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dehydration
when checking pulse (Low Pulse)
orthostatic hypostension
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hyperkalemia causes arrhythmias
irregular heart rate
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infection elevates temperature
fever
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changes in level of consciousness may be due to changes in electrolytes and fluid balance
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1)Pallor may be due to anemia.
2) scratching from dry skin, pruitus may lead to excoriations.
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1)ab find:skin pallor, color, yellow, grey cast 2)dry skin
when assessing: skin, hair, nail
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dehydration = oliguria
thrombocytopenia = bruising
abnormal finding: skin turgor
when assessing: skin, hair, nail
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causes:nailbeds turn white with renal failure
cap refill may result from poor blood flow to the extremeites or anemia
abnormal finding distal portion of nail bedscapillary refill < 3 seconds
when assessing: skin, hair, nail
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causes: may precede glomerulonephritis(kidney disease -helps filter waste and fluids from the blood) symptom blood in urine rust dark
abnormal finding impetigo a streptococcal infection of the skin
when assessing: skin, hair, nail
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retinitis pigmentosa may accompany hereditary nephritis(inflamation of nephron in kidney
blurred vision
-
causes: retinal changes in blood vessels results from prolonged hypertention or diabetes
- retinal arteriosclerotic changes:
- eyes
-
causes may be: anemia
conjunctival pallor
eyes
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1)causes: high frequency deafness may be hereditary nephropathies
2)acute glomerulonephritis may be pharyngitis or strep infection
- 1) deafness,
- 2)strep throat
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causes: renal diseasel can result from alterations of sodium and renal secretions of vasoconstrictors
- hypertention
- cardiovascular
-
causes:may occure with uremia
friction rub
cardiovascular
-
causes: occurs from hypotention increased fluid volume
- ab find: cardiac enlargement of the left ventricle
- cardiovascular
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causes: decreased serum albumin
- ab find: edema
- cardiovascular
-
casues:fluid volume overload
- ab find:SOB, tachypenea, rales
- respiratory
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causes: metabolic acidosis occurs early in renal disease and casues kussmauls respirations
- ab finding: acid base disturbanceskussmauls respirations
- respiratory
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causes: decreased erythropoetin producution in kidney
all blood cells are defective in renal disease
abnormal find; anemia, bruising, bleeding tendencies
hemaltologic
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causes: nausea and changes in taste may lead to diminished appetite
ab find : weight changes / malnutrition
Gastrointestinal
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casues: metabolic and hormonal changes in renal disease lead to GI upset, malnutrition and decreased nutrient intake
ab finding: gastroparesis-gastritis
gastrointestinal
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casue: urea buildup
ab find: metallic taste/ foul urine odor to breath
gastrointestinal
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causes: alterations in elimination occur
ab find: constipation/diarrhea
gastrointestinal
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- Cause:lose concentrating ability
-
cause: UTI or interstitial cystitis
ab find: dysuria
genitourinary
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cause: < 100 ml urine in 24 hr in acute renal disease, end stage,or bilateral ureteral obstruction
anuria
genitourinary
-
ab find: oliguria
cause: urine output is 100-400 ml in 24 hr severe dehydration,shock, transfusion reaction, end stage renal failure
oliguria - genitourinary
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casue: blood in urine may indicate UTI, irritation, obstruction or cancer
ab find: hematuria
genitourinary
-
causes: imbalance of potassium, magnesium, calcium
ab fin: dysrythimia
-
: cause chronic anemia
ab find:angina chest pain
-
cause: increased fluid volume
ab find: distended neck veins (pericardial)
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increased levels of altered fluid balance, urea, creatine, amonia levels and parathyroid hormone may interfere with nerve function and contribute to neuropathies
- diminished deep tendon reflexes
- hyperesthesia
- paresthesia
-
waste products that build up in the blood
uremia
-
presence of crystals on the skin
uremic frost
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normal ph of urine
amount of urine in 24hrs
normal ph 4.6 to 8.0
amount 24 hr 1-2 liters
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formed by liver cells when excess amino acids are metabolized used for energy
urea
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metabolismm of creatine phosphate energy source in muscle
creatine
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breakdown of DNA /RNA
uric acid
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measure of dissolved material in urine
specific gravity = 1.002 to 1.035
- distilled water is 1.000
- higher the SG more dissolved material is present
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structural and functional unit of the kidney. urine is formed in the approx 1 million nephrons in each kidney
nephron
-
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prevents backflow of urine .
carries urine from the kidney to urinary bladder
ureters - ureter/0
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temperary storage of urine and its elimination
urinary bladder cyst/o vesic/o
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carries urine from the bladder to exterior (outside)
urethra
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occurs with diabetes, diabetes insipidus, chronic renal failure
polyuria
-
prostate problems
interrupted urine stream , dribbling, unrine retention
-
urilogical disorder or neurologic disorder
incontinence
-
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occurs with infection, foreign body in urinary tract, urethritis, renal colic or stones
perineal pain
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renal disease inhibits kidney ability to break down insulin
hyperglycemia
-
ab norm: dark amber urine = dehydration
yellow brown to green urine=excessive bilir.
dark smoky= hematuria
orange red or orange brown=pyridium(phenazopyridine)
cloudiness = infection
nearly colorless = lg fluid intake, renal disease, or diabetes
color of urine
normal = yellow or amber
-
abnorm urinalysis results : w/infection foul smell
in diabetic ketoacidosis urine is fruity odor
odor of urine
-
ph below 4.6 in urine
metabolic and respiratory acidosis
-
when urine has been standing or with infection because bacteria decompose urea to form ammonia
ph above 8.0 in urine is seen
-
low specific gravity indicates excessive fluid intake or diabetes insipdus
specific gravity below 1.002
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