adults renal 1

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Author:
kbryant86
ID:
264139
Filename:
adults renal 1
Updated:
2014-02-27 15:46:30
Tags:
renal
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Description:
renal 1
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  1. major nursing problems seen with renal system
    • alt of perfusion
    • alt e.lytes
    • deficit of nutrition
    • alt in emilniation
    • risk for fluid overload
    • decreased mobilty
    • potential for skin break down
    • impaired gas exchange
  2. Dx test:
    urinanalysis
    • 1st of AM preferred
    • place in fridge
  3. Dx test:
    composite urine
    • 24 hrs
    • start w/ emtpy bladder and end with final void 

    check for creat clearance to find GFR
  4. Dx test:
    BUN
    • 5-25
    • nitrogen excretion
    • inc with dehydration or protein excess

    not completely seletive to renal though
  5. Dx test:
    Creat
    • 0.7-1.3
    • protein and muscle metabolism
    • specific to renal disease
  6. Dx test:
    BUN/Creat ratio
    • 10:1
    • when they rise together, renal suspected
  7. Dx test:
    specific gravity
    • 1.005-1.030
    • indicates fluid balance
  8. Dx test:
    Urine C+S
    • Dx for UTI
    • midstream
  9. Dx test:
    residual urine
    should be <50 mL
  10. Dx test:
    angiogram
    • vascular x-ray
    • groin sandbag after
    • check vs Q4hrs
  11. Dx test:
    cystoscopy
    • causes hematuria
    • force fluids, treat pain
  12. Polycystic kidney disease PKD
    patho
    cysts compress tubules, causing ischemia, renal failure
  13. nrsg care for PKD

    Tx
    • maintain renal function
    • -prevent UTI
    • No contact sports
    • mointor UO, BUn, creat, GFR
  14. Hydronephrosis
    • blocked urine dilates renal pelvis
    • caused by stone, infections
    • watch for BUN/Creat to rise

    Goal= reestablish drainage ASAP
  15. UTI
    • infection of any portion of tract
    • acute or chronic
    • E.Coli
  16. UTI:
    S & Sx
    Dx
    Tx
    S= frequency, burning, urgency

    D= Urine C+S

    T= antibios, fluids
  17. Pyleonephritis
    • infect of kidney itself
    • can result from UTI
    • acute or chronic

    May lead to RF
  18. Pyelonephritis:
    S & Sx
    Tx
    • S= fever, chills, malaise
    •  =flank pain
    •  =dysuria
    •  =CVA tenderness
    •  =inc WBC's

    Tx= antibio douche and force fluids
  19. glomerulonephritis

    patho
    Sx
    Tx
    damage to structure and fnct of glomerulus -> dec GFR -> dec UO -> Sx of fluid overload

    • Sx= Cola-colored urine
    • Na and h20 retention
    • edema
    • N/V, anorexia
    • HTN

    Tx= antiobios, diuretic, HTN meds
  20. Prostatitis

    Tx
    inflammed prostate

    • Tx= antibios
    • force fluids
    • NSAIDS
    • Stiz bath
    • special diet
  21. Nephrotic syndrome
    patho
    nrsg care
    autoimmune disorder

    p=inc in glom capillary, leads to fluid overload

    • care= high % progress to CRF
    • =monitor BUN, Creat, UO
    • =watch for infections
    • =may need protein supps
  22. renal vein occlusion

    Tx
    a clot

    anticoag
  23. Arterial occlusion
    2 ways
    renal arterioles slowly narrow, stenosis

    acute obstruction like an aneurysm, emboli, thrombi

    lead to ischemia
  24. renal artery stenosis

    Sx
    Tx
    • major loss in perfusion
    • activates RAAS sytem

    S= HTN, kidney atrophy, stenosis (epigastric bruit)

    T= HTN meds, angioplasty, diet
  25. Renal artery occlusion
    Sx
    Tx
    S= severe flank pain, HTN, N/V, fever

    T= surgery for severe blockage
  26. nephrosclerosis

    Sx
    Tx
    • hardening of arteries
    • caused by prolonged HTN

    Sx= HTN, hematuria, proteinuria, BUN/Creat rise

    Tx=control BP
  27. diabetic nephropathy

    patho
    prevent?
    leading cuase of ESRD

    P= lipids cause renal vessels to narrow and scar

    Rx= control DM
  28. any type of -litiasis

    Sx
    Tx
    kidney stones

    • S= flank pain, N/V
    • T= restablish drainage, force fluids, pain
  29. primary sign of bladder cancer

    Tx
    hematuria

    Tx= chemo, radi, removal

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