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Decreased resistance to invading organisms

Risk factors:• Inability or failure to empty bladder completely• Obstructed urinary flow • Decreased natural host defenses or immunosuppression• Instrumentation of the urinary tract• Inflammation or abrasion of the urethral mucosa• Contributing conditions such as: DM, Pregnancy,neurologic disorders, gout.

Loss of integrity of the mucosal lining

Bacteria enters the urethra

urethritis

• Pain• Swelling,• Discharges• accumulation of

leukocytes

Bacteria Travels from urethra to bladder, attach to and colonize the bladder

Cystitis

Irritation of the lining of the bladder

Attachment & Proliferation of bacteria in the urethra

Urethrovesical reflux

• Acute pain related to infection within the urinary tract

• Deficient knowledge about factors predisposing the pt. to infection & recurrence, detection, & prevention of recurrence &

Urine cultures,Test for WBCs, Test for STDs, CT Scan

Urine stagnation

Cystolithiasis, Pregnancy, Untreated UTI

• oliguria• Passing a cloudy or strong smelling urine• pressure on lower abdomen• low grade fever

Risk for hypertermia

Urinalysis, cystoscopy, Imaging test (ultrasound & x-ray)

• Relieving pain >Antispasmodic agents, Application of heat, Inc. fluid intake, Analgesics, frequent voiding• Monitoring & managing potential complications >Using strict aseptic technique in any procedures Frequent inspection of urine,Performing a meticulous perineal care, maintaining a closed system.• Promoting Home and community-Based care >Good hygiene, increasing fluid intake, urinating regularly & more frequently.

Ureterovesical Reflux

Introduction of bacteria to the ureters

Ureteritis

Infection ascends to the

kidneys

Pyelonephritis

Ultrasound study or ct scan, iv urogram, measurement of creatinine clearance, blood urea nitrogen, creatinine levels.

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Activation of the immune response

Release of pyrogens from bacteria

Release of prostaglandin e2

Elevation of the body thermostat

by the hypothalamus

Vasoconstriction

Shivering

• Fever

General feeling of being well

• Malaise

• Flank Pain • Back Pain

Decreased erythropoietin

Decreased Stimulation of bone marrows

Decreased Erythropoiesis

Decreased RBC production

• Anemia

Reduced heat loss through the

skin

• Chillsineffective tissue

perfusion

Acute Pain

• N&VIrritation of the

urinary tract lining/

• Dysuria

• Hematuria

• Relieving pain >Increase fluid intake to decrease burning sensation• Decrease temperature

>loosen clothing

• Adequate tissue perfusion >Monitor v/s, capillary refill, color of skin & mucosa, provide oxygen as needed

Over production of antibodies

Post infections

Acute glomerulonephritis

Microorganisms circulate in the blood stream

Deposition of antigen-antibody complex in glomerulus

Acute inflammation & damage within the nephrons including the glomerulus

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Increased production of epithelial cells lining the glomerulus

leukocyte infiltration of the glomerulus

thickening of the glomerular infiltration membrane

Scarring and loss of glomerular filtration membrane

Decreased GFR

• Marked Proteinuria

• Pitting edema• hypoalbuminemia• hyperlipidemia• fatty cast in

the urine

• Hematuria

Excess fluid volume related to accumulation of fluids in the

body

• Elevate edematous extremities, change position frequently

• Encourage bed rest

Chronic glomerulonephritis

Repeated episodes of acute

Glomerulonephritis

Cortex shrinks to a layer 1 to 2 mm thick or less

Bands of scar tissue distort the remaining cortex

Surface of the kidney rough and irregular

Numerous glomeruli and their tubules become scarred

Branches of the renal artery are thickened

Branches of the renal artery are thickened

• Hypertension• elevated BUN & Serum Creatinine• vascular changes• severe nosebleed• pedal edema• loss of weight and strength

Urinalysis, chest x-ray, ECG, CT scan, MRI

Electron microscopy and immunoflourescent analysis

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Risk for decreased cardiac output

• Monitor F&E• Give emotional Support• Instruction to the patient include

explanations and scheduling for follow-up evaluations: BP, and blood studies and creatinine levels

Chronic glomerulonephritis progresses

Acute renal Failure

Prerenal failure

Volume Depletion:Renal losses

Intrarenal Failure

Acute pyelonephritisAcute

glomerulonephirtis

Intrarenal Failure

Renal obstruction

Impaired blood flow

Hypo perfusion

Acute parechymal damage to

the glomeruli or

kidney tubules

Problem on osmosis

tubular back leak

Formation of cast/

vasoconstriction

Pressure rises in the kidney

Decrease GFR

• Dry skin• Drowsiness• headache• muscle twitching • seizure• may appear critically ill & lethargic

• Fluid & electrolyte imbalance• Impaired skin integrity

• Monitor fluid & Electrolyte balance• Reducing metabolic pain: Bed Rest• Prevent infection: Asespsis• Provide skin care• Provide psychosocial support

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Chronic renal failure

Sodium & water

Hypertension

Increased vascular volume

Heart failure

potassium Balance

Hyperkalemia

Edema

Elimination of

nitrogenous waste

Uremia

Erythropoeitin production

Anemia

Pericarditis

Skin disorder

G.I. Manifestation

Neurologic Manifestation

Sexual Dysfunction

Coagulopathies

Acid-Base balance

Acidosis

Skeletal buffering

Activation of vit. D

Phosphate elimination

HypocalcemiaHyperparathyroidism

Osteodystrophies

• Risk for decreased cardiac output

• Assess degree of hypertension• Assess level of activity• Investigate report of chest pain

Urinalysis, Blood test, renal ultrasound, Ct/MRI scan, ECG, Renal endoscopy, Renal Biopsy,

• Disturbed thought process

Uremic syndrome develops

END STAGE RENAL DISEASE

PATHOPHYSIOLOGY OF

RENAL DISEASES

SUbmitted by:Billy Gayados, BSN-III, BLOCK-M

SUbmitted to: MR. Dennis ramos

LEGEND:

♆poseidon|billy♆

DIAGNOSTICS

SIgns & Symptoms

Disease

Nursing Diagnosis

Nursing Responsibilities