Maryville NURS 611 Exam 4 ;

How much of the cardiac output do the kidneys require? - ANSWER 20-25% What causes the umbilical referred pain with kidney stones? - ANSWER sensory innervation of the upper part of the ureter arising from the 10th thoracic nerve root. What are the clinical manifestations of a UTI in older adults? - ANSWER confusion and poorly localized abdominal discomfort (symptoms are vague). What is pyelonephritis? - ANSWER it is an infection of one or both upper urinary tracts(ureter, renal pelvis, and kidney interstitium). What are the underlying risk factors for the development of pyelonephritis? - ANSWER urinary obstruction and reflux of urine from the bladder (vesicoureteral reflux). What microorganisms are associated with acute pyelonephritis? - ANSWER e. coli, proteus, or pseudomonas. What do the microorganisms that cause pyelonephritis do to increase the risk of stone formation? - ANSWER the microorganisms split urea into ammonia, making alkaline urine that increases the risk. Define painful bladder syndrome (interstitial cystitis). - ANSWER it is a condition that includes nonbacterial infectious cystitis and noninfectious cystitis. It is possible that noninfectious cystitis is caused by an autoimmune response. What happens during an autoimmune reaction? - ANSWER it may be responsible for inflammatory response, which includes mast cell activation, altered epithelial permeability, neuroinflammation, and increased sensory nerve stimulation. How is a diagnosis of IC differentiated from a diagnosis of pyelonephritis? - ANSWER urine culture, urinalysis, and clinical signs and symptoms. White blood cell casts indicate pyelonephritis, but they are not always present in the urine. What lab values point to a reduced GFR? - ANSWER elevated plasma urea, creatinine concentration, or reduced renal creatinine clearance. What is acute glomerulonephritis? - ANSWER it is a term that includes renal diseases that cause glomerular inflammation through immune mechanisms. What happens to the GFR during an inflammatory response? - ANSWER the glomerularcapillary filtration membrane including the endothelium, basement membrane, and epithelium (podocytes) are damaged by inflammation causing immune mechanisms. What are the classic symptoms of acute glomerulonephritis? - ANSWER sudden onset of hematuria including red blood cell casts and proteinuria (milder than nephrotic syndrome), and in more severe cases, these symptoms are also accompanied by edema, hypertension, and impaired renal function. What is nephrotic syndrome? - ANSWER It is the excretion of 3.0 g or more of protein (massive proteinuria) in the urine per day, hypoalbuminemia (less than 3.0 g/dl), and peripheral edema. What is nephrotic syndrome characteristic of? - ANSWER glomerular injury. What are the primary causes of nephrotic syndrome? - ANSWER minimal change disease (lipoid nephrosis), membranous glomerulonephritis, and focal segmental glomerulosclerosis. What are the secondary forms of nephrotic syndrome? - ANSWER they occur in systemic diseases including DM, amyloidosis, and SLE. It is also seen with certain drugs, infections, malignancies, and vascular disorders.