Renal pyleo.txt

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Renal pyleo.txt
2013-09-14 18:08:14
Renal pyleo

Renal pyleo
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  1. Pyelonephritis
    a bacterial infection in the kidney and renal pelvis; presence of active organisms in the kidney or the effects of kidney infections
  2. Chronic pyelonephritis
    results from repeated or continued upper UTI or the effects of such infections from reflux
  3. When does chronic pyelonephritis occur
    with a urinary tract defect, obstruction, or most commonly when urine refluxes from the bladder back into the ureters
  4. What way do organisms move in pyelonephritis
    from urinary tract into the kidney tissue, bacteria triggers inflammatory response and local edema results
  5. What does acute pyelonephritis involve
    acute tissue inflammation, tubular cell necrosis and possible abscess formation anywhere in the kidney; fibrosis and scar tissue develop from the inflammation, the calices thicken and scars develop
  6. What happens in pyelonephritis
    microbes come in renal pelvis, inflammatory response, fibrosis (scar tissue), decreased tubular reabsorption and secretion and then impaired kidney function
  7. Who usually gets acute?
    Entry of bacteria during pregnancy, obstruction or reflux
  8. Who usually gets chronic?
    If you had reflux as a child or spinal cord injury, bladder tmor, prostate enlargement or urinary tract stones
  9. What can NSAIDS do?
    Lead to papillary necrosis and reflux
  10. Most common pyelonephritis organism?
    E coli; if blood borne, staph a and candida and salmonella
  11. Other causes of kidney scarring
    antibody reactions, cell-mediated immunity against the bacterial antigens or autoimmune reactions
  12. Who is this common in?
    women but after 65, men increases because of prostate issues
  13. Key features of chronic
    HTN, inability to conserve sodium, decreased urine concentrating ability resulting in nocturia, can develop hyperkalemia and acidosis
  14. Key features of acute
    fever, chills, tachycardia, tachypnea, flank pain, tender costovertebral angle, ABD discomfort (colicky), nausea and vomiting, general malaise and fatigue, burning urgency or frequency of urination, nocturia, recent cystitis or treatment for UTI
  15. What will UA show?
    Positive leukocyte esterase and nitrite dipstick and WBC and bacteria; clean catch method
  16. Nursing mgmt
    manage pain (NSAIDS appropriately); usually broad spectrum antibiotics; 2 L of fluids unless contraindicated; surgical; BP control