Diseases of the Kidney
Terms
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- Pyelonephritis
- Kidney Infection caused by E-coli, Good prognosis, CVA pain, burning, cloudy with dtrong odor, Temp 102+,
- Tests for Pyelonephritis
- urine culture, proteinuria, excretory urography, asymmetrical kidneys
- Medical treatment for pyelonephritis
- Fluids, antibiotics, acid-ash diets, meds as Rx
- Chronic polynephritis
- history of bedwetting, unexplained fevers
- Types of Glomerulonephritis
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Acute (AGN)
Rapidly Progressive (RPGN)
Chronic (CGN) - Acute Glomerulonephritis (AGN)
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2-3 weeks after strep or impetigo
Cola colored urine
Flank pain, edema of face, hands and dependent areas, UTI symptoms, GI, skin breakdown - AGN DX
- UA - high specific gravity, proteinuria, blood in urine, Elevated ASO titers (antistreptolysin)
- TX for AGN
- Bedrest, Diet sodium and fluid restricted, increase cabs, antibiotics, diuretics and antihypertensives
- Rapidly progressive Glomerulonephritis (RPGN)
- Several weeks or months, may be caused by infection or multisystem diseases such as SLE, s/s same as AGN
- Treatment for RPGN
- same as AGN plus: plasmapheresis, immunosuppressants, anticoagulants, dialysis if uremia na d fluid rention is not controlled.
- Chronic Glomerularnephritis (CGN)
- Progressive over 20-30 years, may follow AGN, usually no cause, s/s HA, blurred vision, lassitude, dyspnea on exertion, weakness, fatigue, atrophy of kidney
- DX of CGN
- Fixed specific gravity 1.010, proteinuria, hematuria, elevated bun and Creatinine, elevated uric acid level, hyponatremia, hyperkalemia, hyperphosphatemia
- TX of CGN
- Supportive, dialysis, treat any AGN infections, counsel about pg and risks to mother/fetus
- NI for the three types of Glomerulonephritis
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Refer sore throats for propmt treatment.
Complete course of antibiotics
Daily weights
Strict I&O
Assess for neuro changes
Assess for fluid volume excess
Observe for skin breakdown
Bedrest when necessary
Space ADL;s - Client teaching for Glomerulonephritis
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Follow up visits
prompt treatment of sore throats
Diet
Meds as perscribed
Report s/s of AGN to HCP - NDX For glomerulonephritis
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Fluid volume excess
Nutrition altered
Activity intolerance
Knowledge deficit
Infection - Nephrotic Syndrome (nephrosis)
- Results from a glomerular deficit that affects the vessels permeability. Indicates renal damage
- Nephrotic Syndrome is associated with
-
Allergic reactions
infections'systemic diseases (SLE)
Circulatory problems
Cancers
Pregnancy
50-75% develop renal failure within 5 years
May have periods of remission and exacerbation - Clinical Manifestations of Nephrotic syndrome
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Severe generalized edema
pronounced proteinuria (> 3.5)
Hyperlipidemia
Urine volume decreases
Diarrhea and loss of appetite
Pallor
Irritable
Susceptble to infections - DX of nephrotic syndrome
- Frothy urine, massive proteinuria, increased casts, erum protein and albumin decreased, serum cholesterol and triglycerides elevated
- TX of Nephrosis
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Bed rest to conserve energy
Diet (high protein, high calorie, decreased sodium), protect from infection - Drugs for nephrosis
- corticosteroids, watch glucose levels, watch for cushingoid symptoms, diuretics, Salt-poor albumin
- NDX for nephrotic syndrome
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infection risk
Nutrition, altered
Knowledge deficit