SIMCLEX Renal and Genitourinary Disorders
SIMCLEX Renal and Genitourinary Disorders
SIMCLEX Renal and Genitourinary Disorders
khadesia.slaughter@gmail.com
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Renal Calculi
1. Overview
a. Stones that form in the urinary tract
b. Form as a result of chemicals in urine becoming concentrated (calcium or oxalate,
struvite, uric acid, cystine)
c. Causes
i. diet high in calcium, Vit D, protein, purines
ii. dehydration
iii. immobilization
iv. uric acid (gout)
v. infection
vi. obstruction
2. NCLEX Points
a. Assessment
i. pain which radiates from lumbar to side to testicles or bladder
ii. severe pain with sudden onset
iii. dull pain in renal area
iv. signs of UTI
v. hematuria (blood in urine)
b. Therapeutic Management
i. monitor VS looking for infection
ii. increase fluid intake to 3000 mL/day
iii. provide analgesia to treat pain
iv. promote ambulation
v. strain all urine to catch stone
vi. Treatment options
1. Extracoporeal Shock-wave Lithotripsy (ESWL)
Glomerulonephritis
1. Overview
a. Inflammatory disorder of the glomerulus caused by immunological reaction
b. Predisposing factors
i. upper respiratory infection
ii. skin infection
iii. SLE
2. NCLEX Points
a. Assessment
i. fever
ii. anorexia, N/V
iii. malaise
iv. BUN and Creatinine, Creatinine clearance
v. uptake and excretion of dye with renal scan
vi. HTN
vii. Hypoalbuminemia
viii. hematuria, protneinuria
b. Therapeutic Management
i. Plasmapheresis: removal of harmful antibodies from plasma
ii. dialysis
iii. protein restriction, K+, Na+
iv. bedrest
v. monitor daily weight and I&O
Nephrotic Syndrome
1. Overview
a. proteinurea, hypoalbuminemia, edema
b. Plasma proteins leak into the urine, fluid shift occurs leading to massive edema
2. NCLEX Points
a. Assessment
i. severe edema
ii. weight gain
iii. renal failure symptoms
iv. fatigue
v. amenorrhea
vi. positive renal biopsy
b. Therapeutic Management
i. goal is to reduce urinary protein excretion, reduce edema, minimize further
complications
ii. Na in diet
iii. high protein diet
iv. bed rest
v. monitor immunologic function
1. assess for infection
2. Monitor CBC with attention on WBC and differential
3. hand hygiene
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o. complication with dialysis are severe (air embolus, electrolyte imbalance, shock,
hemorrhage, sepsis, encephalopathy)
i. monitor and assess the client thoroughly and frequently
Peritoneal Dialysis
a. peritoneum acts as semipermeable membrane
i. contraindications
1. peritonitis
2. abdominal surgery
ii. can be continuous (24/7)
b. complications
i. peritonitis (infection of the peritoneum)
ii. cloudy outflow sign of peritonitis and should be reported
iii. avoid infection via strict sterile technique
Function of the kidneys
a. maintain acid-base balance
b. fluid and electrolyte balance
c. secrete renin to aid in blood pressure regulation and erythropoietin (stimulate bone
marrow to produce RBCs)
d. urine production
Creatinine clearance used to estimate GFR (normal 125 mL/minute, decreases with age)
Assess allergy to dye, shellfish, iodine prior to urography
a. instruct to drink fluids to flush dye post procedure unless contraindicated
b. dye damaging to kidneys
Cystoscopy used to examine bladder and take biopsy
Renal biopsy
a. assess coagulation studies
b. assess client for bleeding from site post procedure
c. apply pressure to site
Urosepsis
a. most common cause is a urinary catheter
Hydronephrosis
a. renal distention caused by obstruction of normal urine flow
i. monitor fluid and electrolyte balance