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Changes in renal/urinary system associated
with aging
Reduced renal blood flow Thickened glomerular and tubular basement membranes Decreased tubule length Decreased glomerular filtration rate Nocturnal polyuria and risk for dehydration TERM 2
What is the determinant for polycystic
kidney?
DEFINITION 2 If blood pressure rises while patient over age of 50 suddenly, but never before that. TERM 3
Physical assessment for urinary system
DEFINITION 3 Inspection - edema - periorbital and pedal Auscultation - bruit (aneurism) Palpation - enlargement Percussion - dullness Assessment of the urethral meatus for any abnormalities or signs of infection TERM 4
What do you do for a patient that has just had
a renal biopsy?
DEFINITION 4 Assess for bleeding Bed rest for 4-6 hours Vitals Measure Serum Creatinine after a few days Check urine Encourage to drink fluids TERM 5
Cystitis
DEFINITION 5 inflammation of the urinary bladder
What is cystitis caused by
Most commonly caused by bacteria that moved up the urinary tract from the external urethra to the bladder. Catheters are the most common factor placing patients at risk for UTIs in the hospital setting TERM 7
What are the signs and symptoms of
cystitis?
DEFINITION 7 Frequent urge to urinate Dysuria Urgency TERM 8
What drug therapies are used with
cystitis?
DEFINITION 8 urinary antiseptics antibiotics analgesics antispasmodics antifungal agents long-term antibiotic therapy for chronic TERM 9
What are the five types of incontinence?
DEFINITION 9 Stress incontinence Urge incontinence Mixed incontinence Overflow incontinence Functional incontinence TERM 10
What are the interventions for stress
incontinence?
DEFINITION 10 Keeping a diary Behavioral interventions Diet modification Pelfic Floor (Kegel) exercises Drug therapies (estrogen) Surgery
What is important to know about
glomerulonephritis?
Assess for previous history of sore throats and strep TERM 17
What are the interventions for
glomerulonephritis?
DEFINITION 17 Slowing the progression of the disease Preventing Complications Change diet - decrease protein, salt and potassium intake Change fluid - decrease fluid drug therapy - diuretics dialysis - transplant TERM 18
Onset phase of Acute Renal
Failure
DEFINITION 18 Begins with precipitating event and continues until oliguria develops - lasts hours to days Gradual accumulation of nitrogenous wastes, such as serum creatinine and BUN, may be noted. TERM 19
Oliguric phase of acute renal failure
DEFINITION 19 Characterized by a urine output of 100-400 ml/24 hours that does not respond to fluid challenges or diuretics - Lasts 1-3 weeks Laboratory data include increasing serum creatinine and BUN, hyperkalemia, bicarbonate deficit (metabolic acidosis), hyperphosphatemia, hypocalcemia, and hypermagnesemia, sodium retention, regulation of water balance by kidneys is impaired TERM 20
Diuretic phase of acute kidney failure
DEFINITION 20 Often has a sudden onset within 2-6 weeks after oliguric stage. Urine flow increases rapidly over a period of several days Electrolyte losses typically precede clearance of nitrogenous wastes. Later in the diuretic phase, the BUN level starts to fall and continues to fall until level reaches normal limits
Recovery phase of acute renal failure
In this phase, the patient begins to return to normal levels of activity. Patient functions at a lower energy level and has less stamina. Residual renal insufficiency may be noted through regular monitoring of renal function. Renal function may never return to pre-illness level, but renal function is sufficient TERM 22
Reduced renal
reserve
DEFINITION 22 60% nephrons lost TERM 23
renal insufficiency
DEFINITION 23 75% nephrons lost, GFR decreased to 20% TERM 24
End-stage renal disease
DEFINITION 24 90% nephrons lost, GFR negligible TERM 25
What are the symptoms of end stage renal
disease?
DEFINITION 25 Azotemia Uremia Uremic syndrome high BUN Decreased urine output Sodium decreased early, but high late potassium - hyperkalemia acid-base balance changes metabolic acidosis
