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NURSING 304 MedSurgeExam3 Layout Study Guide
Kidney Anatomy/ Physiology
Glomerulus
Network of capillaries at the beginning of a nephron. First
stage in the filtering process of the blood (plasma) to produce
urine. Surrounded by cup-like sac, Bowman’s capsule.
Receives blood supply from afferent arteriole of renal
circulation. 20% of blood that passes through glomeruli is
filtered into the nephrons = 180L/ day
Renin
A hormone made in glomeruli, secreted by juxtaglomerular
apparatus, and involved in the control of arterial BP
Kidney Assessment
Kidney Disorders
Condition S/Sx + Complications Diagnostic Testing/ Labs Treatment Nursing Interventions Pt Education
, 2
Acute Glomerulonephritis Hematuria Elevated BUN, creatinine, -Tx the primary disease Monitor for s/sx of acute Recovery after 2-3 weks
Bilateral inflammation of the Oliguria or anuria ESR, and Specific Gravity -Correct electrolyte kidney injury Important to follow up with
glomeruli, usually after a strep Smokey/ Coffee colored urine imbalance UA at 2,4,8 wks & 4, 6,12
infection, results from antigen- Dyspnea Decreased protein, Hgb -Dialysis I&O’s / F&E balance months
antibody complexes becoming Periorbital edema Hematuria may last up to 2
trapped and collecting in the Increased BP Bilateral kidney -Fluid restriction Monitor LOC years
glomerular capillary membranes Sudden onset of proteinuria enlargement -Sodium restriction until Proteinuria may last up to 3
after infection Nephrotic Syndrome HTN, edema, and months
--massive proteinuria Kidney biopsy is the azotemia clear
May occur as the result of bacterial --hypoalbuminemia definitive Dx -avoid high K+ foods
or viral infection --hyperlipidemiauria
-varicella zoster virus -Oxygen for PE
-Hep B Complications
-Epstein-Barr virus Pulmonary edema MEDS
-Impetigo Heart failure Kayexalate (trades K+
Sepsis for sodium in small
AKI intestine)
Severe HTN Lasix
Cardiac hypertrophy Sodium bicarb
End-stage kidney disease Penicillian
Renal Calculi -Hematuria 24 Hr urine collection HYDRATION unless -Provide IV fluids as ordered Avoid/ Limit
-Abdominal distention -shows calcium oxalate, contraindicated -Strain all urine and send Spinach
Stones form when substances -Costovertebral tenderness phosphorus, and uric acid solid material for analysis Rhubarb
precipitate instead of dissolving in on palpation excretion levels Straining urine for stones -Encourage ambulation to aid Peanuts
urine (calcium oxalate, maleate, -Tachycardia Diet Modification passage Chocolate
calcium phosphate) -Elevated BP UA +specific gravity, Medications -Admin analgesics Parsley
hematuria, crystals, casts, Antibiotics -Inspect urine for color, Juices high in citrate
Risk Factors Complications pyuria Antiemetics clarity, bleeding
-Hx of hyperparathyroidism or -Urinary tract obstruction Analgesics -I&O’s Report fever, hematuria, or
osteoporosis -upper UTI KUB radiography or non- Allupurinol -Monitor for s/sx of infection vomiting immediately
-Renal parenchymal contrast CT - reveals K+ citrate
damage calculi Chelating agents
-Hydronephrosis Prednisone
-Urethral scarring Excretory urography (size) Procardia
-Ureteral stenosis Flomax
-Ureteral perforation Ultrasound - detects Terazosin
-Abscess formation obstructions
-Sepsis Lithotripsy
Ureteroscopy
Ureteral stent
Percutaneous
nephrostomy or
nephrostolithotomy
Acute Renal Failure Oliguria =urine output of Increased BUN, creatinine Hemodialysis During the oliguric phase (at
Can be caused by poor perfusion 250mL/ 24 hours and salty urine (3-12 months) risk for FVE b/c decreased
(kidneys need pressure) or decrease UO) **Limit fluid intake
in circulating volume (hypovolemic Diuretic phase = increased Low specific gravity
shock). May also be caused me urine output, hypotension,
NURSING 304 MedSurgeExam3 Layout Study Guide
Kidney Anatomy/ Physiology
Glomerulus
Network of capillaries at the beginning of a nephron. First
stage in the filtering process of the blood (plasma) to produce
urine. Surrounded by cup-like sac, Bowman’s capsule.
Receives blood supply from afferent arteriole of renal
circulation. 20% of blood that passes through glomeruli is
filtered into the nephrons = 180L/ day
Renin
A hormone made in glomeruli, secreted by juxtaglomerular
apparatus, and involved in the control of arterial BP
Kidney Assessment
Kidney Disorders
Condition S/Sx + Complications Diagnostic Testing/ Labs Treatment Nursing Interventions Pt Education
, 2
Acute Glomerulonephritis Hematuria Elevated BUN, creatinine, -Tx the primary disease Monitor for s/sx of acute Recovery after 2-3 weks
Bilateral inflammation of the Oliguria or anuria ESR, and Specific Gravity -Correct electrolyte kidney injury Important to follow up with
glomeruli, usually after a strep Smokey/ Coffee colored urine imbalance UA at 2,4,8 wks & 4, 6,12
infection, results from antigen- Dyspnea Decreased protein, Hgb -Dialysis I&O’s / F&E balance months
antibody complexes becoming Periorbital edema Hematuria may last up to 2
trapped and collecting in the Increased BP Bilateral kidney -Fluid restriction Monitor LOC years
glomerular capillary membranes Sudden onset of proteinuria enlargement -Sodium restriction until Proteinuria may last up to 3
after infection Nephrotic Syndrome HTN, edema, and months
--massive proteinuria Kidney biopsy is the azotemia clear
May occur as the result of bacterial --hypoalbuminemia definitive Dx -avoid high K+ foods
or viral infection --hyperlipidemiauria
-varicella zoster virus -Oxygen for PE
-Hep B Complications
-Epstein-Barr virus Pulmonary edema MEDS
-Impetigo Heart failure Kayexalate (trades K+
Sepsis for sodium in small
AKI intestine)
Severe HTN Lasix
Cardiac hypertrophy Sodium bicarb
End-stage kidney disease Penicillian
Renal Calculi -Hematuria 24 Hr urine collection HYDRATION unless -Provide IV fluids as ordered Avoid/ Limit
-Abdominal distention -shows calcium oxalate, contraindicated -Strain all urine and send Spinach
Stones form when substances -Costovertebral tenderness phosphorus, and uric acid solid material for analysis Rhubarb
precipitate instead of dissolving in on palpation excretion levels Straining urine for stones -Encourage ambulation to aid Peanuts
urine (calcium oxalate, maleate, -Tachycardia Diet Modification passage Chocolate
calcium phosphate) -Elevated BP UA +specific gravity, Medications -Admin analgesics Parsley
hematuria, crystals, casts, Antibiotics -Inspect urine for color, Juices high in citrate
Risk Factors Complications pyuria Antiemetics clarity, bleeding
-Hx of hyperparathyroidism or -Urinary tract obstruction Analgesics -I&O’s Report fever, hematuria, or
osteoporosis -upper UTI KUB radiography or non- Allupurinol -Monitor for s/sx of infection vomiting immediately
-Renal parenchymal contrast CT - reveals K+ citrate
damage calculi Chelating agents
-Hydronephrosis Prednisone
-Urethral scarring Excretory urography (size) Procardia
-Ureteral stenosis Flomax
-Ureteral perforation Ultrasound - detects Terazosin
-Abscess formation obstructions
-Sepsis Lithotripsy
Ureteroscopy
Ureteral stent
Percutaneous
nephrostomy or
nephrostolithotomy
Acute Renal Failure Oliguria =urine output of Increased BUN, creatinine Hemodialysis During the oliguric phase (at
Can be caused by poor perfusion 250mL/ 24 hours and salty urine (3-12 months) risk for FVE b/c decreased
(kidneys need pressure) or decrease UO) **Limit fluid intake
in circulating volume (hypovolemic Diuretic phase = increased Low specific gravity
shock). May also be caused me urine output, hypotension,
