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227 Cards in this Set
- Front
- Back
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How many older Americans have dementia? |
15% |
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How many dementia patients have Alzheimers? |
60 to 80% have alzheimers |
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6 progressive neurodegenerative diseases that fall under dementia umbrella: |
Alzheimer's disease Dementia with Lewy bodies Front temporal degeneration Down syndrome Amyotrophic lateral sclerosis Parkinson disease Huntington's disease |
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9 Causes of dementia: |
1. Vascular disease 2. Toxic/metabolic/ nutritional disease 3. Neurodegenerative disorders 4. Immunologic (ie AIDS) 5. Systemic disease 6. Trauma 7. Tumors 8. Ventricular disorder 9. Drugs |
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3 Systemic diseases that can cause dementia: |
1. uremic/hepatic encephalopathy 2. dialysis dementia 3. wilsons |
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What is hydrocephalus? |
Increased inter cranial pressures from anatomy of the brain? |
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9 Drugs that can cause dementia: |
1. Anticholinergics 2. Phenytoins 3. Opioids 4. Hypnotic 5. Tranquilizers 6. Antiparkinsonian drugs 7. Cardiac: Digoxin methylaopa 8. Cocaine 9. Heroin |
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60-80% of dementias |
alzheimers disease |
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20% of dementias |
vascular dementia |
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10% of dementias |
dementia w/ lewy bodies |
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What to rule out in abrupt dementia? |
-Infection -Fluid/electrolyte imbalance |
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What 3 labs do you need to run for dementia diagnosis? |
1. Complete blood count (w/ WBC) 2. Hemoglobin & Hemocrit 3. Vitamin B12 4. Neurosyphilis 5. Liver function tests 6. Sodium levels 7. BUN & Creatin (renal disfunction) |
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3 groups with higher alzheimer's rates: |
-African American -Hispanic -Women |
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Type of dementia men are more likely to have? |
-Vascular dementia (strokes) |
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4 Brain abnormalities in Alzheimers: |
1. Neurofibrillary tangles 2. Amyloid plaque 3. loss of neuron connection 4. Neuron death (usually the tail dies) |
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Clinical manifestations of Alzheimers |
Memory loss Difficulty performing familiar task Problems with language Dis-orientation Poor judgment Problem with abstract thinking Misplacing things Changes in mood or behavior Changes in personality Loss of initiative |
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Subjective data to check for Alzheimer's Nursing Assessment: |
Subjective Data: Past medical history Repeated head trauma StrokeExposures to heavy metals CNS infections Family HX of dementia Functional health patterns |
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Objective data you might gather for alzheimer's patients. |
Objective Data: General: Disheveled appearance, agitation Neuro: Loss of recent memory, Disorientation, flat affect, impaired abstract cognition and judgment. |
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Medication given for memory/cognition in alzheimers: |
1. Doneprezil (Aricept) |
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Medication given for Depression in alzheimers: |
SSRIs sertraline(Zoloft) citalopram(Celexa) fluoxetine(Prozac) mirtazapine(Remeron) trazodone(Desyrel) |
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Medication given for Behavioral in alzheimers: |
Antipsychotics haloperidol(Haldol) risperidone(Risperdal) olanzapine(Zyprexa) quetiapine(Seroquel) |
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Medication given for sleep in Alzheimers |
Zolpidem(Ambient) quetiapine(Seroquel) trazodone(Desyrel) |
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Define delirium |
State of temporary but acute mental confusion |
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Who is at risk for delirium? |
-anyone with cognitive disfunction -age over 70 -Psycho active anticholinergic med -Hx stroke/epilepsy -Hx depression -Illicit drug use -Hypernatremia, Hyperglycemia, Hyperthermia -BUN/Creatinine ratio greater than 18 -Renal failure -Liver disease -CHF -Shock (septic/cardiogenic) -HIV -Tube feedings -Rectal/bladder catheters -Central venous cath -Malnutrition -ETOH -Sensory impairment |
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Etiology of Delirium: |
DDELIRIUM D: dementia D: drugs (ploy-charm) E: electrolyte imbalance L: lack of drugs I: Infection R: reduced sensory input I: Intercranial pressure U: urinary/fecal retention M: myocardial/pulmonary (hypoxia) |
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Diagnostic study for Delirium |
Serum electrolytes Blood urea nitrogen level Creatinine level Complete blood count (CBC) Drug and alcohol levels Electrocardiogram (ECG) Urine analysis Liver and thyroid function tests Oxygen saturation level Lumbar puncture |
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What does erythropoietin do? |
1. production of RBC 2. releases hormones that influence stem cell that make WBC & platelets |
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What will a nurse do with an anemic patient |
-monitor safety -address fatigue |
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what are you concerned for with a patient with low platelets? |
bleeds |
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what is the issue with renal failure based anemia |
not enough red blood cells |
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Kidney function: activate vitamin D & absorb calcium from GI tract- what is a nurse thinking with renal failure? (3) |
safetypreventative measures to prevent breaking bones & bone lossmonitor cardiac w/ telemetry |
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7 issues with aging renal system |
Decreased kidney size. Decreased renal blood flow. Decreased nephron function. Decreased GFR. Decreased estrogen in females. Decrease muscle support. Increase prostate size. (with men) |
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4 functions of renal system |
1. regulate volume and composition of extracellular fluid 2. regulate blood pressure 3. make erythropoietin 4. activate vitamin D and promote Ca absorption |
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Normal creatinine clearance |
80 to 135 ml/min |
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What is KUB? |
abdominal X ray can show size of kidneys, bladder,m malignancies |
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Dye Studies |
best indication of vasculature of kidneys (NOTE- dye can actually worsen renal function) |
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Renal Biopsy |
can give us an idea about nephrons and how they are working |
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ESRD |
15ml/min |
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Normal urine color Abnormal urine color |
norm: amber yellow abnormal: dark, cloudy |
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Thoughts on clear urine? |
Kidney may be working overtime |
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Normal/abnormal urine smell |
Norm- aromatic Abnormal- unpleasant |
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Normal clarity of urine/ Abnormal clarity of urine |
Normal: clear Abnormal: cloudy |
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Normal / Abnormal Protein |
normal: 0 to trace abnormal: persistent |
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Normal / Abnormal pH |
Normal 4.0 to 8.0 Abnormal greater than 8.0 |
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Normal / Abnormal glucose |
norm: none abnormal: present |
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Normal / Abnormal ketones |
norm: none abnorm: present |
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Normal / Abnormal bilirubin |
norm: none abnorm: present |
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Normal / Abnormal Osmo |
norm: 300- 1300 abnorm: less than 300, more than 1300 |
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Normal / Abnormal RBC |
norm: 0-4 abnorm: more than 4 |
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Normal / Abnormal WBC |
norm: 0-5 abnorm: greater than 5 |
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oliguria |
diminished amounts of urine at a given time |
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anuria |
no urine (24 hour urine output is less than 100mls) -only normal for patient on hemodialysisSe |
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Second most common bacterial disease |
UTI |
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Most common bacterial infection in women |
UTI |
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Upper urinary tract infection |
pyelonephritis |
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Pyelonephritis |
inflammation of renal parenchyma and collecting system. sx= fever, chills, flank pain |
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Lower urinary tract infection |
cystitis- inflammation of bladder wall |
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Urosepsis |
systematic infection that oriented in urinary tract |
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Sx: flank pain, high white count, fever, fatigue, malaise, diaphoretic |
Pyelonephritis |
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classic symptoms of UTI |
-frequency -urgency -incontinence -nocturia -nocturnal enuresis |
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UTI sx in older adults |
confusion non localized abdominal discomfort |
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2 main steps of Diagnosing UTI |
-urinalysis -culture |
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Urosepsis |
systemic infection from urologic source, can lead to septic shock and death |
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4 frequent organisms seen in UTI |
-E coli -proteus -klebsiella -enterobacter |
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vasicoureteral reflex |
backward movement of urine from lower to upper urinary tract |
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3rd leading cause of renal failure |
glomerulonephrities |
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hematuria, urinary exertion of RBC, WBC, yeast, proteinuria, elevated BUN and Creat are clinical manifestations of what? |
Glomerulonephritis |
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First sign you will see in glomerulonephritis |
Hematouria |
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Kidney biopsy is the best way to diagnose |
Glomerulonephritis |
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Therapy for Glomerulonephritis includes |
rest sodium & fluid restriction diuretics- challenge kidney -antibiotics -antihypertensive therepy -restrict dietary protein |
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3 causes of acute renal failure |
1. Pre renal 2. Intra renal 3. Post renal |
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Acute Pre renal Failure |
-not enough blood filtering into urine (decreased CO= decreased renal output) -Heart failure, blood not moving, kidney not being professed -MI, heart tissue death, dysrhthmias, heart not pumping well, other organs suffer including kind-renal artery thrombosis- |
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3 phases of acute renal failure |
1. Oliguric phase: less than 400 ml/24 hrsdecrease in urine output, abnormal BUN and creatine 2. Diuretic Phase: 1-3 litres per day, abnormal labs 3. Recovery Phase: GFR increases, urine output |
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Tx for pre-renal acute renal failure |
tx dehydration and bleeding |
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Leading causes of ESRD |
-diabetes -hypertension -glomerularnephritis |
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Clinical manifestations of CKD |
hypertension heart failure left ventricular hypertrophy peripheral edema dysrhythmias uremic pericarditis |
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definitive diagnosis for CKD |
Renal biopsy |
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Dementia breakdown: 15% of older Americans have dementia. What percent of those have Alzheimer's? What percent have Lewy Bodies? What percent have Vascular dementia? |
60-80% Alzheimers 20% Vascular Dementia 10% Lewy Bodies |
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20% of dementia patients have |
Lewy Bodies |
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10% of dementia patients have |
vascular dementia |
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60 to 80% of dementia patients have |
Alzheimers |
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examples of Dementia causes (name a few, there are a lot) |
alzheimers lewy bodies front temporal degernareation down syndrome amyotrophic lateral sclerosis parkinson disease huntington's disease vascular disease toxic metabolic nutritional disease immunologic systemic disease trauma tumors drugs ventricular disorders |
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3 examples of vascular disease that cause dementia |
1. vascular (multiinfract) dementia 2. subarachnoid hemorrhage 3. chronic subdural hematoma VERY SPECIAL CHILDREN |
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6 examples of toxic, metabolic/nutritional disease that causes dementia |
1. alcoholism 2. thiamine (B1) deficiency 3. colbalmin (B12) deficiency 4. folate deficiency 5. hyperthyroidism 6. hypothyroidism A TIRED COP FED HIGH HYPOCRITES |
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8 examples of immunologic disease that causes dementia |
1. MS 2. chronic fatigue syndrome 3. infections 4 AIDS 5 Meningitis 6. Encephalitis 7. Neurosyphilis 8. Lupus MY CHILDREN IN AFRICA MADE ELEPHANTS NUSSLE LIONS |
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3 examples of systemic disease that cause dementia |
-uremic/hepatic encephalopathy -dialysis dementia -wilsons |
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9 drugs that can cause dementia |
-anticholinergics -phenytoins -opioids -hypnotic -tranquilizers -antiparkinsonian drugs -cardiac: digoxin methyldopa -cocaine -heroin |
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7 clinical manifestations of dementia |
-mistaken for depression -sadness -fatigue -apathy -despair -inactivity I'M SAD, F. |
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4 ways to diagnose dementia |
1. full medical neurologic and psychological history 2. labs 3. head CT 4. Head MRI |
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important labs for diagnosing dementia |
-vitamin B12 levels -neurosyphilis -hematocrit -hemoglobin -CBC -LFT -Sodium levels -BUN & Creatine |
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to find out if fluid is backing up into brain and building up ammonia AND CAUSING DEMENTIA, what kind of lab will you run? |
=LFT =BUN & Creatine |
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how many american's are effected by Alzheimers? |
5.2 million |
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how many years do people typically live after alzheimer diagnosis |
4 to 8 years |
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what ethnicities/ gender have highest rates of AD? |
-African Americna -Hispanics -Women |
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what gender is most likely to develop vascular dementia? |
men |
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causes of alzheimer's disease |
-unknown -genetic -environmental -brain abnormalities |
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name 4 possible environmental risk factors of AD |
-diabetes -HTN -Smoking -High cholesterol |
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example of mini mental exam |
"If I were to say "No If's, And's, or Buts" what would that mean to you? |
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10 early warning signs of alzheimer's |
1. memory loss 2. familiar task 3. language 4. disorientation to time and place 5. judgement 6. abstract thinking 7. misplacing things 8. mood or behavior 9. personality 10. initiative |
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mild symptoms of alzheimer's |
-forgetfulness -short term memory loss -initiative loss -small personality change -abstract thinking -slow loss of ability to plan or organize |
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a person who is struggling with solving simple math problems may be experiencing this level of alzheimer's symptoms (MILD, MODERATE, SEVERE) |
Mild |
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Forgetting a person's name, recent events, or things.- May be experiencing this level of alzheimer's symptoms (MILD, MODERATE, SEVERE) |
Mild |
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Moderate symptoms of alzheimer's disease |
-memory loss & confusion are obvious -increased trouble organizing, planning, following directions -needs help getting dressed -may start having incontinence -trouble recognizing close family members or friends -agitation, restlessness -lack judgement, begins to wander and get lost -trouble sleeping -delusions, hallucinations, paranoia -behavioral problems |
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This person with AD may need help getting dressed (MILD< MODERATE< SEVERE) |
Moderate or severe |
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This person with AD may become incontinent (MILD< MODERATE< SEVERE) |
Moderate or severe |
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This person with AD may have trouble recognizing family members or friends (MILD< MODERATE< SEVERE) |
Moderate |
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This person with AD may have delusions, hallucinations, and paranoia (MILD< MODERATE< SEVERE) |
Moderate |
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This person with AD may experience agitation and restlessness (MILD< MODERATE< SEVERE) |
Moderate |
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This person with AD may have trouble sleeping (MILD< MODERATE< SEVERE) |
Moderate |
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This person with AD may lack judgement, begin to wander, and get lost (MILD< MODERATE< SEVERE) |
Moderate |
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Severe symptoms of AD |
-severe impairment of all cognitive functions -little memory, unable to process new info -unable to perform self care -requires help with ADL -may lose ability to speak -may not be able to understand speech -may have trouble eating, swallowing -may not be able to walk or sit up without help -immobility -incontinence |
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This person with AD may not be able to walk or sit up without help (MILD< MODERATE< SEVERE) |
severe |
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This person with AD may have difficulty eating or swallowing (MILD< MODERATE< SEVERE) |
Severe |
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This person with AD may not be able to speak or understand words (MILD< MODERATE< SEVERE) |
severe |
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This person with AD may need help with daily needs and may be unable to perform self care activities (MILD< MODERATE< SEVERE) |
severe |
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what are you looking for in a head CT for alzheimer's |
cerebral cortex atrophy |
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what are you looking for in an MRI for alzheimer's |
hippocampal atrophy |
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what could a PET scan show you in diagnosing AD |
small vascular spaces |
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how to Alzheimer's meds (and SSRI's, Antipsychotics, and sleeping meds) effect bowels |
CONSTIPATION OR LOOSE STOOL |
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what is delirium? |
a state of temporary but acute mental confusion |
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is delirium dangerous |
yes, it can be life threatening |
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is delirium preventable |
yes, possibly |
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what population has the highest amount of delirium? |
highest in hospitalized older adults |
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5 terms for delirium |
-vague, off -icu psychosis -a little crazy today -organic brain syndrome -actue change in mental status -toxic psychosis |
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what is the likelihood of developing delirium for NON ICU patients with 3 or more risk factors? |
60% |
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a patient who is over 70, has hypernatremia, and a BUN/Creatinine ratio greater than 18 is at risk for what? |
delirium |
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A patient with a central venous catheter, a bladder catheter, and CHF is at risk for what? |
Delirium |
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A patient who is over 65, is female, and smokes may be at increased risk for |
AD |
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CD2 DELIRIUM |
Chronic stress Dementia, dehydration Drugs (poly pharm) Electrolyte imbalance Lack of drugs (pain, withdrawal) Infection, injury, Immobility Reduced Sensory Input Intracranial pressure Urinary retention/fecal impaction Myocardial/pulmonary hypoxia) |
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precipitating factors of delirium |
-age (65 or older) -gender- male -cognitive status -environmental -prolonged sleep deprivation -functional status -sensory -decreased oral intake -coexisting medical conditions -severe acute/terminal illness -chronic renal/liver disease -hx of stroke -neurologic disease -infection/sepsis -fracture/trauma |
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4 environmental factors that precipitate delirium |
-admission to ICU -use of physical restraints -pain (esp untreated) -emotional stress |
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how long does delirium develop? |
over 2 to 3 day period |
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what are early manifestations of delirium? |
-inabilty to concentrate -irritability -insomnia -loss of appetite -restless -confusion IC-IC-IRL- |
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what are later manifestations of delirium? |
-Hallucinations -Agitation -Misperception -Misinterpretation (HAMM) |
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how long will delirium last? |
1 to 7 days |
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what is the most frequent consequence after unscheduled surgery on older adults? |
delirium |
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3 sudden and key distinctions between dementia and delirium- delirium exhibits- |
-sudden cognitive impairment -sudden disorientation -sudden clouded sensorium |
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what meds will you check for when a patient is presenting with delirium |
anticholinergics, pain meds |
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what laboratory tests might help you explore the cause of delirium |
-serum electrolytes -BUN -creatinine -CBC -Drug & alcohol level -ECG -Urinalysis -Liver & thyroid function tests -Oxygen sat -Lumbar puncture |
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5 meds given to patients with SEVERE delirium (increases risk for falls and injury, use w/ caution) |
start low go slow -haloperiodol -risperidone -olanzapine -quetiapine -short acting benzodiazepines (i.e. lorazepam) |
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note about lorazepam (ativan) in treating delirium |
-usually we stay away from this, it amens agitation worse w/ dementia |
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normal function at PCT |
REABSORB: -electrolytes -water -glucose -amino acids -HC03 SECRETE: H+ Creatinine |
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normal function of glomerulus |
filtration |
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normal function at ascending loop of henle |
REABSORBTION: -Na -H+ |
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normal function at descending loop of Henle |
REABSORBTION -water +Concentration of filtrate |
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normal function at distal tubule |
SECRETION: -K -H+ -Ammonia REABSORBTION: -water (w/ ADH) REGULATION: -Ca -PO4 (w/ PTH) -Na -K (w/ aldosterone) |
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what allows for reabsorption of water from distal tubules |
ADH |
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what allows for regulation of PO4 at distal tubule? |
PTH |
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what allows for regulation of K at distal tubule |
Aldosterone |
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ADH works on what portions of the renal tubules? |
-Collecting duct -Distal tubule |
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what 3 things must you monitor when a person is having kidney problems? |
-electrolytes (potassium, sodium, chloride, waste products BUN and creatinine -Fluid status (daily weights, I& ), lungs) -BP |
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when is renin released? |
in response to: - low flow/ decreased cardiac output -decreased serum sodium/ increased urinary sodium |
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what is Epogen |
synthetic hormone (Erythropoetin) |
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what happens to RBC in renal failure? |
anemia, decrease in RBC, WBC, PLT |
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4 renal functions |
1. fluid & electrolyte balance 2. Erythropoetin 3. Activate vitamin D & absorb calcium from GI tract 4. regulate blood pressure w/ renin angiotensin system |
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calcium plays a key role in what |
muscle contraction, especially cardiac muscle |
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geriatric patients will see what changes to their renal function |
-decreased kidney size -decreased renal blood flow -decreased nephron function -decreased GFR -decreased estrogen females -decreased muscle support -increased prostate size |
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how to diagnose renal issues (9) |
-urinalysis -urine culture -creatinine clearance -GFR -Blood tests (5) -KUB (abdominal X ray) -Ultrasound -CT scan -Dye contrast study -Biopsy -Nuclear studies |
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what are the 5 general blood tests that can be done to diagnose renal disease |
-BUN -Creatinine -Electrolytes: potassium, sodium, chloride -CBC -Calcium, phosphorus BE-CCC |
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What electrolytes are we monitoring when we are worried about kidney function |
potassium sodium chloride calcium phosphorus |
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what is a normal creatinine clearance |
80 to 135 mL/min |
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what is the creatinine clearance with ESRD |
15 mL/min |
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what is creatinine clearance |
the volume of blood cleared of creatinine per unit of time. Usually a 24 urine collection/ kept on ice. |
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what are the benefits of dye studies in diagnosing renal issues |
-best indication of vasculature of kidneys (BUT DYE CAN ACTUALLY WORSEN FUNCTION) |
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what are the benefits of KUB in diagnosing renal issues |
KUB- abdominal Xray can show size of kidneys, bladder, malignancies |
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what can we observe from an ultrasound of the kidneys |
vasculature of kidneys |
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Urinalysis: normal & abnormal- Color |
normal: amber abnormal: dark/cloudy |
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Urinalysis: normal & abnormal- odor |
normal: aromatic abnormal: unpleasant |
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Urinalysis: normal & abnormal- protein |
normal: 0-trace abnormal: persistant |
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Urinalysis: normal & abnormal- glucose |
normal: 0 abnormal: present |
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Urinalysis: normal & abnormal- ketones |
normal: 0 abnormal: present |
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Urinalysis: normal & abnormal- bilirubin |
normal: 0 abnormal: present |
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Urinalysis: normal & abnormal- specific gravity |
normal: 1.003-1.030 abnormal: low or high |
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Urinalysis: normal & abnormal- osmo |
normal: 300-1300 abnormal: <300/>1300 |
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Urinalysis: normal & abnormal- pH |
normal: 4.0-8.0 abnormal: >8.0 |
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RBC |
normal: 0-4 abnormal: >4 |
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WBC |
normal: 0-5 abnormal: >5 |
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Bacteria |
normal: none abnormal: present |
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Keytones in urine may indicate |
-DM -starvation -dehydration -vomiting -severe diarrhea |
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Bilirubin in urine may indicate |
liver disorder |
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abnormal osmolarity variance in urine (<300/ >1300) may indicate |
tubular dysfunction -kidney has lost ability to concentrate urine -over diluted urine |
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abnormal levels of RBC in urine (>4) indicate |
-trauma -UTI -cancer -glomerulonephritism -TB |
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glucose in urine may indicate |
DM Pituitary disorder |
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persistant protein in urine may indicate |
actor or chronic renal disease (involving glomeruli)- check medications |
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Low/high specific gravity in urine may indicate |
low: too dilute high: dehydration |
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define oliguria |
diminished amounts of urine at a given time |
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define anuria |
no urine (24 hour output less than 100mL) |
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when is a 24 hour output of urine less than 100mL normal? |
when a patient is on hemodialysis |
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second most common bacterial disease |
UTI |
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most common bacterial infection in women |
UTI |
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most common pathogen |
escheria coli |
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counts of bacteria 10tothe5th CFU's/mL |
significant UTI |
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Counts as low as 10 to the 2 CFU/mL in a person w/ UTI symptoms |
UTI |
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what parts of the body are affected in Upper UTI |
Renal parenchyma pelvis ureters |
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example of upper UTI |
pyelonephritis: inflammation of renal parenchyma and collecting system |
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example of lower UTI |
cystitis- inflammation of bladder walle |
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what is urosepsis |
systemic infection that originated in urinary tract |
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4 classifications of UTI |
-initial infection -recurrent infection -resistant organism -chronic infection |
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define nocturia |
waking up more than 2x per night to void |
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define urinary frequency |
abnormally frequent more than every 2 hours |
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nocturnal enuresis |
complaint of loss of urine during sleep |
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s/sx of UTI in older adults |
-often absent -non localized abdominal discomfort rather than dysuria -cognitive impairment -less likely to have a fever |
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are older adults more or less likely to have a fever with UTI |
less likely |
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4 groups at risk for UTI |
-debilitated persons -older adults -underlying disease (HIV, diabetes) -taking immunosuppressive drug or corticosteroids |
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how much fluid per pound should someone drink? |
15 mL/lb |
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3 meds for complicated UTI |
-levofloxacin -ciprofloxacin -fluoroquinolones |
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what is acute pyelonephritis |
inflammation of renal parenchyma & collecting system, most commonly cause by bacteria (but can also be caused by fungi, virus, protozoa) |
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4 suspects for acute pyelonephritis infection |
-escheria coli -proteus -Klebsiella -Enterobacter (KEEP) |
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A preexisting factor is usually present when a acute pyelonephritis occurs. 2 factors are: |
-vesicoureteral reflux (backward movement of urine) -dysfunction of lower urinary tract (obstruction from BPH, stricture, urinary stone) |
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recurrent acute pyelonephritis infections lead to |
scarred kidney, chronic pyelonephritis |
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4 symptoms of acute pyelonephritis (sx last a few days and subside, bacteriuria & pyuria still persist) |
-mild fatigue -chills -fever -vomiting -malaise -flank pain -lower UTI sx -costovertebral tenderness on affected side |
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4 laboratory tests for acute pyelonephritis |
-urinalysis -urine culture & sensitivity -CBC w/ differential -blood culture (if bacteremia is suspected) |
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you assess a patient with fever, hematuria, foul smelling urine, tender enlarged kidney, leukocytosis, positive for bacteria in urine, WBC, RBC, pyuria, ultrasound, CT scan, IVP- what do you think they have? |
acute pyelonephritis |
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what is pyuria |
puss in urine |
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What is glomerulonephritis |
immunologic process involving the urinary tract (predominantly renal glomerulus) classified by extent of damage, initial cause of disorder, and extent of change |
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what is the third leading cause of renal failure |
glomerulonephritis |
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how do you classify glomerulonephritis |
-extent of damage (acute/chronic) -Initial cause of disorder (autoimmune, infection, other disease process) -extent of changes |
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what are the 3 leading causes of renal failure |
1. Diabetes 2. HTN 3. Glomerulonephritis |
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What is the first sign you MIGHT see in glomerulonephritis? |
hematuria, if you see anything at all. |
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4 clinical manifestations of glomerulonephritis |
-hematuria -urinary excretion of RBC, WBC, cast -proteinuria -elevated BUN and Creatinine |
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4 diagnostic tests for glomerulonephritis |
-urinalysis -CBC w/ WBC differential -BUN, Creat, Albuming -Renal biopsy |
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3 types of acute renal failure |
-pre renal- related to CO or vasculature -intra-renal- drugs, x-ray dye, lupus, toxemia of pregnancy, ATN acute tubular necrosis -post renal- bladder/prostate cancer, spinal cord disease, neuromuscular disorder |
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3 phases of acute renal failure |
-oliguric phase: <400 mL/ 24hr, increase in BUN and creatine -diuretic phase: 1-3 L/day & abnormal labs -recovery phase: GFR increases, BUN/Cr decreases |
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Oliguric phase of acute renal failure |
<400 mL/24 hr, elevated BUN and Creatine |
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Diuretic Phase of acute renal failure |
1-3 L urine/day & abnormal labs |
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Recovery phase of acute renal failure |
GFR increases, BUN/CR decrease- labs going back to normal |
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How to tx pre renal acute renal failure |
tx dehydration, bleeding |
