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med surg II
Renal Failure
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| A | B |
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| cystitis | Inflammation of the bladder |
| Cystitis: Clinical Manifestations | Dysuria, frequency, urgency, suprapubic pain, incomplete bladder empyting |
| Functions of kidney | Excretion of waste, water and salt balance, acid-base balance, hormone secretion |
| acute renal failure | rapid loss of renal failure, develops over hours or days, potenially reversible condition |
| Prerenal failure (prerenal azotemia | blood flow |
| intrarenal failure (acute tubular necrosis | damage |
| postrenal failure | obstruction |
| chronic renal failure | gradual onset, 90-95% nephron damaged, Permanent damage |
| Prerenal azotemia clincial manifestations | hypotension, tachycardia, decreased cardiac output, decreased central venous pressure, decreased urine output, lethary |
| Clinical Manifestations of Intrarenal ARF and Postrenal Azotemia | Oliguris, increased urine specific gravity, hypertension, tachycardia, shortness of breath, orthopnea, rales or crackles, pulmonary edema, anorexia, nausea, vomiting, flank pain, lethargy, headache, tremors, confusion, generalized edema, weight gain |
| Onset Phase | begins with the precipitating events and continues until oliguria develops, gradual accumulation of nitrogenous wastes, can last hours to days |
| oliguric phase | urine ouput less than 400mL/24 hours, lasts 8-15 days, reduced glomerular filteration rate, increased bun/creatinine levels, hyperkalemia, hypocalcemia/hyperphosphatemia, hypermanesemia |
| diuretic phase | gradual return of renal function, normal or high urine output, diuresis can result in an output of up to 10 L/day, electroloyte losses typically precee clearance of nitrogenous waste, normal renal tubular function is reestabished during this phase, 2-6 weeks |
| recovery phase | begins normal activity, upto 12 months, renal function may never return to pre-illness levels. |
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