GU, Chapter 46&47

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Chapter 46 & 47Medical Surgical Nursing : 

Chapter 46 & 47Medical Surgical Nursing Pyelonephritis, Acute Renal Failure Copyright 2007 Mosby Medical Surgical Nursing

Acute pyelonephritis : 

Acute pyelonephritis Pyelonephritis- Sudden bacterial inflammation Urosepsis- Copyright 2007 Mosby Medical Surgical Nursing

Slide 3: 

http://coursewareobjects.elsevier.com/objects/elr/Lewis/medsurg7e/facultyanimations/videoplayer_fullscreen_AS2_overAll_2.html?video=431 Copyright 2007 Mosby Medical Surgical Nursing

Slide 4: 

Copyright 2007 Mosby Medical Surgical Nursing

Etiology & Pathophysiology : 

Etiology & Pathophysiology Starts with colonization and infection Bacteria: E. Coli, Proteus, Klebsiella, or Enterobacter species Common in Pregnancy Recurring episodes can lead to Chronic pyelonephritis Copyright 2007 Mosby Medical Surgical Nursing

Clinical Manifestations : 

Clinical Manifestations Faituge Chills Fever (102 or higher) Vomiting Malaise Flank plain LUTS CVA pain Copyright 2007 Mosby Medical Surgical Nursing

Collaborative Care : 

Collaborative Care Hospitalization Outpatient Prophylaxis Table 46-7 Copyright 2007 Mosby Medical Surgical Nursing

Chronic Pyelonephritis : 

Chronic Pyelonephritis Small, atrophic, shrunken, lost function Recurring infections in the Upper urinary tract May occur in absence of infection Current infection HX UTI’s Copyright 2007 Mosby Medical Surgical Nursing

Chronic Pyelonephritis : 

Chronic Pyelonephritis Repeated infection Thickening of the calyces Diagnosed by radiologic imaging Copyright 2007 Mosby Medical Surgical Nursing

Acute renal Failure : 

Acute renal Failure Renal Failure is Acute Renal Failure (ARF)- Uremia- Copyright 2007 Mosby Medical Surgical Nursing

Etiology & Pathophysiology : 

Etiology & Pathophysiology Table 47-1, Figure 47-1 Prerenal Above the kidneys Hypovolemia, decreased cardiac output Intrarenal Prolonged ischemia & nephrotoxins Kidneys Postrenal Below the kidneys Obstruction Copyright 2007 Mosby Medical Surgical Nursing

Clincial course : 

Clincial course Initiating Phase Lasts until S&S present Oliguric Phase Occurs within 1-7 days, lasts 10-14 days Diuretic Phase Starts with 1-3L/day may increase to 3-5L/day Recovery Phase Increase in GFR and BUN, improve in 1-2 weeks, takes 12 months to recover Copyright 2007 Mosby Medical Surgical Nursing

Diagnostic Studies : 

Diagnostic Studies History Urinalysis Renal Ultrasound Renal scan CT MRI Renal Biopsy Copyright 2007 Mosby Medical Surgical Nursing

Collaborative Care : 

Collaborative Care Table 47-4 Reverse the cause, manage the S&S, and prevent complications Adequate intravascular volume and CO Fluid restriction Total loss +600ml = Fluid restriction Hyperkalemia-Table 47-5 Nutritional Therapy Nursing Management Copyright 2007 Mosby Medical Surgical Nursing