409 Final 4 (CKD)

Question 1

Prognosis of CKD

Answer 1

its progressive and they don’t recover

Question 2

ESKD is when

Answer 2

the functioning is so low that it can’t sustain the patients life

Question 3

The stages of CKD are based on

Answer 3

GFR, which declines in each stage

Question 4

“Renal Reserve” means

Answer 4

the amount of extra work the kidneys can handle

Question 5

a person in stage 1 could have normal GFR, but

Answer 5

their renal reserve is decreased so they can’t handle extra stress from infection etc

Question 6

renal reserve is decreased because the nephrons are

Answer 6

over compensating just to reach the normal GFR

Question 7

In mild CKD, you still won’t see much a____

Answer 7

azotemia

Question 8

In mild CKD, you might have increased ___ of ___

Answer 8

output of urine

Question 9

In mild CKD the urine may be decreased and also

Answer 9

dilute

Question 10

By the following doctors orders (i.e. diet and BP medication) can

Answer 10

slow the progression of mild CKD

Question 11

In moderate CKD, the nephrons can’t

Answer 11

handle the normal workload anymore.

Question 12

Severe/ESKD: You can’t make ___ urine

Answer 12

dilute

Question 13

Severe/ESKD: the urine osmolarity is

Answer 13

fixed

Question 14

Severe/ESKD: output

Answer 14

decreased

Question 15

EARLY in CKD, the patient could have decreased sodium because

Answer 15

the nephrons don’t work well enough to reabsorb Na, also Na is lost because of polyuria

Question 16

LATE in CKD, they have increased sodium because now

Answer 16

urine output is decreased

Question 17

acid base balance in Early CKD

Answer 17

it’s not affected

Question 18

acid base balance in Late CKD

Answer 18

you get metabolic acidosis because you’re not getting rid of hydrogen ions (also you have less bicarb)

Question 19

in Late CKD the meta acidosis causes this respiratory finding

Answer 19

kussmaul

Question 20

In early CKD you have ___ phosphate and ___ calcium

Answer 20

increase phosphate, decreased calcium (this affects bone density)

Question 21

CKD cardiac changes: common BP finding

Answer 21

htn

Question 22

CKD cardiac changes: HF can occur when the heart can’t handle the

Answer 22

excess fluid volume

Question 23

Pericarditis can occurs because

Answer 23

the uremic wastes infects the pericardial fluids

Question 24

2 signs of tamponade

Answer 24

decreased pulse pressure

bradycardia

Question 25

Anemia is common in ___ CKD

Answer 25

late

Question 26

Food might

Answer 26

taste different

Question 27

2 of the main diseases that cause CKD

Answer 27

DM and HTN

Question 28

Teach people to manage these diseases, stay hydrated, don't abuse NSAIDs because they

Answer 28

reduce kidney perfusion

Question 29

Because of hematologic changes, they may report

Answer 29

bruising/bleeding

Question 30

Encephalopathy can cause __ and __

Answer 30

sz and coma

Question 31

Encephalopathy is treated with

Answer 31

dial

Question 32

SOB with exertion or at night suggests

Answer 32

fluid overload

Question 33

Thick sputum can indicate

Answer 33

uremic lung

Question 34

Skin findings

Answer 34

color can change a little itchy

Question 35

In late CKD, if you don't restrict protein,

Answer 35

the BUN can increase 10 or 20 times the normal amount

Question 36

Imaging: if CKD progresses RAPIDLY you may want US or CT to rule out

Answer 36

obstruction

Question 37

Diuretics can be used for managing fluid volume and BP. However,

Answer 37

by the time you're in ESKD, you shouldn't be using diuretics because they can harm the patient

Question 38

remember the conversion from kg to L

Answer 38

1 to 1

Question 39

Weigh after the pt

Answer 39

voided

Question 40

Treat PE with highfowlers, O2, and

Answer 40

diuretics

Question 41

During pulmonary edema, you may need to decrease heart O2 demand with

Answer 41

morphine

Question 42

Nutrition: patients starting HD or PD need increased

Answer 42

protein

Question 43

In patients on dial, how much Na can they have

Answer 43

2 to 4 grams

Question 44

Digoxin range is

Answer 44

0.8 to 2.0

Question 45

Aluminum-based phosphate binders can cause

Answer 45

neuro problems if taken for a long time

Question 46

As CKD progresses, you may need to decrease insulin dose because

Answer 46

the kidneys aren't excreting insulin as quickly as before

Question 47

A drug that can help with fatigue

Answer 47

erythropoetin

Question 48

Anticoagulants (like ___) are needed during dial

Answer 48

heparin

Question 49

AV fistulas and grafts shouldn't be used for

Answer 49

giving fluids

Question 50

After HD, you would expect some degree of decrease weight and decrease BP. You might need to treat with

Answer 50

NS

Question 51

After HD, slight temp is normal because

Answer 51

the machine warms the blood

Question 52

HD: Neuro changes can indicate d____ ____

Answer 52

disequilibrium syndrome

Question 53

HD: disequilibrium syndrome can be prevented by

Answer 53

starting dial slowing and gradually

Question 54

PD is a better choice if the pt can't tolerate

Answer 54

anticoagulants

Question 55

PD: If the effluent is very cloudy it can indicate

Answer 55

peritonitis

Question 56

PD: What should everyone wear

Answer 56

you should wear mask and sterile gloves patient should wear mask

Question 57

PD: you're using ___ technique

Answer 57

aspetic

Question 58

PD: In the beginning, it can cause pain; ____ing the solution can increase comfort

Answer 58

warming