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2010-11-07 16:12:51

renal chapters 68 69 70 71
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  1. Anuria
    total urine output less than 100 ml in 24 hours
  2. Azotemia
    increased blood urea nitrogen and serum creatinine levels suggestive of renal impairment without outward symptoms.
  3. Dysuria
    pain with voiding
  4. Micturition
  5. frequency
    feeling to void often. usually voiding small amounts every hour
  6. Nocturia
    night voiding
  7. Oliguria
    Decreased urine output between 100-400ml in 24 hours
  8. Polyuria
    increased urine output greater then 2000ml in 24 hours
  9. Uremia
    full blown manifestations of renal failure
  10. Serum creatinine
    • Produced by protein and muscle breakdown.
    • Men:0.6-1.2
    • women:0.5-1.1
  11. Blood Urea Nitrogen BUN
    • Byproduct of protein breakdown in the liver
    • 10-20mg/dL
    • 8-23mg/dL 60-90yo
    • 10-31mg/dL>90yo
  12. abnormal Serum creatinine
    • increased: =renal impairment
    • decreased:=may be caused by decreased muscle mass
  13. abnormal BUN
    • increased:=hepatic/renal disease, dehydration or decreased renal perfusion, high protein diet, infectionm stressm steroid use, GI bleeding, blood in tissues.
    • decreased:=may indicate malnutrition, fluid volume excess, severe hepatic damage
  14. BUN/creatinine
    • helps to determine nonrenal factors such as poor renal perfusion, dehydration.
    • mass ratio:12:1 TO 20:1
    • moe ratio: 48.5:1 to 80.8:1
  15. BUN/Creatinine abnormalities
    • increased: fluid volume deficit, obstructive uropathy, catabolic state, high protein diet
    • decreased:fluid volume excess, acute renal tubular acidosis
  16. Turbidity
    Cloudiness, haziness
  17. Cystitis
    • Urinary tract infection: inflammation of the bladder may be caused by irritation, infection from bacteris, viruses and fungi, or parasites. infectious cystitis is the most common.
    • noninfectious cystitis is caused by irritation by chemicals or raditation.
  18. bacteriuria
  19. bacteria in the urine.
  20. factors contributing to infectious cystits (UTI)
    Obstruction, stones(calculi), vesicoureteral reflux, DM, alkalotic urine, women, Age, Sexual activity, recent use of antibiotics.
  21. interstitial cystitis
    rare chronic inflammation of the entire lower urinary tract
  22. urosepsis
    spread of infection from the urinary tract to the bloodstream
  23. Prevention of UTI
    drink 2-3L of fluid, sleep, proper nutrtion, cleanse peri area, empty bladder after intercourse, cranberry juice, apple cider, vitamin C, take full course of antibiotics.
  24. trabeculation
    an abnormal thickening, of the bladder wall caused by urinary retention, and obstruction
  25. Urethritis
    • inflammation of the urethra, s/s similar to UTI
    • most common cause in men is STDs
    • in men: burning/difficulty urinating
    • in women: in postmenopausal women because of decreased estrogen levels.
  26. uretheral strictures
    • narrowed areas of the urethra
    • may be caused by gonorrhea, trauma during catheterization,urologic procedures or childbirth.occur more often in men. may be a factor in reoccuring UTIs
    • rarely cause pain but do caused obstruction of urine flow.
  27. urethroplasty
    the surgical removal of the affected area with or without grafting to create a larger opening.long term tx for urethal strictures.
  28. stress incontinence
    involuntary loss of urine during activites that increase abdominal and detrusor(bladder muscle) pressure
  29. Urge incontinence
    the involuntary loss of urine asssociated with a strong desire to urinate. Patients cannot suppress the signal from the bladder muscle to the brain that it is time to urinate.
  30. detrusor hyperreflxia (reflex incontinence)
    • the abnormal detrusor contractions result from neurologic abnormalities.
    • -stroke, MS, spinal cord lesions may be the cause.
  31. Overflow incontinence
    the involuntary loss of urine associated with overdistention of the bladder when the bladder's capacity has reached it's maximum
  32. Mixed incontinence
    a combination of stress, urge and overflow incontinence
  33. functional incontinence
    leakage of urine caused by factors other than disease of lower urinary tract
  34. transient causes of incontinence
    incontinence gets better with the treatment of underlying causes
  35. Factors contributing to Urinary incontinence
    • drugs:CNS depressants, opioid analgesics, diuretics, anticholinergics(alter cognition and urge to void)
    • disease: brain damage, arthritis, parkinsons. Depression
    • Inadequate resources:patients afraid to ambulate,
  36. Urolithiasis
    prescence of stones(calculi) in the urinary tract.unknown causes. biut may have a metabolic risk factor:hypercalcemia, hyperoxaluria(excess oxalate)Hyperuricemia(gout)struvite, cystinuria-insoluable cystine crystals in the urine.
  37. nephrolithasis
    formation of stones in the kidneys
  38. ureterolithasis
    formation of stones in the ureter
  39. hematuria
    blood in urine
  40. hydronephrosis
    enlargement of the kidney caused by blockage of urine lower in the tract and the filling of the kidney with urine.
  41. Dietary tx for renal stones.
    avoid Oxalate (spinach, black tea, rhubarb)limit animal protein, reduce calcium intake, limit phosphate intake(dairy products, organ meats, whole grains. decrease uric acid intake, organ meats, poultry, fish, gravies, red wines, sardines.
  42. Polycystic kidney disease (PKD)
    • inherited disorder in which fluid filled cysts develop in the nephrons.d/t abnormal cell division. control of HTNis top priority.
    • S/S:abdominal flank pain, HTN, nocturia, increased abdominal girth, constipation, bloody, cloudy urine, kidney stones.
  43. pyelonephritis
    bacterial infection of the upper urinary tract (kidney, renal pelvis). d/t urinary tract defect, obstruction
  44. acute pyelonephritis
    • involves acute tissue inflammation, tubular cell necrosis, amd possible abscess formation.healthy tissue can lie in the inflammed necrotic tissue.
    • S/S fever chills, tachycardia, flank back pain, CVA, abd discomfort, general malaise, nocturia, burning, urgency, frequency, of urination.
  45. Glomerulonephritis
    Immunorenal disorder, 3RD leading cause of end stage kidney disease.
  46. acute glomerulonephritis
    results in glomerular injury
  47. nephrotic syndrome
    a condition of increased glomerular permability that allows larger particles to pass through the membrane into the urine and then be excreted, which causes massive amounts of protein to be lost, edema formation
  48. types of renal failure
    -intrinsic, prerenal failure, postrenal failure
    With intrinsic renal failure, there is a fixed specific gravity and the urine tests definitely positive for proteinuria. In prerenal failure, the specific gravity is high, and there is very little or no proteinuria. In postrenal failure, there is a fixed specific gravity and little or no proteinuria. There is no disorder known as atypical renal failure.
  49. renal artery embolization
    Renal artery embolization may be done instead of radiation therapy to shrink the kidney tumor by cutting off its blood supply and impairing its overall vascularity. A secondary benefit is that it reduces the risk of hemorrhage during surgery. This procedure can be accomplished in a number of ways, including placement of an absorbable gelatin sponge (Gelfoam), barium, a balloon, metal coil, or any of various other substances.