Nursing 212

Health Differences Across the Lifespan 2 Study Guide

Nephrosis Nephrosis is a condition in which there are degenerative changes in the kidneys, especially the renal tubules, without the occurrence of inflammation. Protein loss is so extensive that edema and hypoproteinemia are produced. Nephrotic Syndrome is the end result of a variety of diseases that damage the capillaries of the glomerulus; it is characterized by massive edema and albuminuria. Thromboemboli (mobilized blood clots) are a common complication and may occlude peripheral veins and arteries, pulmonary arteries, and renal veins. Prognosis is poor for adults with this syndrome; less than 50% experience complete remission, at least 30% develop ESRD. Signs and symptoms include pitting edema, oliguria, sodium and fluid retention, symptoms of renal failure, loss of appetite and fatigue, amenorrhea, pronounces proteinuria, hypoalbuminemia, and hyperlipidemia. Treatment: no specific treatment; nursing care is to control edema; sodium restricted diet and avoid sodium containing drugs (such as OTC products); administer diuretics that block aldosterone formation (Lasix); administer salt poor albumin to reduce fluid retention; provide high protein diet to restore body proteins, or a high calorie diet and a restricted sodium diet if edema is present; maintain bedrest until edema begins to subside; observe for signs of pulmonary edema, such as tachypnea, dyspnea, and crackles in the lungs; record I&O and weight; maintain fluid restrictions, offer ice chips and provide frequent oral care Medications: immunosuppressive for autoimmune disorders; angiotensin converting enzyme (ACE) inhibitors to reduce protein loss; NSAIDs to reduce proteinuria; Penicillin or other broad-spectrum antibiotics to kill bacteria; antihypertensive as needed to lower blood pressure Hydronephrosis is a collection of urine in the renal pelvis, owning to obstructed outflow, forming a cyst by production of distention, and atrophy of the organ. Diagnosis is done by locating a large, fluctuating, soft mass in the region of the kidney, appearing and disappearing as retained urine passes into the ureters and bladder. Neurogenic bladder consists of all types of bladder dysfunction caused by an interruption of normal bladder innervation. Complications include incontinence, residual urine retention, urinary infection, stone formation, and renal failure. This disorder is also known as neuromuscular dysfunction of the lower urinary tract, neurologic bladder dysfunction, and neuropathic bladder.

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