Medical Surgical Nursing

Chapter 43 The Urinary System Assessment & Disorders An illustration of the internal structures of the kidney. ...

Functions of kidney: 1. Urine formation 2. Excretion of waste products 3. Regulation of electrolytes 4. Regulation of acid–base ...

Assessment Use simple language Assess for incontinence (esp. muliparous) Family history Chief concern Location and character of ...

IVP, Retrograde Pyelography Cystography, voiding cystogram CT scan, MRI Renal scan Ultrasound X-ray (KUB) Cystoscopy Renal Angi ...

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Glomerulonephritis –Diagnostic Tests ASO titer ( anti streptolysine O) BUN Serum creatinine Serum electrolytes Urinalysis KUB x ...

Chronic Glomerulonephritis Could be due to repeated episodes of acute glomerulonephritis, hypertensive nephrosclerosis, hyperl ...

Treatment Diuretics (be careful not to cause sever hypovolemia as it may lead to ARF) Loop diuretics + ACE inhibitors lead to d ...

Elderly ARF mostly occur within hospital settings Causes of ARF Prerenal Failure Intrarenal Failure Postrenal Failure Preren ...

Vasodilation resulting from: Sepsis Anaphylaxis Antihypertensive medications or other medications that cause vasodilation Intr ...

Phases of Acute Renal Failure Initiation period: begins with the initial insult and ends when oliguria develops. Oliguria perio ...

Diagnostic tests BUN, creatinine, potassium increase. pH Hgb and Hct Urine studies US of kidneys High phosphorus and low calciu ...

Diuretics Maintain E-lytes May need dialysis (especially with high K) May need to stimulate production of urine with IV fluids, ...

Knowledge deficit Plan- Promote recovery of optimal kidney function. Maintain normal fluid and electrolyte balance. Decrease an ...

Periorbital edema Pericardial friction rub Acidosis (kidney can‘t excrete amonia, reabsorb bicarb, high phosphate) Engorged nec ...

Thick, tenacious sputum Depressed cough reflex Pleuritic pain Shortness of breath Tachypnea Kussmaul-type respirations Uremic p ...

Amenorrhea Testicular atrophy Infertility Decreased libido Muscle cramps Chronic renal failure/ S&S Musculoskeletal Loss ...

Lab findings BUN – indicator of glomerular filtration rate and is affected by the breakdown of protein. Serum creatinine – wa ...

Anemia Immunoligical problems Kidneys cannot excrete wastes or change bicarb levels if needed Retain Na and water which can el ...

Nutritional Therapy Protein is restricted (allowed protein should be of high biologic value) Restrict fluid (500-600 ml/day mor ...