NURS 611 Advanced Pathophysiology Exam #4 Study Guide

NURS 611 Advanced Pathophysiology Exam #4 Study Guide Week 15 Renal and Urologic Systems: Chapters 38 & 39 Urinary Tract Obstruction: interference with the flow of urine at any site along the urinary tract * Impedes urine flow, increases hydrostatic pressure, and dilates structures proximal to the obstruction, increases risk for infection, and compromises renal function Acute Unilateral Renal Obstruction & Hypertension * Passage of kidney stones can be extremely painful & may produce “referred pain” to umbilicus area (due to the sensory innervation of the upper part of the ureter arising from the 10th thoracic nerve roots) Reduced perfusion (kidneys requirement is at least 20-25% CO-MAP) of the affected kidney activates the RAAS, which causes constriction of peripheral arterioles (= HTN) Kidney Stones: masses of crystal, protein, or other substances that are a common cause of urinary tract obstruction * Risk factors are age, sex, race, geographic location, seasonal factors, fluid intake, diet, occupation, genetics, other conditions such as UTI, HTN, atherosclerosis, metabolic syndrome, obesity and DM type II * Classified according to primary minerals that make up the stones--> Calcium Oxalate most common Pathophysiology Complex process; involves (1) supersaturation of one or more salts in urine, (2) precipitation of salts from a liquid to a solid state, (3) growth through crystallization or agglormeration, and (4) effect of stone inhibitors Clinical Manifestations—Pain, N/V, Gross or microscopic hematuria * Renal colic is moderate to severe pain Posterior flank & radiates to groin Renal pelvis or proximal ureter Lateral flank or lower abdomen Midureter