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Exam 4 > Nephritis > Flashcards

Nephritis Flashcards

1
Q

The functioning unit of the kidneys is…

A

Nephrons

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2
Q

Inflammation of the kidneys is called…

A

Nephritis

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3
Q

The inflammation of the glomerular capillary membrane is…

A

Glomerulonephritis

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4
Q

This type of nephritis is caused by a response to a streptococcal infection such as strep throat, and impetigo. Other infections include: staph, pneumococcus, and coxsackie virus

A

Acute post-infectious glomerulonephritis (APIGN)

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5
Q

With APIGN the patient will have an abrupt onset of….

A

Hematuria, Proteinuria, azotemia, salt and water retention, periorbital edema, HTN

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6
Q

In APIGN the onset usually occurs around _______ days after the initial infection.

The patients urine will be

A

10-14 days

Tea/coca-cola colored

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7
Q

This form of nephritis is an abrupt result of an immune complex reaction in the glomerular capillary wall.

A

Acute Proliferative glomerulonephritis

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8
Q

APGN has antibody-antigen complexes that lodge in glomeruli leading to….

A

Inflammation/obstruction

Vascular permeability is decreased leading to leaking of protein and RBC’s

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9
Q

This form of glomerulonephritis is considered “end stage”

A

Chronic glomerulonephritis

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10
Q

Chronic glomerulonephritis is usually seen in what other conditions?

A

RPGN, Lupus Nephritis, and diabetic neuropathy

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11
Q

In chronic glomerulonephritis the patient will have a ____ decline in renal fx. The kidneys will be _____ symmetrically and surfaces become _____.
This disease is not often recognized until ____ develops

A

reduced (small)
rough
renal failure

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12
Q

____ nephritis is caused by a patients disorder of SLE. This happens due to the autoimmune attacks on the kidney. This is one of the more severe consequences of SLE.

A

Lupus

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13
Q

Manifestations of Lupus nephritis are:

A

Hematuria, and proteinuria

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14
Q

Progression of Lupus nephritis may be ___ or ____ with a rapid development of renal failure.

A

Acute/Chronic

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15
Q

This type of nephritis is caused by a rare autoimmune disorder characterized by a formation of antibodies to the glomerular basement membrane.

A

Goodpasture Syndrome

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16
Q

In a person with goodpasture syndrome, if the basement membrane gets damaged this causes damage to the ____ which leads to ____ _____

A

alveoli

Pulmonary hemorrhage

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17
Q

Goodpasture syndrome is seen in what ages?

And is more prevalent in….

A

20-30, and 60 years

White males

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18
Q

Manifestations of goodpasture syndrome include:

A

Hematuria, proteinuria, edema

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19
Q

In goodpasture syndrome progression to ___ is rapid.

A

ARF (acute renal failure)

20
Q

This type of nephritis is caused by injury to the renal tubules and interstitium, secondary to glomerular damage.

A

Tubulointerstitial Nephritis

21
Q

Tubulointerstitial nephritis can be caused by

A

drugs, toxins, radiation, or renovascular disease

22
Q

RF for Nephritis are:

A

HTN, SLE, DM, Infections, OTC meds such as NSAIDS,

Trauma, Sickle cell, AIDS, CHF, Anemia.

23
Q

Nephritis can be prevented by:

A

Washing hands
Controlling BP and diabetes
Not smoking
Maintaining healthy weight (exercise)

24
Q

Glomerulonephritis is usually asymptomatic. It may also have manifestations of

A

fever, mild periorbital edema, hematuria, oliguria

25
Q

What pulmonary signs of edema will the nurse see in a person with glomerulonephritis?

A

pleural effusion, dyspnea, cough, and crackles

26
Q

diagnostic tests include:

A
  • -Throat/skin culture (group A strep)
  • -ASO titer- (+)
  • -ESR (inflammation)- increased with APIGN, and lupus nephritis
  • -KUB- rule out other causes (acute-kidneys enlarged, chronic- small)
  • -Biopsy- most reliable (Tell type of nephritis, prognosis, and tx. needed)
  • -GFR- reduced (#1 indicator)
  • -BUN-increased (up to 50- mild azotemia, >100- severe renal impairment)
  • -Creatinine-increased (level >4 = impaired renal fx.)
  • -serum electrolytes (increased K+)
  • -albumin (low)
  • -UA (check for RBC, and protein in urine)
27
Q

This med can be given to manage HTN and edema by pulling fluids.

A

furosemide

28
Q

These can be given to eradicate any bacteria causing agents, that can cause APIGN, SLE, Goodpasture

A

Antibiotics

29
Q

This med can be given to reduce inflammation.

A

corticosteroid (prednisone)

Given in large doses (1mg/kg)

30
Q

These drugs can be given to suppress the immune system so it doesn’t attack itself (SLE)

A

Immunosuppressants (cyclophosphamide, azathioprine, mycophenolate)

31
Q

This drug must be avoided with APIGN because it may worsen the condition.

A

Corticosteroids

32
Q

These meds can help reduce protein loss and slow the progression of nephritis

A

ACE inhibitors, and ARBS

33
Q

These meds can be given to help with HTN

A

Antihypertensives (lol drugs)

34
Q

Non pharm tx. for Glomerulonephritis are:

A
  • -Bed rest (acute)
  • -Fluid restrictions
  • -dietary restrictions (reduce Na+, K+ intake)
35
Q

If a patient has azotemia this may need to be limited in their diet

A

Protein

36
Q

Examples of complete proteins are:

A

milk, eggs, cheese, meats, poultry, fish, soy

37
Q

Examples of incomplete proteins are:

A

breads, cereals, grains, legumes, seeds, nuts

38
Q

This procedure can be done in combination with immunotherapy to treat RPGN, and Goodpasture. It is done by removing damaging antibodies from the plasma.

A

Plasmapheresis

39
Q

Three nursing Dx. for a person with glomerulonephritis can be…

A
  • -Risk for infection
  • -Fluid volume overload
  • -Imbalanced nutrition
40
Q

The nurse must monitor the patients…

A
  • -VS
  • -UOP (color. clarity, smell)
  • -daily weight
41
Q

Normal urinary output is…

A patient with glomerulonephritis should have a UOP of at least….

A
  • -1 ml/kg/hr

- -0.5 mL/kg/hr

42
Q

What care should the nurse implement when caring for a patient with glomerulonephritis?

A
  • -fluid restriction
  • -Q2 turns if immobile
  • -Pad bony areas
  • -promote nutritional balance
  • -prevent fatigue
  • -Promote self esteem
43
Q

The nurse should prevent infection by…

A
  • -Washing hands
  • -avoiding invasive procedures
  • -use a closed drainage system for urinary catheter
  • -limit visitors
44
Q

when a person is on a low Na+ diet they should be informed not to use ____. These products contain KCl and can cause salt to go up.

A

Salt substitutes

45
Q

If a pt. has salt and water retention. they may present with HTN, hematuria, mild/moderate edema. The nurse should provide what clinical therapies?

A
  • -Diuretics
  • -Antihypertensives
  • -Na+ restriction
  • -Low protein diet
46
Q

If a pt. has severe HTN they will present with extremely high BP with cerebral dysfunction. What is the clinical therapy for this pt?

A

–emergency care that includes IV diazoxide, hydralazine, or labetalol

47
Q

If patient presents with an infection. They will have a fever, edema, and malaise. What is the clinical therapy the nurse can perform?

A
  • -antibiotics
  • -bed rest
  • -low Na+ diet
  • -antipyretics

Exam 4 (10 decks)

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