1. A ute renal failure: Reversible
t
Determining prognosis- kidneys respond to diureti with good output; this indi ates t t
that kidneys are fun tioning well t
2. A ute Pyelonephritis: Diagnosing by lini al symptoms alone an be diffi ult; an
t t t t t t
be similar to ystitis t
Diagnosis established by:
-Urine ulture t
-Urinalysis (WB asts indi ates pyelonephritis, but may not always be present)
T t t
-Signs/Symptoms
- ompli ated pyelonephritis requires blood ultures and urinary tra t imaging
T t t t
3. Renal al uli (Renal Stones): Goals of Treatment:
T t
Manage a ute pain Promote t
passage of stone Redu e t
size of stone
Prevent new stone formation
4. hroni Renal Failure: hroni Kidney Disease ( KD) is a progressive loss of
T t T t T
renal fun tion asso iated with systemi disease su h as hypertension, diabetes
t t t t
mellitus (most signifi ant risk fa tor), systemi lupus erythematosus or intrinsi t t t t
kidney disease
TKD stage is determined by estimates of GFR and albuminuria
5. Who is a andidate for dialysis?: End-stage renal disease (ESRD) is the final
t
stage of KD with the number one ause being diabetes mellitus ombined with
T t t
hypertension. At this point, the patient is ompletely dependent on dialysis to survive. t
KD is lassified into five stages and is based on the patient's GFR rather than
T t
symptoms.
Patients will need dialysis when the following symptoms are present:
--Metaboli a idosis. t t
--Hyperkalemia: Hyperkalemia in the presen e of EKG hanges (peaked T-waves) is t t
an indi ation for dialysis. --Hyperkalemia by itself is not an indi ation for dialysis.
t t
--Drug toxi ity: Drug toxi ity due to the following drugs is an indi ation for dialysis and
t t t
in lude sali ylates, Lithium, Isopropanol, Methanol and Ethylene gly ol).
t t t
--Fluid volume overload that is not responsive to diureti s. t
--Uremi symptoms due to nitrogenous wastes in the blood stream.
t
6. Stage I KD: There is kidney damage with normal or elevated GFR
T
90-120
7. Stage II KD: There is kidney damage with mild de rease in GFR
T t
60-89
, 8. Stage III KD: There is a moderate de rease in GFR
T t
30-59
9. Stage IV KD: There is a severe de rease in GFR
T t
15-29
10. Stage V KD: Kidney failure- End-stage renal disease
T
<15 (dialysis) On e Stage IV is rea hed, progression to Stage V is inevitable as well
t t
as dialysis or kidney transplant
11. ompli ations of De reased GFR: Anemia
T t t
Hypertension
De reased al ium absorption Hyperlipidemia
t t t
Heart failure
Left ventri ular hypertrophy
t
Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metaboli a idosis t t
Malnutrition (late ompli ation) t t
12. GERD: Warning signs in lude: Symptoms over age of 50: t
-Dysphagia (diffi ulty swallowing) t
-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
13. Hiatal Hernia: Often asymptomati t
Generally, a wide variety of symptoms develop later in life and are asso iated with t
other GI disorders, primarily GERD
--Sliding hiatal hernia: treatment usually onservative. Individuals an diminish reflux t t
by eating small, frequent meals and avoiding the re umbent position after eating. t
Abdominal supports and tight lothing are avoided and weight ontrol re ommended fo t t t
obese individuals.
14. Duodenal Ul er: hara teristi manifestation = hroni intermittent pain in epi-
t T t t t t
gastri area t
Pain begins 30 minutes to 2 hours after eating when stoma h is empty t
t
Determining prognosis- kidneys respond to diureti with good output; this indi ates t t
that kidneys are fun tioning well t
2. A ute Pyelonephritis: Diagnosing by lini al symptoms alone an be diffi ult; an
t t t t t t
be similar to ystitis t
Diagnosis established by:
-Urine ulture t
-Urinalysis (WB asts indi ates pyelonephritis, but may not always be present)
T t t
-Signs/Symptoms
- ompli ated pyelonephritis requires blood ultures and urinary tra t imaging
T t t t
3. Renal al uli (Renal Stones): Goals of Treatment:
T t
Manage a ute pain Promote t
passage of stone Redu e t
size of stone
Prevent new stone formation
4. hroni Renal Failure: hroni Kidney Disease ( KD) is a progressive loss of
T t T t T
renal fun tion asso iated with systemi disease su h as hypertension, diabetes
t t t t
mellitus (most signifi ant risk fa tor), systemi lupus erythematosus or intrinsi t t t t
kidney disease
TKD stage is determined by estimates of GFR and albuminuria
5. Who is a andidate for dialysis?: End-stage renal disease (ESRD) is the final
t
stage of KD with the number one ause being diabetes mellitus ombined with
T t t
hypertension. At this point, the patient is ompletely dependent on dialysis to survive. t
KD is lassified into five stages and is based on the patient's GFR rather than
T t
symptoms.
Patients will need dialysis when the following symptoms are present:
--Metaboli a idosis. t t
--Hyperkalemia: Hyperkalemia in the presen e of EKG hanges (peaked T-waves) is t t
an indi ation for dialysis. --Hyperkalemia by itself is not an indi ation for dialysis.
t t
--Drug toxi ity: Drug toxi ity due to the following drugs is an indi ation for dialysis and
t t t
in lude sali ylates, Lithium, Isopropanol, Methanol and Ethylene gly ol).
t t t
--Fluid volume overload that is not responsive to diureti s. t
--Uremi symptoms due to nitrogenous wastes in the blood stream.
t
6. Stage I KD: There is kidney damage with normal or elevated GFR
T
90-120
7. Stage II KD: There is kidney damage with mild de rease in GFR
T t
60-89
, 8. Stage III KD: There is a moderate de rease in GFR
T t
30-59
9. Stage IV KD: There is a severe de rease in GFR
T t
15-29
10. Stage V KD: Kidney failure- End-stage renal disease
T
<15 (dialysis) On e Stage IV is rea hed, progression to Stage V is inevitable as well
t t
as dialysis or kidney transplant
11. ompli ations of De reased GFR: Anemia
T t t
Hypertension
De reased al ium absorption Hyperlipidemia
t t t
Heart failure
Left ventri ular hypertrophy
t
Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metaboli a idosis t t
Malnutrition (late ompli ation) t t
12. GERD: Warning signs in lude: Symptoms over age of 50: t
-Dysphagia (diffi ulty swallowing) t
-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
13. Hiatal Hernia: Often asymptomati t
Generally, a wide variety of symptoms develop later in life and are asso iated with t
other GI disorders, primarily GERD
--Sliding hiatal hernia: treatment usually onservative. Individuals an diminish reflux t t
by eating small, frequent meals and avoiding the re umbent position after eating. t
Abdominal supports and tight lothing are avoided and weight ontrol re ommended fo t t t
obese individuals.
14. Duodenal Ul er: hara teristi manifestation = hroni intermittent pain in epi-
t T t t t t
gastri area t
Pain begins 30 minutes to 2 hours after eating when stoma h is empty t
