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Test 4
BUN (Blood Urea Nitrogen) Lab Values
10-20 mg/dL
40 secs
Loop of Henle
Characteristics
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
2 mins
Proximal Tubule
Characteristics
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
2 mins
Renal Corpuscle
Characteristics
Arterioles
Glomerulus
Capillaries
Fenestrations
Plasma Solutes and Other Small Molecules Become Ultrafiltrate
Bowman's Capsule Encapsulates Glomerulus
2 mins
High Blood Pressure Response
Characteristics
Atria Release Atrial Natriuretic Peptide
Vasodilation
Antagonizes Aldosterone
Na+ and Water Excreted
1 min
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
1 min
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
2 mins
Acute Glomerulonephritis Interventions
Rest
Restrict Salt and Fluid Intake
Restrict Protein
Antihypertensives
Diuretics
Antibiotics
2 mins
Chronic Glomerulonephritis Interventions
Corticosteroids
Antihypertensives
Erythropoietin
Cytotoxic Agents
Dialysis
Plasmapheresis
Transplant
2 mins
Chronic Kidney Disease Early Symptoms Assessment
Characteristics
GFR < 60mL/min
Accumulation of Waste Products
Clinical Features
General Malaise
Hypertension
Proteinuria
Hyperkalemia
Mineral and Bone Disorders
Neuropathy
2 mins
Chronic Kidney Disease Interventions
Interventions
Daily Weights
Strict I/O
Renal Diet
Strict Medication Regimen
Erythropoietin
Manage Hyperkalemia
Manage CKD-MBD
Dialysis
Kidney Transplant
2 mins
Chronic Kidney Disease Late Symptoms Assessment
Metabolic Acidosis
Severe Uremia
Arrhythmias
Edema
CNS Depression
Anemia
Oliguria
Pruritus
Considerations
End Stage Renal Disease (ESRD)
GFR < 15mL/min
2 mins
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
3 mins
Glomerulonephritis Assessment
Mechanism
Group A Beta-Hemolytic Streptococcal Infection
Signs and Symptoms
Hypertension
Hematuria
Proteinuria
Oliguria
Generalized Edema
Increased BUN and CR
Flank Pain
2 mins
Nephrotic Syndrome
Occurs 2-3 weeks after a Strep infection
Hypoalbuminemia
Generalized Edema
I and Os with Daily Weights
Reduce Sodium and Fluids during periods of massive edema
Massive Proteinuria
Monitor serum protein levels
Monitor urine specific gravity
2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
1 min
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
2 mins
Erythropoietin
Mechanism
Stimulates RBC Production
Indications
Chronic Renal Failure
Anemia
Side Effects
Increased Risk of Thrombosis
Pelvic and Limb Pain
Hypertension
Considerations
Do Not Shake
Monitor Hemoglobin (Hgb) Weekly
May Accelerate Tumor Progression
2 mins
Nephritic Syndrome
Inflammatory
Hematuria
RBC casts
Increased Nitrogen in blood
Oliguria
Hypertension
Proteinuria < 3.5 grams per day
2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
2 mins
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