________!#~@Page
1 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
Module II Blueprint
Concentrate on signs and symptoms, patho, nursing interventions and client teaching
URINARY
1ml/kg of body weight/hr
1500-2000ml avg output daily
Extracelluar balance maintained by
Sodium
Chloride
Intracelluar balance maintained by
Potassium
Phosphate
Weigh clients on same scale / same time daily
Fluid Volume Alterations in renal disease
EXCESS: DEFICITS:
Dyspnea ↓ Urine Ouput
Tachycardia ↓ body weight
Juglar distension ↓ skin turgor
Peripheral Edema Dry mucous membranes
Pulmonary Edema Hypotension
Weight gain Weight loss
Watch for signs of Hyperkalemia: No pee No “k”
Dizziness
Weakness
Cardiac Irregularities
Muscle Cramps
Diarrhea
Nausea
Limit high K foods: bananas/ oj/ cantaloupe/ strawberries/ avocados/ spinach/fish
Salt substitutes
** Potassium Sparing Diuretic – aldactone
Interventions for Urinary Incontinence: Pg 1585
Timed Voiding – establish a set voiding frequency – void by the clock instead of when the urge hits
Bladder retraining – “bladder drill” – incorporates timed voiding schedule and urge inhibition exercises
Bladder training (bladder drill)
A. Timed Voiding Schedule (Q2hrs)
B. Urinary Urge Inhibition Exercises (attepmts to remain dry for a set time)
C. Add 15 min to each interval beyond last
Pelvic Muscle Exercises – Kegel exercises – strengthen voluntary muscles that assist in bladder and bowel
continence
Diagnostic tests & Lab Values for urinary problems
BUN: (Blood Urea Nitrogen) 11-23mg/100ml NOT THE BEST TEST—MUST BE USED W/CREATININE
________!#~@Page
1 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
,________!#~@Page
2 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
A. What is it?
a. Broken down protein
b. Amino Acids-what body uses to fuel/rebuild
c. Nitrogenous Waste- what body cant use
d. Urea Nitrogen- End Product of protein metabolism
B. Purpose- (INDEX OF RENAL EXCRETION CAPACITY)
C. Why it goes up?
a. Increase in BUN can be caused by other things than kidney problems:
i. Volume Depletion
ii. Low perfusion (weak heart)
iii. ↑ catabolic process
CREATININE: 0.5-1.1MG/ML BEST MEASURE OF RENAL FUNCTION
A. What is it? Product of Muscle metabolism
B. Purpose- Shows balance PRODUCTION/FILTRATION of renal glomerulus – how well is kidney
filtering?
C. NOT AFFECTED BY DIET/FLUID INTAKE
D. 20:1 BUN ↑ out of proportion to CREATININE when GFR ↓
a. If BOTH rise together= KIDNEY DISEASE
KUB: (Kidney Ureter Bladder) x-Ray used to determine
o Size
o Shape
o Position
o Find Gross Abnormalities
IVP: (Intravenous Pyelogram) CONTRAST DYE USED…..ALLERGIES???? (SHELLFISH)
IV admininstration
o Used to find LESIONS
o Rough est. of Renal Function
• May feel warmth/flushing due to dye (Keep Epi/Adreniline close if reaction
happens)
• If suspicion of allergy – premedicate with steroids, bronchodilators, epinephrine,
Antihistamines
✓ Patient Prep
1. Health history
2. Hx of allergies
▪ If patient has pos allergy hx then a test dose is given
intradermally. No reaction in 15 mins= IV dose is given
▪ Iodine (or shellfish) is the dye that patient is generally allergic
to.
▪ Watch for restlessness/apprehensive/weezing= anaphylactoid
shock
3. Inform patient they may feel a temp feeling of warmth/flushing of
face/unusual flavor (seafood) due to infusion of dye
4. All rooms must Keep Epi/Corticosteriod/vasopressors/antihistamines/
Broncodialators/oxygen equip/trach equip in case of emergency
________!#~@Page
2 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
,________!#~@Page
3 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
RETROGRADE PYELOGRAPHY: Admin thru Urethral Catheter
• Used when IVP not good enough
• Catheter passed thru Ureters into Renal Pelvis w/Cytoscope
• CONTRAST MATERIAL into cath by gravity/syringe
RENAL ANGIOGRAPHY: IV INJECTION
Visualizes Renal Artery Supply
Catheter up FEMORAL / AXILLARY artery into Aorta
PRE-OP:
▪ Consent form signed
▪ Laxative sometimes
▪ NPO 8 hrs
▪ Mark peripheral pulse sites ( radial, femoral, dorsalis pedis)
▪ Warned of transient feeling of heat w/dye
• Burning/nausea
▪ Test for dye sensitivity – premedicate
POST-OP
▪ VS taken until stable (hemorrhage)
▪ Examine puncture site for swelling (hematoma)
▪ Bed rest for Several hrs. To seal puncture site
▪ IF Femoral Puncture done (check pedal pulses)
WARN OF HEAT FEELING WITH ALL DYES
a. CYSTOSCOPY
• Direct study/visualization of Urethra/Bladder
• Oldest method of direct visualization of urinary tract
o Has a lens(magnified) that views bladder
o Calculi can be removed with this procedure
o Patient is conscious – usually no more uncomfortable than a catheterization
Pre-Op:
• Explain means of exam to ↓ fears
• Consent form – sign permit, invasive
• Explain they will get sedation (VALIUM)
• Topical Anesthetic into urethra by Urologist before procedure
• May get Spinal/General anesthesia
o DIFFICULTIES AFTER EXAM
o Burning Pain during Voiding
o Blood Tinged Urine
o Urinary freq. due to trauma to mucous membrane
Post-Op:
• Moist heat to Abdomen to ↓ pain & help muscles relax
• Sitz baths
• Foley to help with urinary retention
• Observe for UTI
• Observe for signs of obstruction – can have edema because of local trauma
________!#~@Page
3 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
,________!#~@Page
4 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
4 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
4 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
b. RENAL ENDOSCOPY (NEPHROSCOPY) Fiberscope into pelvis of kidney thru INCISION
a. Remove calculi
b. Biopsy
c. Aid in dx of renal issues
o Ultrasound: Sound waves
▪ Sound waves
▪ Identifies Masses/malformations/obstructions/gross abnormalities
▪ Non invasive, no special prep
▪ Is usually done first to see if something is wrong
o CTs
▪ With or without contrast
▪ With contrast needs consent
▪ May do first or Ultrasound/MRI
RENAL AND URINARY DISORDERS:
• Glomerulonephritis (acute and chronic)
o ACUTE: NOT AN INFECTION
1. Inflammatory reaction in glomeruli
2. Follows a STREP Infections by interval of 2-3 wks
3. Result of an Antigen-Antibody reaction complexes are formed and circulates
throughout body
a. Complexes lodge in Glomeruli
b. Inducing an INFLAMMATORY RESPONSE that injures kidneys
o Kidneys become LARGE/SWOLLEN/CONGESTED
S/S:
a. Mild response
▪ (may be discovered accidentally thru routine UA)
▪ May excrete protein/glucose in urine
b. SEVERE:
a. Headache/Malaise/Flank pain/Mild HTN/Scant/bloody Urine/↑ BUN
b. PERIORBITAL EDEMA/ FACIAL EDEMA/ANASCARA= (edema all over
the body) Why Edema?
i. Due to loss of protein in blood. (kidneys let it pass thru)
ii. ↓ in Albumin cause changes in Osmotic Pressure
iii. (Proteinuria/Albuminuria)- Proteins in blood hold serum in blood
stream. If protein goes low then edema occurs, because not enough
protein in blood stream to keep fluids in.
▪ Tenderness over the costovertebral angle (flank pain)
▪ ASO Titer- ↑ result of reaction to strep organism (blood test)
INTERVENTIONS:
a. Give antibiotics (PCN) prophylactic (to prevent infection)
b. Bed Rest until urine clears &
a. BUN/CREATININE/ BP normalize (shows that kidneys are getting better)
(↑ in activity may cause ↑ in proteinuria/hematuria)
c. Dietary restrictions of protein if BUN is ↑ - can’t keep giving protein if not absorbing!
________!#~@Page
4 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
4 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
4 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
1 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
Module II Blueprint
Concentrate on signs and symptoms, patho, nursing interventions and client teaching
URINARY
1ml/kg of body weight/hr
1500-2000ml avg output daily
Extracelluar balance maintained by
Sodium
Chloride
Intracelluar balance maintained by
Potassium
Phosphate
Weigh clients on same scale / same time daily
Fluid Volume Alterations in renal disease
EXCESS: DEFICITS:
Dyspnea ↓ Urine Ouput
Tachycardia ↓ body weight
Juglar distension ↓ skin turgor
Peripheral Edema Dry mucous membranes
Pulmonary Edema Hypotension
Weight gain Weight loss
Watch for signs of Hyperkalemia: No pee No “k”
Dizziness
Weakness
Cardiac Irregularities
Muscle Cramps
Diarrhea
Nausea
Limit high K foods: bananas/ oj/ cantaloupe/ strawberries/ avocados/ spinach/fish
Salt substitutes
** Potassium Sparing Diuretic – aldactone
Interventions for Urinary Incontinence: Pg 1585
Timed Voiding – establish a set voiding frequency – void by the clock instead of when the urge hits
Bladder retraining – “bladder drill” – incorporates timed voiding schedule and urge inhibition exercises
Bladder training (bladder drill)
A. Timed Voiding Schedule (Q2hrs)
B. Urinary Urge Inhibition Exercises (attepmts to remain dry for a set time)
C. Add 15 min to each interval beyond last
Pelvic Muscle Exercises – Kegel exercises – strengthen voluntary muscles that assist in bladder and bowel
continence
Diagnostic tests & Lab Values for urinary problems
BUN: (Blood Urea Nitrogen) 11-23mg/100ml NOT THE BEST TEST—MUST BE USED W/CREATININE
________!#~@Page
1 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
1 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
,________!#~@Page
2 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
A. What is it?
a. Broken down protein
b. Amino Acids-what body uses to fuel/rebuild
c. Nitrogenous Waste- what body cant use
d. Urea Nitrogen- End Product of protein metabolism
B. Purpose- (INDEX OF RENAL EXCRETION CAPACITY)
C. Why it goes up?
a. Increase in BUN can be caused by other things than kidney problems:
i. Volume Depletion
ii. Low perfusion (weak heart)
iii. ↑ catabolic process
CREATININE: 0.5-1.1MG/ML BEST MEASURE OF RENAL FUNCTION
A. What is it? Product of Muscle metabolism
B. Purpose- Shows balance PRODUCTION/FILTRATION of renal glomerulus – how well is kidney
filtering?
C. NOT AFFECTED BY DIET/FLUID INTAKE
D. 20:1 BUN ↑ out of proportion to CREATININE when GFR ↓
a. If BOTH rise together= KIDNEY DISEASE
KUB: (Kidney Ureter Bladder) x-Ray used to determine
o Size
o Shape
o Position
o Find Gross Abnormalities
IVP: (Intravenous Pyelogram) CONTRAST DYE USED…..ALLERGIES???? (SHELLFISH)
IV admininstration
o Used to find LESIONS
o Rough est. of Renal Function
• May feel warmth/flushing due to dye (Keep Epi/Adreniline close if reaction
happens)
• If suspicion of allergy – premedicate with steroids, bronchodilators, epinephrine,
Antihistamines
✓ Patient Prep
1. Health history
2. Hx of allergies
▪ If patient has pos allergy hx then a test dose is given
intradermally. No reaction in 15 mins= IV dose is given
▪ Iodine (or shellfish) is the dye that patient is generally allergic
to.
▪ Watch for restlessness/apprehensive/weezing= anaphylactoid
shock
3. Inform patient they may feel a temp feeling of warmth/flushing of
face/unusual flavor (seafood) due to infusion of dye
4. All rooms must Keep Epi/Corticosteriod/vasopressors/antihistamines/
Broncodialators/oxygen equip/trach equip in case of emergency
________!#~@Page
2 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
2 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
,________!#~@Page
3 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
RETROGRADE PYELOGRAPHY: Admin thru Urethral Catheter
• Used when IVP not good enough
• Catheter passed thru Ureters into Renal Pelvis w/Cytoscope
• CONTRAST MATERIAL into cath by gravity/syringe
RENAL ANGIOGRAPHY: IV INJECTION
Visualizes Renal Artery Supply
Catheter up FEMORAL / AXILLARY artery into Aorta
PRE-OP:
▪ Consent form signed
▪ Laxative sometimes
▪ NPO 8 hrs
▪ Mark peripheral pulse sites ( radial, femoral, dorsalis pedis)
▪ Warned of transient feeling of heat w/dye
• Burning/nausea
▪ Test for dye sensitivity – premedicate
POST-OP
▪ VS taken until stable (hemorrhage)
▪ Examine puncture site for swelling (hematoma)
▪ Bed rest for Several hrs. To seal puncture site
▪ IF Femoral Puncture done (check pedal pulses)
WARN OF HEAT FEELING WITH ALL DYES
a. CYSTOSCOPY
• Direct study/visualization of Urethra/Bladder
• Oldest method of direct visualization of urinary tract
o Has a lens(magnified) that views bladder
o Calculi can be removed with this procedure
o Patient is conscious – usually no more uncomfortable than a catheterization
Pre-Op:
• Explain means of exam to ↓ fears
• Consent form – sign permit, invasive
• Explain they will get sedation (VALIUM)
• Topical Anesthetic into urethra by Urologist before procedure
• May get Spinal/General anesthesia
o DIFFICULTIES AFTER EXAM
o Burning Pain during Voiding
o Blood Tinged Urine
o Urinary freq. due to trauma to mucous membrane
Post-Op:
• Moist heat to Abdomen to ↓ pain & help muscles relax
• Sitz baths
• Foley to help with urinary retention
• Observe for UTI
• Observe for signs of obstruction – can have edema because of local trauma
________!#~@Page
3 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
3 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
,________!#~@Page
4 of 3410/5/2026,
@~~!@#)_________!#~@Page
5:02:10
4 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_notes.docx
5:02:10
4 of 3410/5/2026,
AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_surg_1_urinary_system_
5:02:10 AM&@*&#^*^($(@*^$&*&(*^$$&$&*$^^&&@&*^$&^20240402235755_660c9b833ef4b_nursing_med_sur
b. RENAL ENDOSCOPY (NEPHROSCOPY) Fiberscope into pelvis of kidney thru INCISION
a. Remove calculi
b. Biopsy
c. Aid in dx of renal issues
o Ultrasound: Sound waves
▪ Sound waves
▪ Identifies Masses/malformations/obstructions/gross abnormalities
▪ Non invasive, no special prep
▪ Is usually done first to see if something is wrong
o CTs
▪ With or without contrast
▪ With contrast needs consent
▪ May do first or Ultrasound/MRI
RENAL AND URINARY DISORDERS:
• Glomerulonephritis (acute and chronic)
o ACUTE: NOT AN INFECTION
1. Inflammatory reaction in glomeruli
2. Follows a STREP Infections by interval of 2-3 wks
3. Result of an Antigen-Antibody reaction complexes are formed and circulates
throughout body
a. Complexes lodge in Glomeruli
b. Inducing an INFLAMMATORY RESPONSE that injures kidneys
o Kidneys become LARGE/SWOLLEN/CONGESTED
S/S:
a. Mild response
▪ (may be discovered accidentally thru routine UA)
▪ May excrete protein/glucose in urine
b. SEVERE:
a. Headache/Malaise/Flank pain/Mild HTN/Scant/bloody Urine/↑ BUN
b. PERIORBITAL EDEMA/ FACIAL EDEMA/ANASCARA= (edema all over
the body) Why Edema?
i. Due to loss of protein in blood. (kidneys let it pass thru)
ii. ↓ in Albumin cause changes in Osmotic Pressure
iii. (Proteinuria/Albuminuria)- Proteins in blood hold serum in blood
stream. If protein goes low then edema occurs, because not enough
protein in blood stream to keep fluids in.
▪ Tenderness over the costovertebral angle (flank pain)
▪ ASO Titer- ↑ result of reaction to strep organism (blood test)
INTERVENTIONS:
a. Give antibiotics (PCN) prophylactic (to prevent infection)
b. Bed Rest until urine clears &
a. BUN/CREATININE/ BP normalize (shows that kidneys are getting better)
(↑ in activity may cause ↑ in proteinuria/hematuria)
c. Dietary restrictions of protein if BUN is ↑ - can’t keep giving protein if not absorbing!
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