NR 545 Exam 3 with accurate detailed ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
answers
GFR (glomerular filtration rate) ||\\//|| ||\\//|| ||\\//||
a blood test that measures how well the kidneys are working by estimating how much
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
blood passes through the kidneys' glomeruli each minute ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Proteinuria
the presence of an abnormal amount of protein in the urine
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Creatinine and BUN ||\\//|| ||\\//||
BUN-to-creatinine ratio is a medical measurement that compares the levels of blood urea ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
nitrogen (BUN) and creatinine in a patient's blood. It's calculated by dividing the BUN ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
number by the creatinine number. A normal ratio is between 10:1 and 20:1 ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Pyelonephritis --Patho/phys: ||\\//||
One or both kidneys may be involved. The infection extends from the ureter into the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
kidney, involving the renal pelvis and medullary tissue (tubules and interstitial tissue).
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Purulent exudate fills the kidney pelvis and calyces, and the medulla is inflamed. Abscesses ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and necrosis can be seen in the medulla and may extend through the cortex to the surface
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
of the capsule. If the infection is severe, the exudate can compress the renal artery and vein
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and obstruct urine flow to the ureter.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,Pyelonephritis symptoms ||\\//||
1) urinary frequency
||\\//|| ||\\//||
2) urgency ||\\//||
3) burning ||\\//||
4) dysuria in the same way as cystitis
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
5) flank pain and tenderness.
||\\//|| ||\\//|| ||\\//|| ||\\//||
**Pyelonephritis is also a more severe disease, so there is a higher fever and the patient is ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
much more ill. ||\\//|| ||\\//||
Pyelonephritis treatment ||\\//||
UTIs are treated promptly with antibacterial drugs such as:
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• Trimethoprim-sulfamethoxazole (Bactrim, Cotrim, Septra)
||\\//|| ||\\//|| ||\\//|| ||\\//||
• Nitrofurantoin (Furadantin)
||\\//|| ||\\//||
• Cephalosporins (Keflex, Duricef)
||\\//|| ||\\//|| ||\\//||
• Carbapenems (Doribax)
||\\//|| ||\\//||
• Amoxicillin
||\\//||
• Fosfomycin (which is prescribed for pregnant women)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
UTI
E. coli, Staphylococcus saprophyticus (young women)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Tx: Bactrim, Ciprofloxacin
||\\//|| ||\\//||
, Renal Colic ||\\//||
an acute pain in the kidney area that is caused by blockage during the passing of a kidney
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
stone
renal colic signs and symptoms ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Severe pain in flank or back
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Frequently radiates to groin
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Nausea, vomiting
||\\//|| ||\\//||
glomerulonephritis patho/phys ||\\//||
The antistreptococcal antibodies, formed as usual from the earlier streptococcal infection,
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
create an antigen-antibody complex (type III hypersensitivity reaction) that lodges in the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
glomerular capillaries and activates the complement system to cause an inflammatory ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
response in the glomeruli of both kidneys. This leads to increased capillary permeability
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and cell proliferation and results in leakage of some protein and large numbers of
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
erythrocytes into the filtrate. ||\\//|| ||\\//|| ||\\//||
glomerulonephritis signs & symptoms ||\\//|| ||\\//|| ||\\//||
• The urine becomes dark and cloudy (“smoky” or “coffee-colored”) because of the protein
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and red blood cells that have leaked into it.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• Facial and periorbital edema
||\\//|| ||\\//|| ||\\//|| ||\\//||
• Blood pressure is elevated due to increased renin secretion and decreased GFR.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
answers
GFR (glomerular filtration rate) ||\\//|| ||\\//|| ||\\//||
a blood test that measures how well the kidneys are working by estimating how much
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
blood passes through the kidneys' glomeruli each minute ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Proteinuria
the presence of an abnormal amount of protein in the urine
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Creatinine and BUN ||\\//|| ||\\//||
BUN-to-creatinine ratio is a medical measurement that compares the levels of blood urea ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
nitrogen (BUN) and creatinine in a patient's blood. It's calculated by dividing the BUN ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
number by the creatinine number. A normal ratio is between 10:1 and 20:1 ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Pyelonephritis --Patho/phys: ||\\//||
One or both kidneys may be involved. The infection extends from the ureter into the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
kidney, involving the renal pelvis and medullary tissue (tubules and interstitial tissue).
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Purulent exudate fills the kidney pelvis and calyces, and the medulla is inflamed. Abscesses ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and necrosis can be seen in the medulla and may extend through the cortex to the surface
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
of the capsule. If the infection is severe, the exudate can compress the renal artery and vein
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and obstruct urine flow to the ureter.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
,Pyelonephritis symptoms ||\\//||
1) urinary frequency
||\\//|| ||\\//||
2) urgency ||\\//||
3) burning ||\\//||
4) dysuria in the same way as cystitis
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
5) flank pain and tenderness.
||\\//|| ||\\//|| ||\\//|| ||\\//||
**Pyelonephritis is also a more severe disease, so there is a higher fever and the patient is ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
much more ill. ||\\//|| ||\\//||
Pyelonephritis treatment ||\\//||
UTIs are treated promptly with antibacterial drugs such as:
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• Trimethoprim-sulfamethoxazole (Bactrim, Cotrim, Septra)
||\\//|| ||\\//|| ||\\//|| ||\\//||
• Nitrofurantoin (Furadantin)
||\\//|| ||\\//||
• Cephalosporins (Keflex, Duricef)
||\\//|| ||\\//|| ||\\//||
• Carbapenems (Doribax)
||\\//|| ||\\//||
• Amoxicillin
||\\//||
• Fosfomycin (which is prescribed for pregnant women)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
UTI
E. coli, Staphylococcus saprophyticus (young women)
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
Tx: Bactrim, Ciprofloxacin
||\\//|| ||\\//||
, Renal Colic ||\\//||
an acute pain in the kidney area that is caused by blockage during the passing of a kidney
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
stone
renal colic signs and symptoms ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Severe pain in flank or back
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
- Frequently radiates to groin
||\\//|| ||\\//|| ||\\//|| ||\\//||
- Nausea, vomiting
||\\//|| ||\\//||
glomerulonephritis patho/phys ||\\//||
The antistreptococcal antibodies, formed as usual from the earlier streptococcal infection,
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
create an antigen-antibody complex (type III hypersensitivity reaction) that lodges in the
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
glomerular capillaries and activates the complement system to cause an inflammatory ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
response in the glomeruli of both kidneys. This leads to increased capillary permeability
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and cell proliferation and results in leakage of some protein and large numbers of
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
erythrocytes into the filtrate. ||\\//|| ||\\//|| ||\\//||
glomerulonephritis signs & symptoms ||\\//|| ||\\//|| ||\\//||
• The urine becomes dark and cloudy (“smoky” or “coffee-colored”) because of the protein
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
and red blood cells that have leaked into it.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
• Facial and periorbital edema
||\\//|| ||\\//|| ||\\//|| ||\\//||
• Blood pressure is elevated due to increased renin secretion and decreased GFR.
||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//|| ||\\//||
