Renal Function and Disorders

1. filtration of metabolic waste
2. regulation of fluid/electrolyes/acid-base
3. blood pressue control via RASS
4. Production of erythroprotein
5. activation of Vitamin D

Nephron

processes are
1. glomerular filtration
2. tubular reabsorption
3. tubular secretion

20-25%

1. prerenal
2. intrarenal
3. postrenal

becuase of decreased renal perfusion

kidney is normal the problem is inadequete blood flow

dehydration
hemorrhage
sepsis
cardiogenic shock

because of damage within the kidney itsself

Acute tubular necrosis
glomerulonephritis
nephrotoxic medications
prolonged ischemia

beacsuse of obstruction of urine flow

benign porstatic hyperplasis
ureteruc calculi
urethreal obstruction
tumors

its a lab finding

elevated nitrogen-contaning waste products primarily BUN and creatinine in blood stream

is a clinical syndrome from severe kidney failure and may include

LOA
N/V
prurtus
pericarditis

a rapid decline in kidney function occuring ober hours to days

a progressive and irreversible loss of kidney function over months to years

diabetes mellitus
hypertension
chronic glomerular disease
polycystic kidney disease

dialysis and kindey transplantation

fatigue
weakness
N/V
peripheral edema
hypertension
dyspnea from fluid overload

is the most lifethreatining complications

muscle weakness
cardiac dysrhythmias
bradycardia
cardiac arrest

peaked T waves
widened QRS complexes
progressive conduction abnormalties

excess fluid
electrolytes
meabolic waste products

3x a week

a palatable thrill
an audible bruit

BP measurement on the acess arm
IV insertion into the acess arm
Venipuncture involving the acess arm whenever possible

hypotension
muscle cramps
bleeding
infection
hyperkalemia
fluid overload

headahce
N/V
restlessness
confusion
seizures
Decreased LOC

the lower urinary tract (cytitis)

dysuria
urinary frequency
urinary urgency
suprapubic discomdort
hematuria
afebrile

an innfection of the kidney and represents the upper urinary tract infection

fever
chills
flank pain
costoverebral angle tendereness
N/V
dysuria

sudden severe flank pain
pain radiating towards the groin
restlessness
hematuria
nausea and vomiting

these pats cannot remain still

is a common cause of urinary obstruction in older males

difficulty initating urination
weak urinary steam
urinary frequency
nocturia
incomplete bladder emptying
acute urianry retention may occur

inflammation of the epididmyis

gradual onset unilateral scrotal pain
swelling
tenderness
occasinally fever

Chlamydia trachomatid and neisseria gonorrhoeae

sudden severe unilateral scrotal pain
high riding testicle
neausa vomiting
swelling

benign prostatic hyperplasia
urethral obstruction
neruological disroders
certain medications

lower abdominal discomfort
inability to void
bladder distention

dyspnea
orthopnea
pulmonary edema
peripheral edema
hypertension
JVD

missed dialysis
present with weakness
develop bradycardia
demonstarte ECG abnormalities

fever
tahchycardia
hypotnesion
altered mental status
tachypnea

MAP= (SBP + 2 X DBP) / 3

65mmHg

ovaries
fallopian tubes
uterus
cerivx
vagina
vulva

produce ova
produce estrogen
produce progesterone

transport the ovum toward the uterus
typical fertilization site

fallopian tubes

supports implantaion
nourishes the developing fetus
contractd during labour
houses the endometrium

lower portion of the uterus
produces cervial mucus
dilates during labour
helps protect the uterus from asecnding infection

28 days

menstrual phase
follicular phase
ovulation
luteal phase

anterior pituitary

stimulates ovarian follicle development and estrogen prodcutionn

developing ovarian follicle

thickens the endometrium and promotes follicle maturation

anterior pituiatary

LH surge triggers ovularion adn formation of the corpus luteu

corpus luteum

maintains the endometrium and supports implantation

developing embryo/placenta

maointains the corpus luteum during early pregnancy until the placenta assumes hormomne production

Its primary function is to produce progesterone and estrogen during early pregnancy

around day 14 of a 28 dya cycle

raminas viable for approx 12-24 hours

6-10 days after fertilization

increased blood volume
increased heart rate
increased CO
increased respiratory tidal volume

none!

implantation bleeding
theratened abortion
inevitbale abortion
incomplete abortion
complete abrotion
missed abortion
esctopic pregnancy

when the fetilized ovum implants outside the uterine cavity

95% occur in fallpian tube

is a significant risk factor for ectopic pregnancy because chronic inflammation and scarring of the fallopian tubes can impair normal transport of the fertilized ovum

threatend
inevitiable
incomplete
complete
missed

chlamydia tachomatis
neisserdia gonnorrhoeae

infertility
chronic pelvic pain
tubal scarring
increased risk of ectopic pregnancy

whent eh ovary tiwsts and cuts off blood flow

Sudden unilateral pelvic pain
Pain after exercise or intercourse
Mild vaginal bleeding
Peritoneal irritation if significant bleeding occurs

Endometriosis occurs when endometrial tissue grows outside the uterine cavity

ovaries
peritoneum
fallopian tubes
uterosacral ligaments

mittelschmerz ("middle pain") is ovulation pain

painful mensturation without underlying disease

Pain due to another condition such as endometriosis or adenomyosis.

The Bartholin glands are located near the vaginal opening

• Painful unilateral vulvar swelling
• Pain when walking or sitting
• Local tenderness
• Occasionally fever

• Tachycardia
• Anxiety
• Pallor
• Cool skin
• Delayed capillary refill

• Hypotension
• Altered mental status
• Weak peripheral pulses
• Collapse