What is "Acute Renal Failure" aka ARF?
Rapid breakdown of the renal system. This is a REVERSIBLE condition.
What are the 3 types of ARF?
Prerenal-Disrupted blood flow to the kidney.
Intrarenal-Renal tissue damage.
Postrenal-Disruption in the urine flow.
What is the cause of Prerenal?
Decline in kidney perfusion. i.e. Hemorrhage, Dehydration, Burns, Allergic Reaction.
What is the cause of Intrarenal?
Tissue damage of the glomeruli and or tubes (i.e. R/T NSAIDS)
What is the cause of Postrenal?
Obstruction
What is the focus of tx for ARF
Focus is on restoring electrolytes and function
What are the three phases of Intrarenal?
Oliguric/Nonoliguric Phase-Low urine output <400mL in 24 hrs. Usually lasts 1-2wks
Diuretic Phase- Increased urine output >6L qday. Usually lasts days to wks.
Recovery Phase-Urine output returns to normal
What is "Chronic Renal Failure" (CRF)?
A condition in which the kidneys ability to function deteriorates. This condition is a multi-system disease and is NON-REVERSIBLE.
What are the 3 stages of Chronic Renal Failure (CRF)?
Reduced Renal Reserve, Renal Insufficiency and End Stage Renal Disease (ESRD)
What signals ESRD?
Severe fluid and electrolyte imbalance.
What is the suggested fluid intake schedule for CRF?
500mL Day, 200 mL Evening, 100mL Night
What are the main causes of CRF (In Order of Prevalence)
DM, HTN, Glomerulonephritis, Cyctic Kidney
What is the main goal for tx of CRF?
Preserve remaining kidney function and prevent complications
What is Urolithiasis?
stones, calculus, calculi (plural). AKA Kidney Stones
What are predisposing factors for Urolithiasis?
People who are immobile, have hyperparathyroid or recurrent UTI's
Types of tx for Urolithiasis?
Medical-Extracorporeal Shock Wave Lithotripsy (ESWL)
Surgial-nephrolithotomy, pyelolithotomy or nephroscopic
Pharmacological-Antispasmodics such as Propantheline (Pro-Banthine) or Allopurinol (Zyloprim)
Diet to tx Urolithiasis
Low purine (meat, fish, poultry, organ meat)
What is "Hemodialysis"?
Machine with artificial membrane used to filter blood.
What is "Peritoneal Dialysis"?
Uses peritioneal lining of abdominal cavity as a membrane through which diffusion and osmosis occurs.
N/I for Hemodialysis?
Wt. pt before and after.
Feel the Thrill, Listen for the bruit (check for patency).
Check peripheral pulse
Don't give BP, IV or Lab Draws on same arm
Give medication after dialysis
N/I for Peritoneal Dialysis?
Have pt. void before start
Mx asepsis
Give at body temp
Don't infuse to quickly
Fluid removed should not be cloudy
S/S of organ rejection
Scanty Urine, No Urine, Bloody Urine
Sudden Weight Gain, Edema
Fever
Tenderness over kidney
What is Polycystic Kidney?
Grape like fluid-filled cysts develop and enlarge both kidneys
What are some S/S of Polycystic Kidney?
HTN, Polyuria, UTI, Flank Pain, HA
What is the main goal in tx Polycystic Kidney?
Preserve kidney function, prevent infection and relieve pain.
What Meds are used to tx Polycystic Kidney??
Anti-HTN, Diuretics and Fluid/Diet Modifications
What is Cystitas?
Inflammation of the urinary bladder
What is the cause of Cystitas?
Weak pelvic floor muscles leading to a decreased ability to empty the bladder resulting in bacterial growth.