Renal & Urological Blueprint Flashcards
(54 cards)
What is the cardinal sx of Post-Streptococcal Glomerulonephritis?
hematuria
List the sx of Post-Streptococcal Glomerulonephritis (hint: 17)
- Edema (pitting & dependent)
- Decreased weight
- Decreased urine output
- lethargy
- Irritability
- Pallor
- Febrile
- Headaches
- Dysuria
- Abd pain
- Elevated BP
- Foamy urine
- Frequent hiccups
- Generalized itching
- Nosebleeds
- Increased bruising
- Seizures
What is a life threatening complication of Post-Streptococcal Glomerulonephritis?
pulmonary embolism
What causes Post-Streptococcal Glomerulonephritis?
Group A beta-hemolytic streptococcal infection
List the nursing diagnoses for Glomerulonephritis (hint: 6)
- Ineffective breathing pattern related to the inflammatory process.
- Altered urinary elimination related to decreased bladder capacity or irritation secondary to infection.
- Excess Fluid volume related to a decrease in regulatory mechanisms with the potential of water.
- Risk for infection related to a decrease in the immunological defense.
- Imbalanced nutrition less than body requirements related to decreased appetite, nauses, or vomiting.
- Hyperthermia related to the ineffectiveness of thermoregulation secondary to infection.
List the tx for Post-Streptococcal Glomerulonephritis (hint: 6)
Penicillin G
Penicillin V
Supportive care
Manage HTN
Dietary modifications
Bed rest
What dietary modifications are used for Glomerulonephritis and why?
Na and fluid restriction should be advised for treatment of S&S of fluid retention (eg, edema, pulmonary edema)
Why is bed rest recommended for Glomerulonephritis?
until signs of glomerular inflammation and circulatory congestion subside as prolonged inactivity is of no benefit in the patient recovery process.
List the nursing interventions for Glomerulonephritis (hint: 5)
- Obtain complete physical assessment
- Monitor daily weight to have a measurable account on the fluid elimination.
- Monitor I&O every 4 hours to know progressing condition via glomerular filtration.
- Monitor BP and HR every hour to know progression of HTN and basis of further interventions mostly BP for HTN
- Assess for adventitious breath sounds to know for possible progression in the lungs
what is bladder exstrophy?
Congenital defect where the bladder is open and exposed to the outside of the abdomen.
What is the highest priority in bladder exstrophy?
skin disruption related to the exposed bladder mucosa
How can bladder exstrophy be corrected? (hint: 4 ways)
- Bladder closure (moving it inside the body)
- Epispadias repair with reconstruction of the genitalia.
- Bladder neck reconstruction (reconstruction of the urinary sphincter muscles)
- Pelvic osteotomy (closing the pelvic bones)
What imaging is involved in bladder exstrophy?
Imaging will include renal ultrasounds and pelvic X-rays. Prior to surgery, low-dose CT scan to assess pubic diastasis and potential hip issues.
Before bladder exstrophy correction surgery, what is sometimes given to males and when?
In some males, pre-operative testosterone is administered six weeks before the operation and then again three weeks before the operation.
What is the ideal age for bladder exstrophy correction surgery?
between 4 weeks and 16 weeks of age
Post-op considerations for bladder exstrophy correction surgery include management of what?
Management of their many tubes (ureteral stents, bladder suprapubic tube, urethral stent, and drain)
Is epispadias common?
No, it is rare
What is epispadias?
a birth defect where the urethra (the tube that carries urine from the bladder) does not develop into a full tube, and the urine exits the body from an abnormal location
mild to severe
severe epispadias is associated with what?
exstrophy of the bladder
what is important to note about epispadias and circumcision?
Male infant should not be circumcised until corrective surgery for epispadias is done
What is the cause of nephrotic syndrome?
Pathogenesis not understood → may be metabolic, physiochemical, biochemical, or immune-mediated disturbance that causes the basement membrane of the glomeruli to become permeable to protein
List the secondary systemic causes of nephrotic syndrome (hint: 4)
Lupus Erythematosus
Cancer
Heavy Metal Poisoning
Hepatitis
List the sx of nephrotic syndrome (hint: 15)
- Edema
- Proteinuria
- Anorexia
- Abd pain
- Fatigue
- Weight gain
- BP normal or slightly decrease**
- Susceptible to infection
- Hyperlipidemia
- Increased risk of thrombosis
- Bad kidney can give secondary HTN or renal HTN
- hyperalbuminurea**
- hypoalbuminemia**
- hypovolemia**
- Overall reduced volume
What is the tx options for nephrotic syndrome? (hint: 6)
Diuretics
Antibiotics
Corticosteroids
ACE inhibitors
Blood thinners
Low-sodium diet with moderate amounts of protein
