CHAPTER 37 DISORDERS OF THE URINARY TRACT MED SURGE
azotemia
rapid accumulation of toxic in the blood
kidney stones
renal calculi
Urosepsis
septicemia originating from the urinary tract.
diagnostic test
several test are available to differentiate pyelonephritis of cystitis
a classic clinical manifestation of PKD are
severe headache (brain aneurysm)
intermittent catheterization
short-term catheter which is inserted several times a day to drain urine. Changed every 3 hours
overflow incontinence
small amounts of urine leak from a full bladder
cytostomy
surgical creation of an artificial opening into the urinary bladder to provide an alternative exit pathway for urine
symptoms of PKD
symptoms -headache -HTN -
complications of Policystic disease
the patient may have aneurism, that may rupture and lead to sub-arachnoid hemorrhage
Hypertension is related
to renal disease and fluid overload
causes of stone formation
too much a animal protein vitamin C
urea is formed by the liver
when protein get mettabolized
IN PKD cyst are fluid filled
with blood, or urine, they may experience
treatment for pyelonephritis
-antibiotic take it for several weeks you may need to be in the hospital if you have any other problems
changes in renal function that comes with age
-decrease glomerular filtration rate -decreased renal flow -risk for toxicity and overdose
Keep your kidneys healthy
-drink plenty of water -cranberry juice -vitamin C -do not resist the urge to urinate -urinate after sex
Glomerulonephritis
-symptoms -oliguria/HTN/ -electrolyte imbalance -edema
detrusor muscle
Smooth muscle that compresses the urinary bladder and expels urine into the urethra.
Lithotrypsy
Technique that uses ultrasound to smash the stone into "gravel" that is small enough to pass through the ureter, bladder and urethra?
Uremic frost
Urea and uric acid salt deposits excreted in sweat as a result of uremia, giving the skin a powdery appearance
urine constituents
Urea, nitrogen, Creatinine and urea
the kidneys are responsible for maintaining blood PH
blood PH
elements present in urine
blood, white blood cells, nitrates positive
Types of renal stones
calcium oxalate calcium phosphate Uric acid
sometimes glomerulonephritis
can be immunologic, and can progress into CKD (Goodpasture syndrome)
repeating infections of the kidneys
can lead to scarring and loss of kidney functions
some elderly can experience
changes in mental status with a UTI infection
Nephrotic SYNDROME
characterize by large amount of protein in urine, increased membrane permeability
angina may occur with
chronic anemia
CVA
costo vertebral angle tenderness, evidence phyelonephritis
people develop UTI
due to obstruction of urine
women are ost susceptible to Urinary infections
due to the short length of the urethra, it means shorter distance from anus, which facilitate bacterial colonization
UTI SYMPTOMS
dysuria urgency frequency cloudy urine foul smelling urine
vertebral intercostal pain
evidence renal disease
renal cast
evidence renal disease\
renal stone symptoms
fever/nausea/vomiting
is important to monitor serum/creatinine levels
for patients receiving drug therapy
PKD symptoms
hematuria hypertension
symptoms of renal calculi
includes excruciating pain, the patient also have costovertebral tenderness, some people develop nausea or diarrhea because of the proximity of the GI
...
increased fluid
in nephrotic syndrome
increased membrane permeability allow red blood cell to
cystitis
inflammation of bladder
Cystitis
inflammation of the bladder wall may be caused by bacteria. Commonly treated with ciprofloxacin
urethritis
inflammation of urethra
Escherichia Coli
is a bacteria commonly found in feces, is responsible for Uti
PKD
is a genetic disease, where genetic mutation allow for a numerous formation of cyst, kidney get enlarged
specific gravity
is a measure of dissolved materials in the urine range is 1002 to 1035
renal colic
is pain caused by renal stones, when stones formed in the kidney start moving into the bladder
Urine stasis
is the most common cause of urinary stones
capacity of the renal pelvis is about
5 to 8 ml
patients can pass stones in urine if they are
5mm or smaller
potassium levels above
7 can be lethal
uretherolithotomy
kidney stone surgery removal
KUB
kidney, ureter, bladder is a test to detect renal calculi
oliguria
less than 400 ml daily
anuria
less than 50 ml daily
Renal diet
low potassium low calcium protein low fluid
IV pyelogram
An x-ray of the renal structures after injection of a radiopaque dye into the venous system
data collection for urinary system
lung sounds (fluid collection) increased blood pressure skin, inspect color, texture conjunctival pallor (anemia)
streptococcal infection
may precede *Glomerulonephritis*
phenazophiridine
Is a urinary analgesic
pyelonephritis
Is an infection of the renal pelvis of the kidney
Urine Culture
Is done to see what bacteria is causing the infection
Functional incontinence
Is the inability to reach the bathroom due to normal obstacles
A patient with total incontinence
Is usually neurologically impaired
How you diagnose PKD
Kidney ultrasound
urine cytology
Noninvasive and accurate at detecting high-grade bladder cancer
suggest consuming cranberry juice
or cranberry capsules, to prevent bacteria from sticking to walls of the bladder
E coli is the most common cause of
Urinary tract infection
Kussmal respirations
What does the body do to compensate for metabolic acidosis?
what causes hydronephrosis
a blockage of any nature, especially those caused by calcium stone
hydronephrosis
abnormal dilation of the renal pelvis and the calyces of one or both kidneys due to pressure from accumulated urine that cannot flow past an obstruction in the urinary tract
nephrosclerosis
arterioles changes, decreasing blood supply to the kidneys, that can eventually destroy the kidney