Patho Renal Quiz
Glomerulonephritis
acute inflammation of kidney at glomerulus, caused by immune response, hematuria and proteinuria
polyuria
alot of urine coming out
what is treatment for UTIs?
antibiotics, puridium, increase fluids
A client with acute kidney injury has a serum potassium level of 6.0mEq/L. The nurse should plan which action as a priority? a. Check the sodium level b. Place the client on a cardiac monitor c. Encourage increased vegetables in the diet d. Allow an extra 500 mL of fluid intake to dilute the electrolyte concentration
b
pyelonephritis
FEVER, cystitis untreated can lead to this, higher up than cystitis, affects ureters, pain with urination, CVA tenderness, pyuria (WBCS in urine), usually caused by obstructive uropathy, with healing fibrosis and atrophy may occur
The nurse is assessing the patency of a client's left arm arteriovenous fistula prior to initiating hemodialysis. Which finding indicates that the fistula is patent? a. Palpation of a thrill over the fistula b. Presence of a radial pulse in the left wrist c. Absence of a bruit on auscultation of the fistula d. Capillary refill less than 3 seconds in the nail beds of the fingers on the left hand
a
The nurse is reviewing a client's record and notes that the health care provider has documented that the client has a renal function disorder. On review of the laboratory results, the nurse most likely would expect to note which finding? a. Elevated creatinine level b. Decreased hemoglobin level c. Decreased red blood cell count d. Decreased white blood cell count
a
Nephron
basic unit of kidney, FILTERS the blood of waste and conserves fluid and electrolytes that the body needs
Glomerular Filtration Rate (GFR)
best indicator of kidney function, blood filtration, how much blood kidneys receive, peaks at age 30
hematuria
blood in urine, sign of kidney stones
A client arrives at the emergency department with complaints of low abdominal pain and hematuria. The client is afebrile. The nurse next assesses the client to determine a history of which condition? a. Pyelonephritis b. Glomerulonephritis c. Trauma to the bladder or abdomen d. Renal cancer in the client's family
c
recovery
can take up to a year, normal urine output, renal function returning to normal
female risk factors for UTI
cleaning back to front, tight restrictive clothing, irritating bath products, sex
The nurse is collecting data from a client who has a history of benign prostatic hyperplasia. To determine whether the client currently is experiencing this condition, the nurse should ask the client about the presence of which early symptom? a. Nocturia b. Urinary retention c. Urge incontinence d. Decreased force in the stream of urine
d
male risk factors for UTI
diabetes, dehydration, enlargement of prostate gland, catheters, bladder cancer
glomerulonephritis
disorder where kidneys become inflamed that damages the membranes of the glomerulus (affects kidney filtration)
kidney functions:
fluid balance, acid base balance, activates vitamin D, controls RBC production
diuresis
fluid being leaked out but not filtered, BUN and creatinine still high
cystitis symptoms
frequency, urgency, dysuria (burning), supra pubic and low back pain, hematuria, cloudy urine, flank pain, asymptomatic
How do you assess an AV fistula?
hearing loud bruit and feel a thrill
signs of glomerulonephritis
hematuria and proteinuria
axotemia
high BUN and creatinine
Reasons why Renin Angiotensin Aldosterone system (RAAS) is activated:
how body regulates systemic BP and blood volume, renal blood flow and GFR, causes sodium and water reabsorption
what electrolyte imbalance do you have with acute and chronic kidney failure?
hyperkalemia and hypocalcemia
What do both ADH and Aldosterone both do?
increase blood pressure and decreases something
effects of chronic renal failure
increased BUN and creatinine, edema, hypertension, high potassium levels, acidosis, hypocalcemia, anemia, uremic skin residues
stages of acute renal failure:
initial oliguria polyuria recovery
chronic renal failure
irreversible, no nephrons working, hemodialysis and kidney transplant are only options for life support,
when assessing functions of the kidneys you have to look out for what?
kidney stones, the urine would be bloody
prerenal
lack of blood flow, perfusion problem, urine output drops, ischemia of the kidney, ex. hypovolemic shock
acute renal failure
lack of perfusion or ischemia to kidneys, reduced renal blood flow, MAP drops too flow, kidneys are healthy its just a perfusion problem, injury can lead to failure
oliguria
low urine output, less than 20ml hr or 400ml daily
Creatinine Clearance
measure blood and urine creatinine over 24hr period, how much creatinine leaves body through urine
what's another term for kidney stones?
nephrolithiasis
Blood Urea Nitrogen (BUN)
normal level 5-20, increases when person is dehydrated, high protein diet and kidney isn't functioning correctly
Serum Creatinine
normal range is 0.5-1.5, takes 12 hrs to raise after injury of some sort, higher the level the lower the GFR, don't want it to be high
postrenal
obstruction, of outflow of urine, urine outflow prevented, could be kidney stones
GRF stages:
okidney damage with normal GRF omild reduction in GRF, 50% nephrons not working omoderate reduction in GRF, 75% not working osevere reduction in GRF okidney failure—kidneys atrophy
intrarenal
problem with kidney itself, nephrotoxic drugs GENTAMYCIN
Aldosterone
reabsorbs more sodium and water into bloodstream, secretes potassium into tubule fluid
erythropoietin
secreted by kidney, stimulates bone marrow to produce RBCs in response to hypoxia
initial insult
something causing injury
During the GRF stages, when do symptoms become apparent?
stage 3---BUN and creatinine start to rise
ADH
stops the body from getting rid of fluid
symptoms of BPH
• Poor force of stream • Frequent voiding • Nocturia • Intermittent urinary stream • Urgency • Incomplete bladder emptying