Ch. 70 renal disorders Hydronephrosis, hydroureter, urethral stricture are what we will talk about here. Hydronephrosis is enlargement of the renal pelvis, it is caused by an obstruction in the upper part of the ureter. Whereas hydroureter is a ureteral enlargement that is caused by an obstruction in the lower part of the ureter. A urethral stricture is very low in the urinary tract, and a stricture of course means narrowing and a lot of times with a stricture, you will have symptoms such as distention and abdominal pain before they have any sort of back flow of urine that will cause Hydronephrosis or hydroureter. So assessment specifics going to be of course symptoms they complain of if they have some sort of discomfort, some stream issues, course flank pain is going to be an indicator of these types of renal disorders we will discuss. Lab assessment is going to of course include BUN and creatinine levels, even your GFR can be affected some. But these type of obstructions, but remember if there is an obstruction really is going to be acute nature and really shouldn’t affect your GFR too greatly. GFR is a number that can move up or down really depending what’s going on with the client. so if the GFR is affected, when that obstruction is removed or eliminated, it really is going to take care of itself. Interventions for these are going to be cystoscope which allows for stint placement if that’s indicated. Radiologic interventions suggest a nephrostomy, on which is going to be a surgical incision that it creates a stoma for urine to come to the external of the body. Pyelonephritis is a bacterial infection in the kidney and renal pelvis, going to be considered upper urinary tract, this occurs related to reflux of urine or abscesses that might be present in the urinary tract. This can be acute or chronic. Key features can be fever and chills that might be associated, client can be tachycardic, and tachypnic, if you look at those symptoms in and of themselves, they really make you think infection, which is of course what pyelonephritis is. Flank pain, back are something specific to pyelonephritis is loin pain. Malesia and fatigue which you know does often accompany any sort of infection. Risk factors for pyelonephritis are going to be of course the use of catheters, having a history of diabetes, those are also common risk factors that are strongly associated with pyelonephritis and/or cystitis. Chronic renal stones, where you may have some reflux that occurs because of the obstruction and where it might be and over use of analgesics is going to be a risk factor for pyelonephritis is going to be a risk factor for it or frequency of developing pyelonephritis. It's kind of good to know the importance especially when we are talking about symptomology when we are talking about acute and chronic pyelonephritis and the thing with the acute is that the symptoms are more vague if you look at and compare them to the chronic. Chronic one of the vague symptoms might be hypertension, but also we think about an acute infection where it got out of hand. Hypertension
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- Winter '16
- acute pyelonephritis