NUR 507 Advanced Pathophysiology Renal and Urinary Tract Function Practice Guide Exam 2026

NUR 507 NUR 507 NUR 507 Advanced Pathophysiology Renal and Urinary Tract Function Practice Guide Exam 2026 What bacteria primarily cause UTI’s? - -Escherichia coli (E. coli) What cells are activated in an inflammatory response to bacteria? - -Neutrophils, macrophages Diagnostic tests for UTI – -Urine Dipstick - Nitrates - Leukocyte Esterase - Blood Urine culture in infection is present - To identify bacteria Uncomplicated UTI - -No loss of renal function Complicated UTI - -Compromised renal function (usually kidneys) UTI symptoms - -- Disuria (painful urination) - Increased urine frequency and urgency - Suprapubic pain - Hematuria (blood in urine) Cystitis (inflammation of the bladder) symptoms - -- Disuria - Increased urinary frequency - Urgency - Supeapubic pain - Hematuria - Cloudy or foul-smelling urine - Urinary incontinence - Fatigue or Malaise Acute Pyelonephritis Symptoms - -- Similar to UTI (fatigue, dysuria, hematuria, etc) - Flank pain - Abdominal tenderness - Fever NUR 507 NUR 507 - Cills - Tachicardia Acute pyelonephritis diagnosis - -- Urinalysis - CBC (elevated WBC's) - Ultrasound, CT scan (identify structural abnormalities, and obstructions) Treatment of Acute pyelonephritis - -- Antibiotics - Hydration - Analgesics Renal Calculi - -kidney stone Renal calculi diagnosis - -- Ultrasound - CT scan - X-ray - Urinalysis - Blood test Treatment of renal calculi - -- Pain management - Promote stone passage - Reduce size of stone - Prevent new stones - Surgery if larger then 5mm or causing sever symptoms Erythropoietin - -A hormone produced and released by the kidney that stimulates the production of red blood cells by the bone marrow. hydrostatic pressure - -the pressure within a blood vessel that tends to push water out of the vessel Renal secretion - -Content moves from the blood into the nephron Functions of healthy kidney - -- Sodium and water removal - Waste removal - Hormone production Unhealthy Kidney - -Problems: -Fluid overload -Elevated wastes (Urea, Creatinine, Potassium) - Changes in hormone levels that control: Blood pressure, RBC production, Uptake of calcium Renin - -hormone secreted by the kidney that raises blood pressure Erythropoietin - -Hormone stimulating red blood cell production. NUR 507 NUR 507 Calcitriol - -Active form of vitamin D, increases calcium absorption. Prostaglandins - -Intensify histamine and kinin effect Atrial natriuretic peptide (ANP) - -A hormone, secreted by the heart, that reduces blood pressure, inhibits drinking, and promotes the excretion of water and salt at the kidneys. Brain Natriuretic Peptide (BNP) - -Produced by the kidneys to increase sodium excretion in the urine Acute Renal Failure - -A sudden loss of kidney function caused by illness, injury, toxin that stresses the kidneys (kidney function may recover) - Increased BUN, Phosphorus and Potassium. - Failure of kidneys up to 2weeks Chronic kidney disease - -A long, slow process where the kidneys lose their ability to function; occurs in various stages. - Kidneys not functioning after three months time End-stage renal disease - -Kidneys completely shut down-irreversible Symptoms of acute renal failure - -- Nausea - Decreased appetite - Headache - Lethargy - Tingling in the extremities - Decreased urine output - Fluid retention - Drowsiness - Fatigue - Confusion - Seizures/Coma in sever cases - Chest pain/pressure Oliguric phase of AKI - -- Vomiting - Disorientation - Edema - Hyperkalemia - Decreased sodium (dilutionl) - Increased BUN/Creat. - Acidosis - Heart failure/Pulmonary edema - Hypertension caused by hypovolemia - Anorexia - Sudden drop in UOP NUR 507 NUR 507 - Convulsions - Coma - Bowel changes Diuretic phase of AKI - -- Increased UOP - Gradual decline in BUN and Creat. - Hypokalemia - Hyponatrimia - Tachycardia - Improved level of consciousness (due to loss of nitrogen wastes) Diseases that cause intrinsic ARF - --Glomerulonephritis -Acute tubular necrosis -Acute interstitial nephritis -Rhabdomyolysis -Tumor lysis syndrome -Certain medication classes: (calcineurin inhibitors-tacrolimus) - Other: contrast dye from a procedure Stage 1 Kidney Damage - -- Kidney damage, proteinuria and normal GFR - GFR greater than 90 - Kidney function deterioration 50-60% Stage 2 Kidney Damage - -- Kidney damage and mild decrease in GFR - GFR is 60-88 - Kidney function deterioration 60-70% Stage 3 Kidney Damage - -- Moderate decrease in GFR - GFR is 30-59 - Kidney function deterioration 70-77.5% Stage 4 Kidney Damage - -- Severe decrease in GFR - GFR is 15-29 - Kidney function deterioration 77.5-85% Stage 5 Kidney Damage - -- Kidney failure-end-stage renal disease (dialysis or kidney transplant needed) - GFR is less than 15 - Kidney function deterioration 85% or above Causes of CRF (Chronic renal failure) - -•Diabetes mellitus*** •Glomerulonephritis •Hypertension •Tubulointerstitial nephritis •These are now the leading causes NUR 507 NUR 507 Symptoms of chronic renal failure (CRF) - --Hyponatremia (dilutional) -Dry mouth -Poor skin turgor -Confusion, salt overload, accumulation of potassium with muscle weakness -Fluid overload and metabolic acidosis -Proteinuria, glycosuria -Urine: RBCs, WBCs, and casts Effects on the cardiovascular system with CRF - -•Hypertension •Arrhythmias •Pericardial effusion •Heart failure •Peripheral edema Nurological symptoms of CRF - -•Burning, pain, itching (neuropathy) •Motor/nerve dysfunction •Muscle cramping •Shortened memory span •Apathy •Drowsy, confused, seizures, coma GI Symptoms of CRF - -•Stomatitis •Ulcers •Pancreatitis •Uremic fetor: urine-like odor on the breath of people with uremia. The odor occurs from the smell of ammonia, which is created in the saliva as a breakdown product of urea •Vomiting constipation Respiratory Symptoms of CRF - -•Increased chance of respiratory infection •Pulmonary edema •Pleural friction rub and effusion •Dyspnea •Kussmaul's respirations from acidosis (compensatory mechanism) Endocrine symptoms of CRF - -•Stunted growth in children •Amenorrhea •Male impotence •Increased aldosterone secretion •Impaired glucose levels R/T impaired CHO metabolism •Thyroid and parathyroid abnormalities Hemopoietic symptoms of CRF - -•Anemia •Decrease in RBC survival time •Blood loss from dialysis and GI bleed NUR 507 •Platelet deficits •Bleeding and clotting disorders: purpura and hemorrhage from the body orifices, ecchymoses Skeletal symptoms: CRF - -•Muscle and bone pain •Bone mineralization •Pathological fractures •Blood vessel calcifications in myocardium, joints, eyes, brain Skin symptoms: CRF - -•Yellow-bronze skin with pallor •Pruritis •Purpura •Uremic frost •Thin, brittle nails •Dry, brittle hair •Alopecia Normal potassium level - -3.5-5.0 mEq/L Normal calcium levels - -4.5-5.5 mEq/L NUR 507