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Radiologic study to evaluate structure, function of KUB

Using radiographs and radiopaque dye

Force fluids after to excrete dye

Intravenous pyelography


Visualization of complete ureter, renal pelvis needed.

Performed during cystoscopy

Carries risk of sepsis, severe UTI

Retrograde pyelography


Evaluates the bladder structure abnormalities, filling.



Rapid series of x rays while voiding

Contradicted in UTI

Voiding cystourethrography


Evaluate bladder, renal function, assess cause of reduced urinary flow, urinary retention or incontinence.

Uroflowmetry, cystometrography

Urodynamic studies


BUN normal range



GFR normal range

90 or greater


Inflammation in glomeruli believed to be from antigen antibody stimulation in the glomerular membrane which changes the membrane permeability. More common in males

More common in children and young adults.

Proceeded by strep or viral inf

Acute glomerulonephriris/ Bright’s disease


Hematuria and proteinuria is a S/S of

Acute glomerularnephritis/Brights disease


How do you dx acute glomerularnephritis/brights disease


Elevated ASO titer

Percutaneous renal biopsy


Tx for acute glomerularnephritis/Bright’s disease


Bed rest until BUN decreases and hematuria decreases

Low sodium diet and dec fluids if needed

Diuretics/ antihypertensives/ steroids

i&O and weights


Nursing care for acute glomerularnephritis/ Bright’s disease

Inc urine output and dec wt means patient is improving.

VS monitor BP

Sodium and protein diet restriction


Pt not cured till urine free of protein and RBC for 6 mo


Causes of ____ ____ causes are autoimmune connective tissue disorders (lupus) resulting in scar tissue that replaces nephrons and may progress in renal failure

Slow progressive disease in which there is inflammation of the glomeruli that causes irreversible damage to nephrons

Chronic glomerulonephritis


S/S of ___ ___ may not have SS for years

Anasarca- which is caused by a fluid shift and protein (albumin) is lost in urine.

Ss of renal failure

DX- dec RBC
Azotemia- nitrogenous waste in blood
Protein and casts in urine
Early stages percutaneous kidney bx

TX: symptomatic
Dec edema, and bp
Prevent CHF, correct fluid and electrolyte prob, eliminate UTI
May eventually require dialysis or kidney transplant

Chronic glomerulonephritis


___ ___ ___ inherited as autosomal dominant trait, infantile (rare) and adult forms, formation of multiple bilateral kidney cysts. They cause kidneys to greatly enlarge as cysts accumulate fluids

*hypertension, pain, colic. Hematuria, renal stones

Dx findings:
Abd US, CT, MRI, IVP, labs

Tx- no cure, tx HTN, *avoid all nephrotoxic meds-nsaids/cephalosporins
Surgical removal of kidney, dialysis, transplant
Monitor BP, I&O and labs

Polycystic renal disease


Stones in urinary tract



Stone in kidneys



Stones in ureters



Chronic ureteral stone formation; compressive congenital anomalies of conditions

S/S flank pain or discomfort, tenderness

DX: voiding cystourethrogram, ultrasonography

Tx: dilation ureteroplasty(remove narrow section of ureter and put good parts together)

Typical post op care, I&O, assess for shock pain SS of UTI

Ureteral stricture


___ ___ are typically malignant

*painless hematuria, flank pain, palpable mass.

Tumor cells often metastasize to *lungs, bone, lymph, liver, and brain by way of renal vein and vena cavae

Dx finding/ PE, radiography, IVP, cystoscopy w retrograde pyleogram, ultrasonography, MRI, CT, renal angiography

Med management: nephrectomy; radiation therapy; chemotherapy, palliative tx for metastases
*wilms rumor in children do not palpate

Kidney tumors

Nurse care: discourage laying on operative side, monitor I&O, pain, bleeding. Encourage fluids, irrigate tubes/catheter or ordered


___ ___ is the inability of nephrons in kidneys to maintain fluid/electrolyte & acid base balance: excrete waste products and to perform their regulation of body

Acute: ARF, sudden, rapid decrease in renal function

Chronic: CRF, progressive, irreversible, takes years to develop

Renal failure


__ ___ ___ develops due to prerenal, intrarenal, and post renal disorders.

Acute renal failure


___ ___ ___ usuAlly is caused by intrarenal conditions or systemic diseases

ESRD- less than 10% of kidney function and pt require dialysis. GFR less than 15

Damage to nephrons is slow and often do not notice declining renal function.

Uremia, hyponatremia, electrolyte imbalances-metabolic acidosis, uremic frost-skin acts as excretory organ and precipitation-irritation of skin and smells bad.

Chronic renal failure

H/A blurred vision,
Inability to concentrate
Inc BP
Dec urine output
Facial puffiness
Dry itchy skin
Odor of urine


Dx of chronic renal failure

Inc BUN, creatine, K, MG, Ph
Dec CA, RBC, h&h, GFR
blood ph is acidotic
Renal Bx

Tx: prevention
ARF promptly tx cause
Hemodialysis/peritoneal dialysis
Kidney transplant

Medical TX
IV fluids, vasodilator, diuretic, dopamine, temp hemodialysis while tubules regenerate, protein K, NA, ph restriction.
-protein restriction helps decrease urea build up in body. NA polystyrene sulfonate (po/rectal)
IV glucose and insulin to move K back into the cells
Epogen inj- inc o2 compacity of RBC