Renal System

IAN PEATE is a Visiting Professor at Northumbria University, a Senior Clinical Fellow at the University of Hertfordshire, and a Professorial Fellow at the University of Roehampton. He is also the Editor-in-Chief of the British Journal of Nursing and the Consultant Editor of the Journal of Paramedic Practice and the International Journal of Advancing Practice.

• Preface viiiAcknowledgements x1 Anatomy and Physiology: The Renal System 1Renal System 1Kidneys (External) 1Kidneys (Internal) 2Nephrons 3The Functions of the Kidney 7Kidney Blood Supply 8Urine Formation 9Hormonal Control of Tubular Reabsorption and Secretion 10Composition of Urine 12Ureters 13Urinary Bladder 14Urethra 15Male Urethra 15Female Urethra 17Micturition 17Conclusion 17Glossary of Terms 18Multiple Choice Questions 19References 202 Renal System Assessment 21Assessing Needs 21History Taking 22Effective Communication 22The Health History 24Application of the Patient History to Renal System Conditions 26Introduction and Establishing Rapport 26Chief Complaint and Presenting Symptoms 26History of Present Illness 26Pain Assessment 26Past Medical History 27Medication History 27Allergy History 27Family History 28Dietary Habits, Including Salt and Fluid Intake 28Social History 28Occupational History 28Review of Systems 28Urinary Habits 29Fluid Intake and Output 29Weight 29Fluid Balance Charts 30Psychosocial History 30Patient Concerns andExpectations 30Patient Education Needs 30The Physical Examination 30Specific Gravity 32Additional Factors 33Conclusion 35Glossary of Terms 36Multiple Choice Questions 37References 383 Pyelonephritis 39Pathophysiological Changes Associated with Pyelonephritis 39Epidemiology 42Risk Factors 43Clinical Presentation 44Clinical Investigations and Diagnosis 46Clinical Investigations 48Management 50Health Teaching 52Conclusion 53Glossary of Terms 53Multiple Choice Questions 54References 554 Acute Kidney Injury 57Pathophysiological Changes Associated with Acute Kidney Injury 57Categorisation of Acute Kidney Injury 58Epidemiology 58Risk Factors 61Clinical Presentation 64Clinical Investigations and Diagnosis 67The History 67Physical Examination 68Investigation and Tests 70Laboratory Tests 70Urinalysis 70Electrolyte and Acid-Base Balance 70Full Blood Count 70Inflammatory Markers 71Imaging Studies 71Renal Biopsy 71Management 71Health Teaching 73Conclusion 73Glossary of Terms 74Multiple Choice Questions 74References 765 Chronic Kidney Disease 77Acute Kidney Injury 77Pathophysiological Changes Associated with Chronic Kidney Disease 78Epidemiology 80Risk Factors 80Clinical Presentation 80Clinical Investigations and Diagnosis 82Categorisation of Chronic Kidney Disease 82Medical History and Physical Examination 83Investigations and Tests 86Management 87Health Teaching 88Conclusion 89Glossary of Terms 89Multiple Choice Questions 90References 916 Renal Calculi 93Pathophysiological Changes Associated with Renal Calculi 94Typical Sites of Stone Impaction in the Urinary Tract 96Epidemiology 98Risk Factors 98Clinical Presentation 99Clinical Investigations and Diagnosis 101Physical Examination 103Clinical Investigations 104Management 106Health Teaching 108Conclusion 108Glossary of Terms 108Multiple Choice Questions 109References 1117 Bladder Cancer 112Pathophysiological Changes Associated with Bladder Cancer 114Epidemiology 115Risk Factors 116Clinical Presentation 116Clinical Investigations and Diagnosis 117History Taking 118Physical Examination 118Staging of Bladder Cancer 119Bladder Cancer Grading 121Management 122Treating Non-muscle-invasive Bladder Cancer 123Treating Muscle-invasiveBladder Cancer 123Health Teaching 123Conclusion 124Glossary of Terms 125Multiple Choice Questions 125References 1278 Urinary Tract Infection 128Pathophysiological Changes Associated with Urinary Tract Infection 129Epidemiology 130Risk Factors 130Clinical Presentation 132Clinical Investigations and Diagnosis 132Obtaining a Midstream Specimen of Urine 136Management 137Recurrent Urinary Tract Infection 139Health Teaching 140Conclusion 141Glossary of Terms 142Multiple Choice Questions 142References 144MCQ Answers 145Index 146

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