All cards
1
the renal system maintains ___________ by balancing bodily ________, _________, and ________
homeostasis, fluids, electrolytes, metabolites
2
the renal system filters _____ products
waste
3
the renal system excretes _______
metabolites (urea)
4
the renal system removes excess fluid in __________
fluid, hypervolemia
5
the renal system balances the electrolytes of ______, _________, _____________ ____, _________, _________
sodium, potassium, hydrogren ion, oxygen, glucose
6
the renal system makes ________
hormones
7
Image occlusion: name the hidden labels
8
Image occlusion: name the hidden labels
9
Image occlusion: name the hidden labels
10
Image occlusion: name the hidden labels
11
Image occlusion: name the hidden labels
12
Image occlusion: name the hidden labels
13
the renal pelvis brings waste products to the
ureter
14
the Loops of Henley help with
reabsorption and collecting ducts
15
What hormones do the kidney's make?
erythropoietin
renin
calcitral
16
what does erythropoietin do?
for red blood cells
17
what does renin do?
for blood pressure modulation
18
what does calcitral do?
for Vitamin D to maintain Ca++
19
What is pyelonephritis
inflammation of renal pelvis/ basin
20
Signs and symptoms of acute pyelonephritis
quick onset of fever, chills, malaise, headache, BACK PAIN, FLANK PAIN, signs of UTI
usually a bacterial infection from UTI -> travels up from the bladder to the basin
usually a bacterial infection from UTI -> travels up from the bladder to the basin
21
signs and symptoms of chronic pyelonephritis
chronic inflammation
injury, obstruction of reflux
can lead to end stage renal disease (ESRD)
injury, obstruction of reflux
can lead to end stage renal disease (ESRD)
22
diagnosis of pyelonephritis
Urine analysis: bacteria, hematuria, leukocytosis,
23
treatment of pyelonephritis
treat with antibiotics, 14 day course
24
what to watch for in patients with pyelonephritis
signs of infection
make sure they complete their course of medications
make sure they complete their course of medications
25
what is Glomeruonephritis
inflammation of filtering units, most common cause of renal failure
26
who gets glomerulonephritis
people with diabetes, lupus, PAD
27
signs and symptoms of glomerulonephritis
hematuria, proteinuria + decreased urine output
leads to systemic edema and pulmonary edema
increases in BP
leads to systemic edema and pulmonary edema
increases in BP
28
diagnosis of glomerulonephritis
UA: proteinuria, hematuria, pyuria
29
treatment of glomerulonephritis
diet: low fat, decrease protein in diet, restrict dietary salt
pt may be on diuretic or ACE inhibitor
BP rx: diuretics, CCB, beta blockers
dialysis and transplantation
pt may be on diuretic or ACE inhibitor
BP rx: diuretics, CCB, beta blockers
dialysis and transplantation
30
what to watch for in patients with glomerulonephritis
electrolytes may be off
Muscle cramping or weakness, hemodynamic compromise, increase in SBP
toxins remain in system
excess fatigue
Increase BP, but if on dialysis BP decreases, monitor during exercise
Muscle cramping or weakness, hemodynamic compromise, increase in SBP
toxins remain in system
excess fatigue
Increase BP, but if on dialysis BP decreases, monitor during exercise
31
what is renal calculi?
kidney stones
32
signs and symptoms of renal calculi
Pain - flank pain and back pain
symptoms associated with UTI - urgency, frequency, hematuria
symptoms associated with UTI - urgency, frequency, hematuria
33
diagnosis renal calculi
Imaging - CT or ultrasound
34
treatment renal calculi
time and pain meds
lithotripsy if the stone is too big
lithotripsy if the stone is too big
35
what to watch for in renal calculi
intermittent obstruction + decreased urine output
recurrent infections
recurrent infections
36
what is rhabdomyosis
crush or exertional induced breakdown of muscle
37
signs and symptoms of rhabdomyosis
muscle ache/pain
increased CK levels
overflow proteinuria
toxic to tubules
acute renal dysfunction
dark urine
decreased urine output
back and flank pain
confusion
nausea and vomiting
acute renal failure
increased CK levels
overflow proteinuria
toxic to tubules
acute renal dysfunction
dark urine
decreased urine output
back and flank pain
confusion
nausea and vomiting
acute renal failure
38
Kidney trauma grades
I-V
39
Signs and symptoms of kidney trauma
hematuria, LBP, signs of internal bleeding
decreased urine output
hypotension
hypertension
renal insufficiency/failure
decreased urine output
hypotension
hypertension
renal insufficiency/failure
40
diagnosis and treatment kidney trauma
ultrasound (FAST)
conservative treatment for I-IV
excision
conservative treatment for I-IV
excision
41
what to watch for in kidney trauma
trauma from contact sport, fall, or injury
look for signs and symptoms
look for signs and symptoms
42
Renal failure is usually secondary to
diabetes, hypertension, chronic UTI, SLE, primary renal dysfunction, advancing age
43
signs and symptoms of renal failure
increase in weight, edema, mental status change, fatigue, increased BP, nausea, vomiting, decreased apetite, itching, oliguria
long term: bone demineralization, tendon avulsion, avascular necrosis, demyelination of sensory and motor nerves of PNS, anemia
long term: bone demineralization, tendon avulsion, avascular necrosis, demyelination of sensory and motor nerves of PNS, anemia
44
diagnosis and treatment of renal failure
lab tests
diet, meds, dialysis (renal replacement therapy), transplant
diet, meds, dialysis (renal replacement therapy), transplant
45
Types of renal replacement therapy
Hemodialysis fast and furious
Hemodialysis slow and steady
Peritoneal Dialysis slow and independent
Hemodialysis slow and steady
Peritoneal Dialysis slow and independent
46
Hemodialysis fast and furious
3x per week for 3-4 hours
need A-V fistula
home units available
need A-V fistula
home units available
47
hemodialysis slow and steady
24 hours
48
Peritoneal Dialysis slow and independent
home dialysis
sterile dialysing fluid instilled into peritoneal cavity and left for hours then drained
done multiple times a day
requires peritoneal catheter
night time units available
sterile dialysing fluid instilled into peritoneal cavity and left for hours then drained
done multiple times a day
requires peritoneal catheter
night time units available
49
Transplants effectiveness
successful with a long life
50
secondary diseases from renal dysfunction
hypertension
altered temperature regulation
cardiac arrhythmias
altered glucose metabolism
decreased erythropoeisis
pulmonary edema
altered temperature regulation
cardiac arrhythmias
altered glucose metabolism
decreased erythropoeisis
pulmonary edema
51
what to watch for for renal failure
BP + HR changes following dialysis
fatigue following dialysis, increase in metabolites before dialysis
may be fluid restricted
depression is common in people on dialysis
infections at dialysis catheter site
myopathies, neuropathies which lead to muscle wasting, balance impairments and increase risk of falls
complications from secondary disorders
fatigue following dialysis, increase in metabolites before dialysis
may be fluid restricted
depression is common in people on dialysis
infections at dialysis catheter site
myopathies, neuropathies which lead to muscle wasting, balance impairments and increase risk of falls
complications from secondary disorders
52
can you exercise with dialysis?
same guidelines as general population
no differences with adverse events, and decreases days spent in the hospital
inrease in 6MT and TUG scores
no differences with adverse events, and decreases days spent in the hospital
inrease in 6MT and TUG scores
53
guidelines for exercise with dialysis
10-15 min bouts, 3x per week, mod-vig intensity, during 1st 2 hours of HD