acute & chronic kidney disease Flashcards
1
Q
acute kidney injury
A
- rapid reduction in kidney function
- failure to maintain waste elimination, fluid and electrolyte balance and acid base balanc e
- occurs few hours or days
2
Q
acute kidney injury serium creatinine
A
increase serum creatinine by .3 mg/dl
- increase in serum creatinine to 1.5 times or more occurring in 7 days
3
Q
acute kidney injury causes
A
- reduced perfusion to kidneys damage to kidney tissue, and obstruction or urine outflow
- RISK FACTORS INCLUDE: SHOCK, CARDIAC SURGERY, HYPOTENSION, PROLONGED MECHANICAL VENTILATION, SEPSIS
- OLDER ADULTS WITH DIABETES, HYPERTENSION, PERIPHERAL VASCULAR DISEASE, LIVER DISEASE, CKD
4
Q
acute kidney injury physical assessment
A
- hourly urine output
- assess for fluid overload
- evaluate vital signs for hypoperfusion and hypoxemia
- build up of nitrogenous waste and decreased urine output
5
Q
acute kidney injury lab assessment
A
- creatinine, BUN
- blood electrolyte values
- urine tests
6
Q
acute kidney injury imaging assessments
A
- US, CT, xrays (pelvis, kidneys, KUB), MAG3
7
Q
acute kidney injury other diagnostic
A
- kidney biopsy
8
Q
acute kidney injury intervention/ management
A
- avoid hypotension, maintain normal fluid fluid balance
- reduce exposure to nephrotoxic agents and drugs
- frequently monitor lab values
- closely watch I/o
- drug therapy
- nutrition
- kidney replacement therapy
9
Q
acute kidney injury history
A
- changes in urine appearance, frequency, volume
- recent surgery or trauma, transfusion, allergic reactions
- drug history
- coexisting conditions
- immunity- mediated aki
- anticipate aki after hypotension or shock
- history of obstructive problems
10
Q
acute kidney injury health promotion
A
- teach healthy adults to drink 2-3l water daily
- dehydration reduces perfusion
- nurses should monitor kidney function
- urine output 30 for 2 hr or dark amber urine should be reported
- avoid exposure
11
Q
chronic kidney disease
A
- progressive, irreversible disorder
- ckd become end stage kidney
12
Q
azotemia
A
buildup of nitrogen based waste in the blood
13
Q
uremia
A
azotemia with symptoms
14
Q
uremic syndrome
A
urea and other waste products build up in body bc kidneys are unable to eliminate
15
Q
chronic kidney disease causes
A
- hypertension
- diabetes mellitus
16
Q
chronic kidney disease physical assessment s/s
A
- neurologic changes
- cardivascular symptoms
- respiratory symptoms
- hematologic symptoms
- skeletal symtoms
- urine symtoms
skin symtoms
17
Q
chronic kidney disease psychoscial
A
- anxiety, fear
- coping mechanisms
- support recommendation or mental health
18
Q
chronic kidney disease lab assessment
A
- creatinine BUN
- sodium, potassium , calcium, phosphorus, bicarb
- hemoglobin and hematocrit
- GFR
- urinalysis
19
Q
chronic kidney disease intervention
A
- managing fluid volume
- improving cardiac function
- enhancing nutrition
- preventing injury
- minimising psychosocial compromise
20
Q
stage 1
A
at risk, normal kidney function but urine indicate kidney
21
Q
stage 2
A
slightly reduced kidney function
22
Q
stage 3
A
moderately reduced kidney function
23
Q
stage 4
A
severely reduced kidney function; a noticeable jaundice may occur, partially around eyes
24
Q
stage 5
A
end stage kidney disease
25
chronic kidney disease changes: Kidney changes
- reduced GFR
- BUN increases, urine output decreases
- risk for fluid overload with edema, pulmonary crackles, shortness of breath, and pleural or pericardial effusion
26
chronic kidney disease changes: metabolic changes
- fluid and electrolyte balance is disrupted
| - acid and base balance disrupted
27
chronic kidney disease changes: cardiac changes
- hypertension
- hyperlipidemia
- heart failure
- pericarditis
28
chronic kidney disease changes: hematologic and immunity changes
- anemia
- increased bleeding or bruising
- reduced immunity= increased risk for infection
29
chronic kidney disease changes: GI changes
- halitosos (uremic fetor), stomatitis (mouth inflammation), anorexia, n/v, hiccups, peptic ulcer disease, uremic colitis, hemorrhagic shock from severe GI bleed
30
ckd health promotion and maintenance
control diseases that lead to ckd
- dietary adjustments
- weight maintenance
- smoking cessation
- exercise
- limitation of alc
31
ckd anaylysis cues
- fluid overload inability of disease kidneys to maintain body fluid balance
- decreased cardaic function due to reduced stroke volume , dysrhythmias, fluid overload, and increased peripheral vascular resistance
- weight loss due to inability to ingest, digest, absorb food and nutrients
- potential for injury due to effects of kidney disease on bone density, blood clotting, and drug elimination
32
hemodialysis procedure
dialysis works by passive transfer of toxins by diffusion
| - beaware of blood clotting
33
hemodialysis precuations
- check pedal pulses and cap refil in arm with fistula or graft
- check for bruit or thrill by auscultating or palpating access site
34
hemodialysis access complications
- thrombosis
- stenosis
- infection
- aneurysm
- ischemia
hf
35
hemodialysis drug intervene
- many drugs are dialyzable
- some drugs are held after dialysis
- short acting hypertensives can lead to hypotension
36
complications of dialysis
- hypotension
- dialysis equilibrium syndrome
- cardiac events
- reactions to dialyzers
37
peritoneal dialysis procedure
- soft plastic tube is placed in pt. abdominal cavity
- sterile cleansing fluid put into catheter
- after filtering process is finsihed fluid leaves pt. body through catheter
38
types of peritoneal dialysis
- continuous ambulatory peritoneal
- intermittent peritoneal
- intermittent perutoneal
39
peritoneal dialysis complications
peritonitis
pain
do not microwave fluid
40
peritoneal dialysis nursing care
- assess vitals
- weigh pt. using same scale
- monitor pt. dry weight
- baseline lab test doen before and during
- check dressings
- measure and record overflow
41
kidney transplantation: candidate selection
- advanced kidney disease
- reasonable life expectancy
- medically and surgically fit
- in u.s waiting list when gfr <20 ml
42
kidney transplantation donors
- living donors (highest rate of graft survival)
- non-heart beating donors
- cadaveric donars
43
kidney transplantation preoperative care
- immunologic studies
- dialysis 24 hours before surgery
- blood transfusion before surgery
44
kidney transplantation operative procedures
- varies depending on status of donar
- failed kidneys are left in place
- new kidneys placed in right or left anterior iliac fossa
45
kidney transplantation post operative care
- urologic management
- assess hourly urine output x 48 hours
- cbi
- monitor i/o
- immunosuppressive drug therapy
46
kidney transplantation post operative care complications
- rejection
- thrombosis
- renal artery stenosis
47
specific gravity
the concentration of particles, electrolytes and waste
| - test done thru urine
48
specific gravity normal range
1.005- 1.030
49
serum cr. male range
.6-1.2
50
serum cr. normal range female
.5-1.1
51
blood urea nitrogen normal range
10-20
