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Renal SystemMedical Surgical Nursing

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What should be monitored in a patient with glomerolonephritis?
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Urine output.
Who is most likely to suffer from chronic UTI's?
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Elderly, incontinent women who live in nursing homes; usually given prophylactic antibiotics.
Within the kidney...
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Intrarenal
What are common antiemetics used for patients with RF?
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Zofran; Phenegren (increased fatigue)
What is the most common cause of acute renal failure in children?
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Hemolytic uremic syndrome (the older the child, increased risk of severe damage). 90% get well!
How does an obstruction lead to renal failure?
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Obstruction leads to urinary stasis leads to enlargement and fibrosis of the distal nephron leads to enlargement and fibrosis of the proximal nephron leads to damaged glomeruli leads to decreased GFR leads to inability to conserve Na+, HCO3 or excrete H+
Strictures occur in the _______ urinary tract.
Show Answer
upper: ureter
What conditions increase the risk of pyelonephritis?
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Pregnancy; obstruction; sexual trauma.
A lower tract obstruction can lead to _______ and then on to impaired renal function.
Show Answer
chronic pyelonephritis (an ascending UTI which has reached the pelvis of the kidney).
Who is more likely to get pyelonephritis?
Show Answer
Women, diabetics, and history of kidney stones. Men have higher incidence after age 65, complication of BPH.
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What are the 3 main forms of nephrotic syndrome?
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Idiopathic, secondary (from lupus, diabetes, drugs, venom), congenital.
What are signs and symptoms of post renal obstructions?
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anuria followed by polyuria; flank pain
How is pyelonephritis treated?
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Rocephin or fluoroquinolones
Where do stones commonly form?
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Papillae; renal tubes; calcyes; renal pelvis. Can also occur in the ureter, urethra or bladder.
What are risk factors for kidney stones?
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Men; caucasian; family history; south; summer; prolonged bed rest.
What are signs and symptoms of kidney stones?
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Depends on location. Renal colic; urinary frequency/urgency; hematuria; n/v; hydronephrosis; decreased GFR, increased creatinine; renal failure.
What are some characteristics of rapidly progressing glomerulonephritis?
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Develop over a period of days to weeks; affects primarily adults aged 50-60; can be idiopathic or associated with a proliferative glomerular disease; hematuria (may/may not have proteinuria, edema, HTN); decrease in glomerular fxn, RF in weeks/months.
What are the phases of acute renal failure?
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Oliguria: 1 day after events, last 1-3 weeks; Diuresis: watch electrolytes; Recovery: 3-12 months.
What are some secondary causes of glomerulonephritis?
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Lupus; Good pasture's syndrome; infective endocarditis.
Chronic pyelonephritis results in...
Show Answer
destruction of tubules; inability to concentrate urine; renal failure.
What are the signs and symptoms of a lower tract obstruction?
Show Answer
Increased frequency of urination, greater than every 2 hours; nocturia; poor force of stream; intermittent stream; urgency/hesitancy; feeling of incomplete emptying; acute urinary retention history.
  
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