Nursing 410 Renal System Physiology

Nursing 410 Renal System Physiology

Nursing 410 Renal System Physiology

 

The renal system regulates the volume, electrolyte concentration, and acid base balance of body fluids; detoxify the blood and eliminate wastes; regulates blood pressure; and support red blood cell production.

Glomerulonephritis – bilateral inflammation of the glomeruli, typically following a strep infection.

Causes:

• Berger’s disease
• Impetigo
• Lipoid nephrosis
• Strep infection of respiratory tract

 

Signs & Symptoms:

• Decreased urination
• Smoky or coffee colored urine due to hematuria
• Periorbital edema due to hypervolemia
• Bibasilar crackles due to heart failure

 

Treatment:

• An antibiotic for 7 – 10 days to treat infections contributing to ongoing antigen- antibody response
• Fluid restrictions to decrease edema
• Dietary sodium restriction to prevent fluid retention
• Dialysis or kidney translate for chronic disease process

 

Nephrotic Syndrome – results from a defect in the permeability of glomerular vessels

Causes:

• Allergic reactions
• Circulation diseases such as heart failure, sickle cell anemia, and renal vein thrombosis
• Hereditary nephritis
• Metabolic diseases such as diabetes mellitus

 

Signs & Symptoms:

• Periorbital edema due to fluid overload
• Orthostatic hypotension due to fluid imbalance
• Ascites due to fluid imbalance
• Pallor and shiny skin with prominent veins due to edema

 

Treatment:

• Correction of underlying cause, if possible
• Nutritious diet, concentrating on protein
• Restricted sodium intake to reduce edema
• A diuretic, to diminish edema

 

Polycystic Kidney Disease – inherited disorder characterized by multiple, bilateral, grape like clusters of fluid- filled cysts that enlarge the kidneys, compressing and eventually replacing functioning renal tissue.

 

Causes:

• Autosomal dominate trait (adults)
• Autosomal recessive trait (infant)

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Signs & Symptoms:

      Neonates

• Pronounced epicanthic folds (vertical fold of skin on either side of nose) a pointed nose, small chin, floppy low set ears
• Respiratory distress related to impaired renal function and fluid imbalance

 

Adults

• Hypertension, due to activation of the renin angiotensin system
• Lumbar pain, due to enlarging kidney mass
• Widening abdominal girth, due to enlarged kidneys

 

Treatments:

• An antibiotic for infections
• Angiotensin-converting enzyme inhibitors for hypertension
• Adequate hydration to maintain fluid balance
• Surgical drainage of cystic abscess or retroperitoneal bleeding