14 - Renal Disorders Flashcards
kidney main functions
1 blood vol 2 waste excretn 3 acid-base 4 BP/renin 5 Ca + Ph 6 RBC/EPO
protein monitoring is critical
- urea levels rise w kidney disease
- urea is a protein waste product
end-stage kidney disease
s/s
- fatigue
- anemia
- decr urinatn
- headache
- wt loss
acute kidney disease
s/s
- rise in BUN
- decr urinatn
- decr sensatn in extremities
- swelling of lower extremities
- flank pain
nephrotic syndrome
- edema
- high proteinuria
- hypo-albumin
- hyper-lipid
- blood hyper-coag
*prolonged protein loss> protein malnutrition, anemia, vitamin D deficiency
kidney stones
- sudden intense pain in flank
- –unrelieved by positn changes
- –pain occurs when stones moves out of kidney pelvis down the ureter
kidney stones s/s
- diaphoresis
- n/v
- hematuria
most of kidney stones is made of…
calcium oxalate
nursing actions
- monitor daily wt (fluid status)
- monitor fluid intake
- encourage compliance w fluid restrictions
- monitor UO
- monitor for signs of constipatn (caused by fluid restrictn)
- alteratns w intake of protein, cal, Na, K, Ph, vitamins
chronic kidney disease [stg 1-4/pre-dialysis]
incr creatinine, decr GFR
-
chronic kidney disease [stg 1-4/pre-dialysis]
goal
- slow progressn of CKD
- control blood glucose
- control HTN
- limit kidney> reduce Ph> preserve kidney function
high levels of Ph contributes to…
Ca + Ph deposits in the kidneys
too little protein results in…
breakdown of body protein
chronic kidney disease dietary recommendations
- low Na>BP
- low K
- protein restrictions
- limit high Ph foods
- avoid energy drinks, meal supplements, protein sports drinks
- avoid herbal supplements that affect bleed time + BP
chronic kidney disease
protein recommendations
- protein 0.8-1g/kg
- meat intake 5-6 oz for males, 4oz for females
- limit dairy 1/2 cup per day
high phosphorous foods
- limit for CKD*
- peanut butter
- dried peas + beans
- bran
- cola
- chocolate
- beer
- some whole grains
End-Stage Kidney Disease [ESKD] or stage 5
GFR < 15mL/min
+
rise in creatinine level
ESKD dietary recommendation
- low protein
- low Ph
- low K
- low Na
- fluid restriction
- incr vitamin D
ESKD sodium intake
2-3 g/day
ESKD calories
35 kcal/kg
-to maintain body stores
protein needs for ESKD
predialysis: 0.6-1g/kg
dialysis: 1.2-1.5 g/kg bc proteins + amino acids are lost in dialysate
phosphorous for ESKD
700-1200 mg/day
-high protein requirement leads to an increase in phosphorous intake
Acute Kidney Injury
abrupt rapid decline in kidney function
-usually reversible
Acute Kidney Injury caused by…
- trauma
- sepsis
- poor perfusion
- med
