NR 283 Patho Exam 3 Study guide(Latest):
Pathophysiology: Chamberlain
Patho exam 3
•Renal failure results when the kidneys cannot remove the body’s metabolic wastes
(urea) or perform their regulatory functions. The wastes accumulate in the body
fluids, leading to a disruption in endocrine and metabolic functions as well as fluid,
electrolyte, and acid–base disturbances. Renal failure is a systemic disease and is a
final common pathway of many different kidney and urinary tract disease.
* Unhealthy or injured kidney.
1. Causes the electrolytes to become imbalanced, affecting particular sodium,
calcium and potassium.
2. It will affect acid base balance by retaining too much bicarbonate or hydrogen
ions.
,* Injury to the glomerulus -Protein will be found in the urine when there's injury to
glomerulus. Diabetics should have microalbuminuria lab test done annually to
monitor for kidney disease. May lead to anemia. With impaired renal function,
there may be changes in BP, fluid balance causing edema and decreased urine
output.
*Calcium oxalate or calcium phosphate stones account for 70% to 80% of stones.
*Struvite stones account for about 15% and are composed of magnesium,
ammonium, and phosphate.
*Uric acid stones account for about 7% of stones.
*Spinal cord injury contributes to uncontrolled or premature contractions of the
detrusor muscle associated with a neurological disorder. This can also be from
Guillain-Barré or transverse myelitis.
*Pyelonephritis indicates inflammation that involves of the upper tracts
*Glomerulonephritis is an inflammation of the glomeruli and is often caused by a
streptococcal infection. It usually occurs 7 to 10 days after the infection.
*Nephrotic syndrome is characterized by excretion of 3.5 grams or more of protein
in the urine per day due to glomerular injury.
*Nephritic syndrome is characterized by blood in the urine with red and white cell
casts and varying degrees of protein.
*Acute renal failure presents with oliguria and a reduction in GFR and BUN.
Rapidly progressive glomerulonephritis usually affects adults in their 50s and 60s
and presents with hematuria.
,*factors that determine severity for obstructive uropathy are locations of blockage,
the degree of completeness, duration, involvement of one or both upper urinary
tracts, and cause of the lesion.
*factors that is required before a stone is formed are:
1. Supersaturation of one of the salts
2. Precipitation from a liquid to a solid
3. Aggregation
4. Presence or absence of Tamm-Horsfall protein
*causes of obstructed urine flow:
1. Prostate enlargement
2. Pelvic organ prolapse
3. Low bladder wall compliance
4. Detrusor hyperflexia
*Kussmaul respirations can be a result of pulmonary edema and metabolic acidosis
*Nephrolithiasis- Calculus in the kidney
* Nephrotoxins - Any substance that causes damage to the glomerulus or the
kidney in general, such as bacteria, heavy metals, or drugs
, * Healthy kidney -Maintains fluid and electrolyte balance, Assists in maintaining
acid base balance, Produces erythropoietin which makes RBCs
*BUN - Blood urea nitrogen - 10-20 mg/dL
* Serum creatinine - 0.6-1.5 mg/dL
* Azotemia -Increased levels of serum urea and other nitrogenous compounds
related to decreasing kidney function.
* Uremia -Abnormally high levels of waste products in the blood
* Oliguria -Decreased urine output
*Uremic frost - Powdery deposits on the skin, especially the face, including urea
and uric acid salts, due to excretion of nitrogenous compounds in the sweat; seen in
severe uremia.
* Anuria -No urine output
* Puruitis - Itching of the skin caused by urea deposits causing irritation of the skin
* Casts - Congregated protein or cellular debris that forms within a renal tubule
Acute Renal Failure- Sudden interruption of kidney function resulting from
obstruction, reduced circulation, or disease of the renal tissue
Results in retention of toxins, fluids, and end products of metabolism
Usually reversible with medical treatment
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