Renal Flashcards
(35 cards)
1
Q
involuntary urination in children >4yo
A
enuresis
2
Q
high BUN & creatinine
A
azotemia
3
Q
swelling of one or both kidneys
A
hydronephrosis
4
Q
GFR requiring adjustment of med dosages
GFR requiring dialysis
A
60
10-15
5
Q
URINARY TRACT OBSTRUCTION
explanation
etiology
s/s
dx test
A
- Blockage that inhibits flow of urine through normal pathway
- Etiology - urolithiasis; BPH; tumor
- s/s - fever; n/v; flank pain; difficulty starting stream; limited urine; hydronephrosis
- Blunt percussion to the kidney causing pain indicates hydronephrosis
6
Q
RENAL CALCULI
explanation
etiology & types
r/f
s/s
complication
A
- Urolithiasis - usually made of calcium or uric acid (also struvite, crystalline) - form inside kidney & can travel through UT
- Etiology - varies on type
- Struvite - infection
- Uric acid - gout
- r/f - dietary; infection; ↑ uric acid; genetics
- s/s - hydronephrosis; unilateral flank pain; n/v; retching with waves of pain; dysuria; hematuria; frequency with small voids; hesitancy
- More painful & complicated if stone gets stuck in ureter
7
Q
CYSTITIS
etiology
r/f
s/s
A
- “UTI” or “bladder infection”
- Etiology - usually E. coli
- r/f - aging (loss of estrogen, skin changes around vulva); young girls; female; Foley; incontinence; sexual activity
- s/s - dysuria; frequency; hematuria; cloudy urine; malodorous urine; confusion in older pts
8
Q
PYELONEPHRITIS
etiology
r/f
s/s
A
- “Kidney infection”
- Etiology - often ascends from bladder; usually E. coli
- r/f - frequent UTI; reflux; catheter use; enlarged prostate; CKD; kidney stones; DM; immunocompromise
- s/s - systemic - fever; n/v; malaise; colicky flank pain, waves of nausea; chills; dysuria (burning with urination); malodorous urine; hematuria; urgency; frequency; pyuria
9
Q
STRESS INCONTINENCE
explanation
etiology
r/f
s/s
A
- Physical activity puts pressure on bladder
- Etiology - sphincter & pelvic muscles are stretched out and weak
- r/f - pregnancy; childbirth; obesity
- s/s - loss of urine with standing up, laughing, coughing, sneezing, lifting, sex, exercise
10
Q
OVERFLOW INCONTINENCE
explanation
etiology
r/f
s/s
A
- Overfull bladder
- Etiology - nerve damage affecting ability to sense fullness; blockage in urinary tract; weak detrusor muscle; medications
- r/f - enlarged prostate; kidney stones; neurological damage; tumors; DM; MS; trauma
- s/s - leaking urine without sensation of fullness__, with full bladder
11
Q
URINARY RETENTION
explanation
etiology
r/f
s/s
A
- Inability to completely empty bladder
- Etiology - nerve damage affecting ability to sense fullness; blockage in urinary tract; weak detrusor muscle
- r/f - recent surgery, especially to bladder; neurological damage; blockage; structural
- s/s - inability to empty bladder despite fullness
12
Q
NEPHROTIC SYNDROME
explanation
etiology
r/f
s/s
A
- Too much protein excretion
- Etiology - damage to basement membrane - ↑ permeability of capillary wall
- r/f - infection; CKD; DM; lupus; medications
- s/s - proteinuria; edema; foamy urine; wt gain, ascites, puffy face (fluid leaving vascular compartment); fatigue; loss of appetite; hypoalbuminemia; HLD (liver’s response to hypoalbuminemia); ↓ antithrombin 3 (hypercoagulative state)
13
Q
GLOMERULONEPHRITIS - NEPHRITIC SYNDROME
explanation
etiology
r/f
s/s
A
- Inflammation of glomerulus; Damage to basement membrane - larger molecules (RBCs, WBCs) able to enter filtrate
- Etiology - autoimmune, type 3 hypersensitivity - complexes get stuck in glomerulus & cause damage
- r/f - infection; immune disease; vasculitis; DM; HTN
- s/s - severe hematuria (cola colored)__; pyuria__; proteinuria; edema; HTN; oliguria
14
Q
3 types of acute kidney injury
A
- Prerenal - blood flow to kidney
- Intrarenal - within kidney
- Postrenal - ureters, bladder, urethra
15
Q
PRERENAL AKI
etiology
r/f
s/s
A
- Sudden renal hypoperfusion
- r/f - hemorrhage/blood loss__; HF; sepsis; severe dehydration; severe burns; pancreatitis; hepatitis; blood loss in surgery, injury
- s/s - hypovolemia; thirst; ↓ urine; dizziness; ortho hypotension; v/d; hemorrhage
16
Q
INTRARENAL AKI
etiology
r/f
s/s
A
- Sudden episode of kidney failure due to direct glomerular damage
- r/f - infection; chronic disease (GN, nephrotic syndrome); toxins; medications
- s/s - vary - fever; rash; hematuria; oliguria; fatigue; dyspnea; nausea
17
Q
POSTRENAL AKI
etiology
A
- Sudden episode of kidney failure - blockage below kidneys causes waste to back up
- Etiology - varies - tumor; enlarged prostate; stone
18
Q
9th leading cause of death in US
A
CKD
19
Q
gradual, progressive loss of kidney function
A
chronic kidney disease/renal failure
20
Q
stages of renal failure with % kidney function
A
- 1 - 90% or more function
- 2 - 60-89%
- 3 - 30-59%
- 4 - 15-29%
- 5 - <15% - end stage renal failure
21
Q
etiology of CKD
A
increasing amount of glomerular damage, leading to kidneys’ inability to manage filtration
- Acute bil kidney diseases
- Severe, prolonged circulatory shock/HF
- Nephrotoxins
- Mechanical obstruction
22
Q
r/f for CKD
A
DM; HTN; CV disease; older age; Native American; African American; smoking; obesity; abnormal kidney; family hx
23
Q
urinary sx of CKD
A
↓ urine output
azotemia
24
Q
neuro sx of CKD
A
anxiety
depression
fatigue
h/a
sleep disturbance
encephalopathy
peripheral neuropathy
25
CV sx of CKD
HTN
HF
CAD
pericarditis
PAD
anemia (↓ erythropoietin)
bleeding
26
ocular sx of CKD
hypertensive retinopathy
27
GI sx of CKD
anorexia
n/v
bleeding
gastritis
28
respiratory sx of CKD
pulmonary edema
uremic pleuritis
pneumonia
29
endo/reproductive sx of CKD
hyperparathyroidism
thyroid abnormalities
amenorrhea
ED
30
integ sx of CKD
pruritus (azotemia)
ecchymosis
dry, scaly skin
31
metabolic sx of CKD
carbohydrate intolerance
HLD
32
MS sx of CKD
calcifications
osteomalacia
33
**HEMODIALYSIS**
function
accessed how?
performed when?
* Filters wastes and water from blood
* Helps control BP, balance K, Na, Ca
* Vascular access - ONLY use for dialysis
* Arteriovenous (AV) fistula
* AV graft
* Catheter
* 3x/week for 4 hours
34
**PERITONEAL DIALYSIS**
uses what?
how to use?
accessed how?
* Uses peritoneum to filter blood
* Must empty used solution & refill with fresh solution 4-6x/day
* Surgical catheter placement
35
**BLADDER CANCER**
prevalence
r/f
s/s
prognosis
* Very common cancer
* r/f - _smoking_; older age; _male_; exposure to toxins; _parasitic_ infections
* s/s - _hematuria_; dysuria; _back pain; pelvic pain_; frequency
* Prognosis - _\>77%_ survive 5 years
