N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide Treatment: extracorporeal shock wave lithotripsy (ESWL); increased fluid intake; moist heat to flank; hot baths; goal of treatment is to relieve symptoms, provide pain relief, monitor urinary function and I&O; strain all urine and save solid material for analysis; encourage ambulation and large fluid intake to help the patient pass calculi; diet for calcium stones (acid- ash) with limited calcium intake; diet for oxalate stones (alkaline-ash) with limited intake of foods high in oxalate (cola, tea); diet for uric acid stones (alkaline-ash) with limited intake of foods high in purine Other procedures and treatments include: • ESWL: a procedure that uses externally generated waves to pulverize or shatter urinary stones and calculi, which are then excreted in urine • Ureterolithotomy, pyelolthotomy or nephrolithotomy: surgical removal of the calculi from affected area; it requires large flank incisions and an extended recovery time • Percutaneous nephrostomy: a surgical procedure with a small incision in flank to allow insertion of an endoscope to visualize the renal pelvis; stones are removed with forceps or a basket device, or lithotripsy is used to crush stones • Transurethral uroscopy: the passage of a ureteral catheter via cystoscope to drain urine proximal to a stone and dilate ureter, allowing the stone to pass; use of a basket catheter passed through cystoscope to remove calculus Glomerulonephritis Glomerulonephritis is the inflammation of the capillary loops in the glomeruli of the kidney. It may be caused by an immunologic reaction to an antigen, such as a streptococcal infection of the respiratory tract, or a skin infection like impetigo. Symptoms appear 2-3 weeks after the original infection (typically group A beta hemolytic streptococcus). Signs and symptoms include pharyngitis, fever, malaise, lower UTI, pericarditis, anorexia, vomiting, peripheral and periorbital edema, tea or cola colored urine, hypertension, hypoalbuminemia, and pulmonary infiltrates. Diagnosis: urinalysis reveals proteinuria and hematuria; RBCs, WBCs, and mixed cell casts are common findings in urinary sediment; positive antibody response test for streptococcal exoenzymes; elevated antistreptinolysin O (ASO); elevated SED rate, BUN, and creatinine; decreased creatinine clearance; decreased sodium, elevated potassium, and decreased phosphate; delayed uptake and excretion of radioactive dye in renal scan; positive renal biopsy findings Interventions: plasmapheresis (removal of harmful components in plasma); dialysis if disease progresses to renal failure; maintain fluid restrictions, complete bedrest during acute stage, monitor I&O and weight daily; monitor for signs of renal failure (oliguria, azotemia, and acidosis); diet high in carbohydrates with high vitamin intake; restrict sodium, protein, potassium, and fluids Medications: antimicrobials (PCN) for infection; analgesics for pain relief; vitamin and electrolyte replacement as needed ©2017 Achieve Test Prep Page 84 of 140