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Nur 326 > Exam 2 Renal Conditions > Flashcards

Exam 2 Renal Conditions Flashcards

(64 cards)

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1
Q

Pyelonephritis

A

Inflammation of the kidneys

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2
Q

Pyelonephritis Etiology

A

Ascending infection or bloodstream infection

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3
Q

Pyelonephritis risk factors

A

pregnancy, recurrent lower UTIs, antibiotic resistant strain

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4
Q

Pyelonephritis response

A

Inflammatory == kidney tissue is damaged

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5
Q

Pyelonephritis extra

___ and ___ can

A

abscesses and necrosis can develop impairing renal function

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6
Q

Pyelonephritis clinical manifestations – sudden onset

A

Fever, chills, CVA tenderness (back)

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7
Q

Pyelonephritis other manifestations - 5

A

Lower UTI symptoms (dysuria), frequency and urge, hematuria, N/V, anorexia

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8
Q

Pyelonephritis Treatment - 3

A

Antibiotics - trimethoprim/sulfamethoxazole, ciprofloxacin, nitrofurantoin

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9
Q

Pyelonephritis complications

A

urosepsis

more likely in elderly, severe systemic response, high mortality rates

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10
Q

Urinary obstruction locations - 4

A

renal pelvis, ureter, bladder, or pelvis,

blockages in any point of the system prevent the flow of the liquid, causing the system to back up

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11
Q

Reval pelivs obstruction cause

A

renal calculi

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12
Q

ureter obstruction causes

A

renal calculi, pregnancy, tumors

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13
Q

bladder and urethra obstruction causes - 6

A

bladder cancer
neurogenic bladder
prostratic hyperplasia
prostrate cancer
urethral structures
pregnancy
(not usually kidney stones)

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14
Q

complications of obstruction - 3

A

stasis of urine flow (infection)
potential complications – back up pressure

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15
Q

back up pressure - 3

A

hydroureter
hydronephrosis
postrenal acute kidney injury (kidneys not working due to blockage)

ex. enlarged prostate

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16
Q

manifestations of acute obstruction depend on - 3

A

site, cause, speed of onset

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17
Q

which factor primarily determines the severity of pain?

A

speed of onset

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18
Q

nephrolithiasis

A

renal calculi or kidney stones

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19
Q

def of nephrolithiasis

A

clumps of crystals in the urinary tract
most common cause of renal obstruction

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20
Q

nephrolithiasis size and shape

A

small as grain of salt to large as golf ball
may be smooth or jagged

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21
Q

nephrolithiasis pathogenesis

A

urine is a solution of solvent and solutes. Problem is super saturated with solute so crystals begin forming in NEPHRON.

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22
Q

Crystal formation is enhanced by

A

PH changes (UTI)
Excessive concentration of salts - dehydration, bone disease, gout, renal disease
Urinary stasis - immobility, dedentary

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23
Q

nephrolithiasis risk factors - 7

A

sex - men
age - 20s to 30s
white
family history
congenital defect of kidney, urine system
weather - dehydration
obesity

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24
Q

Types of kidney stones: calcium oxidate/calcium phosphate

A

most common
family history
idiopathic
increase calcium, increase oxaluria

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25
struvite
15% urinary tract infection
26
uric acid
gout
27
nephrolithiasis clinical manifestations - pain location, radiation, spasms, sharp
location - flank radiation - lower abd and groin spasms - colicky and last 20-60 min sharp - calculi scrape and ureter wall
28
nephrolithiasis clinical manifestations symptoms - 6
n/v dysuria chills fever ONLY if infection hematuria foul smelling urine diaphoresis
29
nephrolithiasis pharmacology
morphine or nsaids (nothing long term) iv fluids
30
nephrolithiasis preventative meds
calcium - thiazide diuretics struvite - antibiotics urate - allopurinol
31
urology cancers - kidneys
rare renal cell carcinoma - 85% prognosis depends on metastasis (not usually diagnosed until after metastisized)
32
risk factors kidney cancer 5
smoking obesity age male genetics
33
renal cell carcinoma clinical manifestations - early 1 and late 3 Metastasis Usually
early: none late: CVA tenderness, hematuria, possible palpable abdominal mass metastisis usually to bone or lung - dyspnic usually resistant to chemo -- surgery
34
urological cancer - bladder
fourth most common for men urothelial carcinoma - lining of bladder
35
risk factors bladder cancer 4
smoking male occupations with exposure to toxins low fluid intake
36
bladder cancer clinical manifestations Early 1 Late 3
early - hematuria (pink/reddish) late - frequency, urgency, disuria
37
bladder cancer treatment
chemotherapy depends on stage stage 1 = intravesical chemo advanced stages - systemic chemo
38
BCG vaccine
given for intravesical therapy given weekly for 6-12 weeks
39
BCG vaccine moa
stimulates inflammatory response in bladder - goal is for immune system to recognize cancerous cells and attack
40
BCG vaccine adverse effects
bladder irritation, systemic infection -- watch if immune compromised
41
BCG vaccine patient instructions - 3
1. empty bladder 2. instill BCG vaccine into the bladder - dwell time 2H 3. Change position q 15 mintues to allow med to touch all areas Disinfect urine for 6 hours post treatment - watch for infection (Bleach urine)
42
Glomerulonephritis def Can be Third Primarily
a variety of conditions that cause the inflammation of glomeruli - can be local or diffuse -third leading cause of kidney failure -Primarily an IMMUNE process
43
Glomerulonephritis where Delicate
glomerulus delicate network of arterioles within the bowman's capsule
44
tubules
massive consumer of oxygen
45
glomerular disorders Alterations
alterations in glomerular capillary
46
capillary membranes of glomerulus have three layers
endothelium basal membrane - where most issues occur podocytes
47
type 2 reactions
occur on cell surface and result in direct cell death or malfunction
48
type 3 reactions
immune complexes are disposed into tissues and resulting inflammation destroys tissue
49
etiology of Glomerulonephritis (2)
1. antibodies attach to antigens of the glomerular basement membrane (anti GBM antibodies) = TYPE 2 2. Antibodies react with circulating antigens and are deposited as immune complexes in the GBM - 90% - TYPE 3
50
both forms have this in common Accumulation Complement
accumulation of antigens, antibodies and complexes complement activation results in tissue injury
51
Acute glomerulonephritis Abrupt
abrupt onset of Glomerulonephritis
52
characteristics of acute Glomerulonephritis 4
HARP Hematuria Azotemia - buildup of waste Retention - sodium and water - oliguria (leads to HTN and edema) Proteinuria - proteins in urine
53
Acute Glomerulonephritis triggers - 3 Post infectious Primary disease Multisystem disease
post infectious - strep or nonstrep primary disease - Berger disease (IgA causes inflammation) multisystem disease - goodpasture syndrome, systemic lupis, vasulitis
54
Acute Glomerulonephritis pathogenesis
Trigger > immune complex forms > complement activated > release of mediators > tissue injury > Hematuria proteinuria Decreased GFR
55
Chronic Glomerulonephritis Long Manifestations Prognosis
--Long term inflammation of the glomerulus - scar tissue --manifestations same as acute --prognosis: slow progressive destruction to ESRD.
56
Nephrotic syndrome
The glomerulus is too permeable to plasma proteins Elimination of >3 grams of protein per day
57
nephrotic syndrome etiology
glomerulonephritis DM
58
Nephrotic syndrome pathogenesis 3 Increased Proteinuria Hypo_
Increased glomerular permeability -- not functional Proteinuria - decreases albumin -- third spacing Hypo-albuminemia
59
Nephrotic syndrome clinical manifestations
edema hypertension liver problems : hyperlipidemia, hypercoagulation, loss of antithrombin 3 and plasminogen
60
Glomerulopathy: Diabetic nephropathy
major complication gross thickening of GBM-- decrease urine, increase buildup ultimately leading to ESRD
61
Glomerulopathy: hypertensive glomerular disease
scarring decreased renal perfusion - sclerotic glomerular changes
62
glomerulopathy manifestations
hematuria proteinuria oliguria low albumin fluid retention increased BUN/Cr ratio
63
Hydroureter
Dilation of proximal ureter
64
Hydronephrosis
Dilation of renal pelvis and calicies

Nur 326 (6 decks)

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