and 2% in women
63
What are the common screening tests used to detect prostate cancer?
- serum PSA - rectal exam (hard nodular tumors) - ultrasound (small tumors)
64
Clients with chronic kidney disease experience an increased incidence of cardiovascular disease related to which of the following (select all that apply)? - genetic predisposition - hypertension - vascular calcification - increased HDLs - increased release of EPO
- htn + vascular calcification

NURS 2514 (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions