Week 7 Flashcards
(38 cards)
What are the functions of a normal kidney?
- Filtration of the blood
- Production of erythropoietin which regulates red blood cell production
- Aids in calcium absorption by activating vitamin D
- Control of blood pressure - renin-angiotensin II mechanism
How does glomerular filtration work if the afferent arteriole is constricted?
- Decreases blood flow
- Decreases glomerular filtration pressure
- Decreases glomerular filtration = decreases urine output
- May be due to shock, vasoconstriction
How does glomerular filtration work if the efferent arteriole is constricted?
- Increases resistance to outflow from the glomerulus
- Increases glomerular pressure
- Increases glomerular filtration = increases urine output
- May be due to vasoconstriction effect of Angiotensin II
What does the acidity (pH) in a urinalysis indicate?
What would an abnormal pH indicate?
Indicates the amount of acid in the urine.
An abnormal pH would indicate a kidney or urinary disorder
What does a specific gravity urinalysis indicate?
Shows how concentrated particles are in the urine.
Higher than normal concentration often is a result of not drinking enough fluids
Describe Renal Calculi.
The most common cause of obstruction.
Usually starts in the kidney.
Made up of materials normally excreted in the urine
What are the causes of renal calculi?
- High levels of calcium in blood and urine
- Crystallisation
- Alteration in anatomy of the urinary tract
- Metabolic disorders
- Recurrent UTIs
What are the signs and symptoms of renal calculi?
- Severe colicky pain
- Some urgency and frequency
- May be haematuria
What nursing management is associated renal calculi?
- Pain relief
- Collect all urine for straining to collect stones
- Urinalysis to check for infection
- Encourage fluids
- Pre and post procedure care
- Education on any dietary changes and fluid intake
What are some causes of renal obstructive disorders?
- Renal calculi
- Strictures form scarring
- Tumours
- Congenital disorders
What are the signs and symptoms of renal obstructive disorders?
- Recurrent UTIs
- Pain either from distended kidney or a stone
- Hypertension can be due to enhanced renin-secretion due to decrease flow
- If blockage complete may lead to
>Anuria
>Oliguria
>Renal Failure
Describe Urinary Tract Infections
- The colonisation of a pathogen to a point where it overwhelms the host inherent defence mechanisms and causes inflammation of the urinary tract
What are the causes/risks of UTIs?
- Age and gender
- Poor hygiene
- Bacteria
- Indwelling Catheter
- Diabetes
- Dehydration and urinary stasis
List the signs and symptoms of UTIs.
- Dysuria
- Frequency and urgency
- Haematuria
- Suprapubic or lower back discomfort
- Offensive smelling urine
- Elevated body temperature
- Confusion of the elderly
What nursing care is needed for UTIs?
- Pain relief as ordered
- Monitor TPR
- Encourage fluids
- Give antibiotics as ordered
- Educate patient on use of antibiotics
Describe acute pyelonephritis
- An infection of the renal pelvis
- Usually caused by bacteria
- May be due to obstruction
- Reflux from the bladder causing an ascending infection
- Rarely causes renal failure
What are the signs and symptoms of acute pyelonephritis?
- Fever and chills
- Flank/groin pain
- Frequency and dysuria
- Confusion in elderly
- Cloudy foul smelling urine
- Pyuria and haematuria
- Nausea and vomiting
Discuss the nursing care/treatment of acute pyelonephritis?
- Causes found and treated to prevent recurrence
- Give and encourage antibiotics as ordered
- Encourage fluids
- Monitor TPR
- Provide pain relief as ordered
Describe chronic pyelonephritis
- Persistent, recurrent infections
- Usually associated with obstruction or reflux
- Causes progressive inflammation and damage to the renal pelvis and the renal tubules
- Because of the diffuse scarring the kidneys are no longer able to concentrate urine as well
List the signs and symptoms of chronic pyelonephritis
- Hypertension
- Frequency and urgency
- Flank pain
- May be changes in urine output if the disease has progressed
Describe Nephrotic Syndrome
- A condition of the kidneys
- Usually caused by one of the diseases that damage the kidneys filtering system = results in an increase in permeability of the capillary walls of the glomerulus
- This allows albumin to be filtered into the urine
What is the aetiology of diabetic nephropathy?
- Glomerulosclerosis = scarring
- Damage occurs to the capillary network of the glomerulus by the long term effects of high BGLs
List signs and symptoms of diabetic nephropathy.
- First sign = protein in the urine
- May be a rise in blood pressure
- Their cholesterol and triglycerides may show at elevated levels in blood tests
Describe polycystic kidney disease
- Genetic disorder where cysts grow in the kidneys
- Can enlarge and replace normal kidney tissue = decrease kidney function
