warning signs of kidney disease
burning or difficulty urinating, increased frequency of urination @ night, blood in urine, puffiness around eyes, swelling in hands and feet especially in children, back pain, increased BP.
kidneys do what?
assist in acid based balance, raise BP by secreting renin, and produce the hormone erythropoietin (production of RBC's and their release)
subjective data collection
family hx, color, odor, or mucus in urine, diuretics, pruritis, HTN medications, antibiotics.
with age these changes occur
decreased production, filtration, decreased renal clearance of drugs, unable to conserve sodium, and decreased bladder capacity.
Lab values for urine
PH 4.6 - 8.0, specific gravity 1.010 - 1.025, protein 0-18mg/dl, RBC0-4hpf, WBC0-5, serum creatinine0.6-1.5, BUN 8-25.
NI for angiography
NPO 4-8hrs. before, bedrest of 12hrs. after, monitor for bleeding @ injection site.
cystitis ( UTI)
inflammation of the bladder. more common in females. common bacteria that causes it is E-coli, or yeast.
medications for UTI
bactrim unless pt. has sulfa allergy, then Cipro. Monural for yeast, and pyridium.
bacterial infection of renal pelvis, caused by backflow, trauma, E-coli most common cause. Urine is cloudy, bloody, or has mucos or pus.
treatment for pyelonephritis
push fluids, daily wt., pain relief, light diet @ first then high cal, high protein.
strepp infection, can lead to CHF, and pulmonary edema. inflammation of the glomerulus.
slower progression, can take up to 30 yrs. for signs of renal insufficiency. Meds. are the same as acute, high carb, low sodium diet.
complications of CRF
insomnia, anemia, GI bleed, hyperkalemia, hypermagnisemia, hypervolemia, hypovolemia, HTN, hypocalcemia, and infection.
accumulation of nitrogenous waste products in the blood caused by kidneys inability to filter out these waste products. may occur from CRF or ARF.
S/S of uremic syndrome
oliguria, presence of protein, RBC's, casts in the urine, Increased levels of uric acid, potassium, and magnesium. hypotension, hypertension, and changes in LOC.
NI for uremic syndrome
monitor vitals, serum electrolytes, I & O's for oliguria, limited sodium, potassium, and nitrogen diet.
process of cleansing the pts. blood. removes by products such as urea, creatinine, and uric acid. removes excess fluids and maintains the buffer system of the body. maintains electrolyte levels of the body.
works on the principles of osmosis, diffusion, and ultrafication. PD occurs via the transfer of fluid and solute from the bloodstream through the peritoneum.
a rubber siliconized catheter that is surgically inserted into the peritonel cavity to allow infusion of dialysis fluid.
a gram negative backteria caused by E-coli, usually with indwelling catheter. can cause septic shock if left untreated, fever is the most common and earliest manifestation.
NI for urosepsis
obtain urine specimen for C&S, before giving antibiotics. administer IV antibiotics for 3-5 days, then by PO after.
cause of stones
family hx, urinary stasis, obstruction, dehydration, diuretics, UTI's, increased uric acid level, and a diet high in vitamin D, calcium, milk, and protein.
Benign Prostatic Hypertrophy (BPH)
enlargement of the prostate gland, with hypertrophy and hyperplasia of normal tissue.
data collection for BPH
diminshed size and stream of urine, urgency, frequency, nocturia, hesistancy, hematuria, dysuria, and UTI's.
NI for BPH
increase fluids to 2000-3000 cc, avoid giving anticholinergics, antihistamines, decongestants, and antidepressants. Give meds to shrink and relax prostate.
prerenal acute renal failure
decrease in kidney perfusion that reduces glomerular perfusion. S/S pale cool skin, orthostatic hypotension and oliguria.
intrarenal acute renal failure
tissue damage of glomeruli and tubules, antigens and antibodies complexes formed in glomerulonephritis become trapped in the basement of the membrane and cause inflammation.