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11 Cards in this Set
- Front
- Back
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Kidney function |
avg daily urine output = 1500mL oliguira = <400mL *As renal function DEC --> Cr INC & CrCl DEC |
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Acute renal failure |
abrupt onset oliguria, edema, wt gain - rapid dec renal fxn, elevated creatinine* *normal creatinine = 0.6-1.3 *Chronic renal failure will need erythropoietin replacement therapy if hgb level <10 |
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eGFR |
normal = <90% Renal failure = <15% (stage 5 CKD) ESRD = <10% |
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BUN |
if abnormal then check GFR --> if GFR is normal renal function is probably normal* |
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Dipstick |
Acidity (pH) --> 4.6-8; high = risk for kidney stones, UTI, kidneyproblem Protein --> kidney disease (protein should not be in your urine,it is being leaked from kidney problems) Glucose --> DM WBC --> infection Bilirubin --> liver disease Blood --> infection, kidney problem, meds, heavy exercise Specific gravity --> 1.010-1.020 (high = dehydrated) |
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Microscopic exam |
RBC: kidney dz, kidney stones, infection,bladder CA, glomerulonephritis WBC: infection Casts: tube-shaped forms of protein, result ofkidney disorder -- hyaline casts = NORMAL: dehydration, exercise, diuretics -- red cell casts, white cell casts & renal tubular cell casts = renal dz -- WBC casts = infection (UTI, pyelonephritis) Crystals: large enough = kidney stones |
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UTI |
aka cystitis - majority caused by e.coli - <3yo, pregnant --> usually progress to pyelonephritis Infancy: UTIs common boys d/t anatomic abnls Females: highest during reproductive years Uncomplicated UTI: bactrim x 3 days Complicated UTI: males, DM, preg, children, elderly, immuno, recurrent, anatomic abnl --> bactrim 7-10 days |
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Acute pyelonephritis |
acute onset fever, chills, dysuria, freq, unilateral flank pain PE: CVA tenderness, temp >100.4F, leuks, hematuria, WBC casts, proteinuria (albuminuria) Tx: ceftriaxone IM during visit; cipro x 14 days Follow-up: 12-24hrs |
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Kidney stones (nephrolithiasis) |
majority made up of calcium oxalate* Risks: fam hx, low fluid intake, gout, bariatric surgery S/s: severe colicky flank pain, hematuria Labs: strain urine, renal u/s Tx: inc fluid (up to 2L/day), avoid high oxalate foods (spinach, beets, chocolate, tea, meat) Refer urology: large stone, inability to pass, acute renal failure ED: high fever (urosepsis), extreme pain, acute renal failure *method to identify small renal stones = CT scan *man w/ painful urination --> do NOT prescribe a diuretic (can prescribe an alpha blocker, inc fluids & analgesic) |
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Urinary incontinence |
Urge - most common form - strong sensation needing to void - tx: behavioral therapy Transient: - occurs during acute illness Stress: - a/w lifting, coughing, sneezing, exercise - tx: kegel exercise, pessary use Functional: - mobility problems Treatable causes: Delirium Infection (urinary) Atrophic urethritis & vaginitis Pharmaceuticals Psych (depression) Excessive urine output (HF, DM) Restricted mobility Stool impaction |
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Bladder cancer |
- men work around chemicals - bloody urine without pain - smoking hx |
