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Wong's Nursing Care of Infants and Children, 11th Ed., Hockenberry, Wilson & Rogers | Nursing (RN) School Study Aid


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24 - The Child with Renal Dysfunction
28 Picmonics to Learn | 44 mins

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Renal Corpuscle
Characteristics
Arterioles
Glomerulus
Capillaries
Fenestrations
Plasma Solutes and Other Small Molecules Become Ultrafiltrate
Bowman's Capsule Encapsulates Glomerulus
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
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
Distal Tubule
Characteristics
Hormonally Regulated
Aldosterone Causes Na+ Reabsorption
Na+ Reabsorbed Via Active Transport
Water follows Na+
Parathyroid Hormone Causes Ca2+ Reabsorption
Leads to Collecting Duct
1 min
Collecting Duct
Characteristics
Na+ Reabsorption via Passive Transport
Vasopressin Causes Water reabsorption
Concentrates Filtrate
2 mins
WBC Differential Lab Value
White Blood Cells (WBC)
5-10 (5,000-10,000)
Leukocyte Differential
Neutrophils (50%-70%)
Bands (2%-5%)
Segs (50%-70%)
Lymphocytes (20%-40%)
Monocytes (4%-8%)
Eosinophils (2%-4%)
Basophils (0.5%-1.5%)
2 mins
Red Blood Cell Count (RBC) Lab Values
Women: 3.5-5.5 million cells/ MuL
Men: 4.3-5.9  million cells/ MuL
1 min
pH - Blood and Urine Lab Value
Blood
7.35 - 7.45
Urine
4.0 - 8.0
1 min
Urine Specific Gravity Lab Value
1.003-1.030
1 min
Creatinine Lab Values
Measures Renal Function
0.6 - 1.3 mg/dL
1 min
BUN (Blood Urea Nitrogen) Lab Values
10-20 mg/dL
40 secs
Urinary Tract Infection Symptoms
More common in Elderly
Most common in Females and Babies
Change in LOC
Dehydration
Fever
Urgency
Urethra Infection
Burning
Smelly Urine
Dark Cloudy Urine
Frequency of Urination
54 secs
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
Pyelonephritis Assessment
Cause/Mechanism
Ascending Urethral Bacteria
Assessment
Dysuria
Fever
Fatigue
Flank Pain
Costovertebral Tenderness
Nausea and Vomiting
1 min
Pyelonephritis Interventions
Urinalysis
NSAIDs
Antibiotics
Increase Fluid Intake
Avoid Catheterization
Consideration
Urosepsis
1 min
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
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
Cyclosporine (Sandimmune) Overview
Mechanism
Immunosuppressant
Inhibits Calcineurin, Decreasing IL-2
Indications
Prevent Transplant Rejection
Psoriasis
Rheumatoid Arthritis
Considerations
Monitor Plasma Levels
Avoid Grapefruit Juice
Increased Risk of Lymphoma
2 mins
Cyclosporine (Sandimmune) Side Effects
Side Effects
Nephrotoxicity
Hepatotoxicity
Infection
Hypertension
Hirsutism
Tremor
Hyperkalemia
Hypomagnesemia
Gingival Hyperplasia
1 min
Loop Diuretics
Mechanism of Action
Thick ascending limb of Loop of Henle
Inhibits Na+-K+-2Cl-
Sulfa drug
Drug Names
Furosemide
Lasix
Side Effects
Ototoxicity from Rapid Injection
Gout
Dehydration
Hypocalcemia
Hypokalemia
Orthostatic Hypotension
2 mins
Diabetes Insipidus Assessment
Polyuria
Nocturia
Low Specific Gravity (USG)
Polydipsia
Dehydration
Hypotension
Tachycardia
Confusion
2 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
Infusion of Glucose and Insulin
Diuretics
Kayexalate
Prevention Education
2 mins
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
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
Kidney Transplant
Indications
End Stage Renal Disease (ESRD)
Considerations
Selective Candidacy
Close Compatibility
Immunosuppressants
Monitor for Rejection
Monitor for Infection
Monitor Urine Output
2 mins
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
Hydrocele
Mechanism
Impaired Lymphatic Drainage
Signs and Symptoms
Large Scrotum
Painless
Considerations
Needle Aspiration or Surgery
Scrotal Support
Monitor for Bleeding and Infection
1 min

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