Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Registered Nurse (RN) School Study Aid
Renal Corpuscle
- Arterioles
- Glomerulus
- Capillaries
- Fenestrations
- Plasma Solutes and Other Small Molecules Become Ultrafiltrate
- Bowman's Capsule Encapsulates Glomerulus
Proximal Tubule
- Na+ Reabsorbed Via Active Transport
- Water Follows Na+
- Most Of Glucose Reabsorbed
- Most Of Amino Acids Reabsorbed
- Bicarbonate Exchanged For H+
- Drugs and Toxins Excreted
- Filtrate Osmolarity Same As Plasma
- Leads To Loop Of Henle
Loop of Henle
- Descending Limb
- Water Follows Na+
- Medullary Hypertonicity
- Increased Water Reabsorption
- Vasa Recta
- Na+ Reabsorbed Via Active Transport
- Ascending Limb
- Reabsorbs Na+, K+, Cl-
- Decreased Concentration of Filtrate
- Impermeable to Water
- Distal Tubule
Distal Tubule
- Hormonally Regulated
- Aldosterone Causes Na+ Reabsorption
- Na+ Reabsorbed Via Active Transport
- Water follows Na+
- Early Distal Tubule is Impermeable to Water
- Parathyroid Hormone Causes Ca2+ Reabsorption
- Leads to Collecting Duct
Collecting Duct
- Na+ Reabsorption
- Vasopressin Causes Water reabsorption
- Concentrates Filtrate
WBC Differential Lab Value
- White Blood Cells (WBC)
- 5-10 (5,000-10,000)
- Neutrophils (50%-70%)
- Bands (2%-5%)
- Segs (50%-70%)
- Lymphocytes (20%-40%)
- Monocytes (4%-8%)
- Eosinophils (2%-4%)
- Basophils (0.5%-1.5%)
Red Blood Cell Count (RBC) Lab Values
- Women: 3.5-5.5 million cells/ MuL
- Men: 4.3-5.9 million cells/ MuL
pH - Blood and Urine Lab Value
- Blood
- 7.35 - 7.45
- Urine
- 4.0 - 8.0
Urine Specific Gravity Lab Value
Creatinine Lab Values
- Measures Renal Function
- 0.6 - 1.3 mg/dL
BUN (Blood Urea Nitrogen) Lab Values
Urinary Tract Infection Symptoms
- More Common in Elderly
- Most Common in Females and Babies
- Change in LOC
- Dehydration
- Fever
- Urgency
- Urethral Infection
- Burning
- Smelly Urine
- Dark Cloudy Urine
- Frequency of Urination
Urinary Tract Infection Prevention and Treatment
- Shower after Sex
- Urinate after Sex
- Wipe front to Back
- I and Os with Daily Weights
- Increase Water Intake
- Antibiotics
- Avoid Caffeine
- Dr Appointment in 2 Weeks
- Void every 2 - 4 hours
Pyelonephritis Assessment
- Ascending Urethral Bacteria
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Urosepsis
Glomerulonephritis Assessment
- Group A Beta-Hemolytic Streptococcal Infection
- Hypertension
- Hematuria
- Proteinuria
- Oliguria
- Generalized Edema
- Increased BUN and CR
- Flank Pain
Acute Glomerulonephritis Interventions
- Rest
- Restrict Salt and Fluid Intake
- Restrict Protein
- Antihypertensives
- Diuretics
- Antibiotics
Chronic Glomerulonephritis Interventions
- Corticosteroids
- Antihypertensives
- Erythropoietin
- Cytotoxic Agents
- Dialysis
- Plasmapheresis
- Transplant
Cyclosporine (Sandimmune) Overview
- Immunosuppressant
- Inhibits Calcineurin, Decreasing IL-2
- Prevent Transplant Rejection
- Psoriasis
- Rheumatoid Arthritis
- Monitor Plasma Levels
- Avoid Grapefruit Juice
- Increased Risk of Lymphoma
Cyclosporine (Sandimmune) Side Effects
- Nephrotoxicity
- Hepatotoxicity
- Infection
- Hypertension
- Hirsutism
- Tremor
- Hyperkalemia
- Hypomagnesemia
- Gingival Hyperplasia
Loop Diuretics
- Thick Ascending Limb of Loop of Henle
- Inhibits Na+-K+-2Cl-
- Sulfa Drug
- Furosemide
- Lasix
- Ototoxicity from Rapid Injection
- Gout
- Dehydration
- Hypocalcemia
- Hypokalemia
- Orthostatic Hypotension
Diabetes Insipidus Assessment
- Polyuria
- Nocturia
- Low Specific Gravity (USG)
- Polydipsia
- Dehydration
- Hypotension
- Tachycardia
- Confusion
Hyperkalemia
- > 5.0 mEq/L K+
- Abdominal Cramps
- Muscle Weakness
- Diarrhea
- Arrhythmia
- Tall, Peaked T Waves
- IV Calcium
- Infusion of Glucose and Insulin
- Loop or Thiazide Diuretics
- Kayexalate
- Dialysis
- Prevention Education
Therapeutic Diets
- High Fiber
- Low Residue (Fiber)
- Low Sodium
- Low Cholesterol
- Diabetic
- Renal
- Dysphagia
- Diet Education
Dialysis
- Hemodialysis
- Rapid Shifts of Fluid and Electrolytes
- Disequilibrium Syndrome
- Hypotension
- NO BP IN ARM with Shunt or Fistula
- Assess for Thrill and Bruit
- Peritoneal Dialysis
- Slow Process
- Peritonitis
- Loss of Protein
- Hyperglycemia
Kidney Transplant
- End Stage Renal Disease (ESRD)
- Selective Candidacy
- Close Compatibility
- Immunosuppressants
- Monitor for Rejection
- Monitor for Infection
- Monitor Urine Output
Prednisone (Glucocorticoids)
- Glucocorticoid
- Inflammatory Conditions
- Organ Transplant Rejection
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Adrenal Insufficiency
- Taper Gradually
Hydrocele
- Impaired Lymphatic Drainage
- Large Scrotum
- Painless
- Needle Aspiration or Surgery
- Scrotal Support
- Monitor for Bleeding and Infection