Glomerulonephritis: Acute can lead to - ✔✔ chronic
Glomerulonephritis: It is an - ✔✔ inflammatory reaction in the
... [Show More] glomerulus
Glomerulonephritis: Antibodies lodge in the ________________, causing _____________________________________ - ✔✔ glomerulus; scarring and decreased filtering
Glomerulonephritis: Main cause - ✔✔ streptococcus (Group A beta) (attacks the valves in the heart)
Glomerulonephritis: Signs/Symptoms - ✔✔ -flank pain
-oliguria
-hematuria
-proteinuria
-periorbital edema
-increased BP
-FVE
-increased urine specific gravity
-azotemia
-malaise and H/A
Glomerulonephritis Signs/Symptoms: Flank pain is - ✔✔ costovertebral angle tenderness (CVA tenderness)
-tap on back to see how high the infection is in the kidney
Glomerulonephritis Signs/Symptoms: Periorbital edema will - ✔✔ progress to other areas of the body
Glomerulonephritis Signs/Symptoms: Azotemia is - ✔✔ abnormally high BUN and creatinine
Glomerulonephritis Signs/Symptoms: Why does the client experience malaise and H/A? - ✔✔ toxins
Glomerulonephritis: Treatment - ✔✔ -get rid of the strep or cause
-I & O and daily weights
-diuretics
-monitor BP
-restrict fluids
-balance activity with rest
-dialysis
-modify dietary needs
Glomerulonephritis Treatment: How is fluid replacement determined? - ✔✔ 24 hour fluid loss + 500 mL
Glomerulonephritis Treatment: How are dietary needs modified? - ✔✔ -increased carbs
-decreased sodium
-decreased protein (makes BUN go up)
Glomerulonephritis Client Teaching: Diuresis begins in - ✔✔ 1 to 3 weeks after onset
Glomerulonephritis Client Teaching: ____________________ may stay in the urine for _________________ - ✔✔ Blood and urine; months
Glomerulonephritis Client Teaching: Teach the signs/symptoms of - ✔✔ renal failure
Glomerulonephritis Client Teaching: Signs/Symptoms of renal failure - ✔✔ -malaise
-H/A
-anorexia
-nausea
-vomiting
-decreased output
-weight gain
Glomerulonephritis Client Teaching: If you notice s/s of renal failure present.... - ✔✔ call the provider
Nephrotic Syndrome: These clients lose a lot more protein than clients with - ✔✔ glomerulonephritis
Nephrotic Syndrome: Pathophysiology - ✔✔ -it is an inflammatory response in the glomerulus
-big holes form so protein starts leaking out in the urine (proteinuria)
-NOW the client is hypoalbuminemic
-without albumin you can't hold onto fluid in the vascular space
-so the fluid goes out into the tissues
-NOW the client has edema
-the circulating blood volume is decreased as a result
-the kidneys sense this decrease & the want to replace it
-the RAS system kicks in
-aldosterone is produced and retains sodium and water
-but there is no protein (albumin) in the vascular space to hold it
-so this fluid goes into the tissues (MORE edema)
-this results in ANASARCA
Nephrotic Syndrome: What is anasarca? - ✔✔ total body edema
Nephrotic Syndrome: Problems associated with protein loss - ✔✔ -blood clots (thrombosis)
-increased cholesterol
-increased triglycerides
Nephrotic Syndrome: Why would blood clots form as a result of protein loss? - ✔✔ they are losing proteins that normally prevent their blood from clotting
Nephrotic Syndrome: Why are levels of cholesterol and triglycerides increased with protein loss? - ✔✔ the liver compensates by making more albumin causing an increased release of cholesterol and triglycerides
Nephrotic Syndrome: Causes are idiopathic (unknown cause), but have been related to - ✔✔ -bacteria or viral infections
-NSAIDs
-cancer and genetic predispositions
-systemic diseases such as lupus or diabetes
Nephrotic Syndrome: Signs/Symptoms - ✔✔ -massive proteinuria
-hypoalbuminemia
-edema (anasarca)
-hyperlipidemia
Nephrotic Syndrome: Treatment includes - ✔✔ -diuretics
-ACE inhibitors
-prednisone
-cyclophosphamide
-diet
-lipid lowering drugs
-anticoagulation therapy
-dialysis
Nephrotic Syndrome Treatment: We give ACE inhibitors to block - ✔✔ aldosterone secretion
Nephrotic Syndrome Treatment: We give prednisone for - ✔✔ inflammation
Nephrotic Syndrome Treatment: We give cyclophosphamide to - ✔✔ decrease the body's immune response
Nephrotic Syndrome Treatment: How does cyclophosphamide decrease the immune response? - ✔✔ shrink holes so protein can't get out
Nephrotic Syndrome Treatment: Patients on cyclophosphamide are - ✔✔ immunosuppressed
Nephrotic Syndrome Treatment: Major complication of nephrotic syndrome and being on cyclophosphamide - ✔✔ infection
Nephrotic Syndrome Treatment: How much protein should these clients receive? - ✔✔ 1 to 2 grams/kg/day
Nephrotic Syndrome Treatment: The client can become _______________________ fast - ✔✔ malnourished
Nephrotic Syndrome Treatment: We should decrease their ________________ intake - ✔✔ sodium [Show Less]