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Med Surg 1 > acute & chronic kidney disease > Flashcards

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
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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

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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
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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
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5
Q

acute kidney injury lab assessment

A
  • creatinine, BUN
  • blood electrolyte values
  • urine tests
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6
Q

acute kidney injury imaging assessments

A
  • US, CT, xrays (pelvis, kidneys, KUB), MAG3
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7
Q

acute kidney injury other diagnostic

A
  • kidney biopsy
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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
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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
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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
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11
Q

chronic kidney disease

A
  • progressive, irreversible disorder

- ckd become end stage kidney

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12
Q

azotemia

A

buildup of nitrogen based waste in the blood

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13
Q

uremia

A

azotemia with symptoms

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14
Q

uremic syndrome

A

urea and other waste products build up in body bc kidneys are unable to eliminate

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15
Q

chronic kidney disease causes

A
  • hypertension

- diabetes mellitus

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16
Q

chronic kidney disease physical assessment s/s

A
  • neurologic changes
  • cardivascular symptoms
  • respiratory symptoms
  • hematologic symptoms
  • skeletal symtoms
  • urine symtoms
    skin symtoms
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17
Q

chronic kidney disease psychoscial

A
  • anxiety, fear
  • coping mechanisms
  • support recommendation or mental health
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18
Q

chronic kidney disease lab assessment

A
  • creatinine BUN
  • sodium, potassium , calcium, phosphorus, bicarb
  • hemoglobin and hematocrit
  • GFR
  • urinalysis
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19
Q

chronic kidney disease intervention

A
  • managing fluid volume
  • improving cardiac function
  • enhancing nutrition
  • preventing injury
  • minimising psychosocial compromise
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20
Q

stage 1

A

at risk, normal kidney function but urine indicate kidney

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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
Q

chronic kidney disease changes: Kidney changes

A
  • reduced GFR
  • BUN increases, urine output decreases
  • risk for fluid overload with edema, pulmonary crackles, shortness of breath, and pleural or pericardial effusion
26
Q

chronic kidney disease changes: metabolic changes

A
  • fluid and electrolyte balance is disrupted

- acid and base balance disrupted

27
Q

chronic kidney disease changes: cardiac changes

A
  • hypertension
  • hyperlipidemia
  • heart failure
  • pericarditis
28
Q

chronic kidney disease changes: hematologic and immunity changes

A
  • anemia
  • increased bleeding or bruising
  • reduced immunity= increased risk for infection
29
Q

chronic kidney disease changes: GI changes

A
  • halitosos (uremic fetor), stomatitis (mouth inflammation), anorexia, n/v, hiccups, peptic ulcer disease, uremic colitis, hemorrhagic shock from severe GI bleed
30
Q

ckd health promotion and maintenance

A

control diseases that lead to ckd

  • dietary adjustments
  • weight maintenance
  • smoking cessation
  • exercise
  • limitation of alc
31
Q

ckd anaylysis cues

A
  • 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
Q

hemodialysis procedure

A

dialysis works by passive transfer of toxins by diffusion

- beaware of blood clotting

33
Q

hemodialysis precuations

A
  • check pedal pulses and cap refil in arm with fistula or graft
  • check for bruit or thrill by auscultating or palpating access site
34
Q

hemodialysis access complications

A
  • thrombosis
  • stenosis
  • infection
  • aneurysm
  • ischemia
    hf
35
Q

hemodialysis drug intervene

A
  • many drugs are dialyzable
  • some drugs are held after dialysis
  • short acting hypertensives can lead to hypotension
36
Q

complications of dialysis

A
  • hypotension
  • dialysis equilibrium syndrome
  • cardiac events
  • reactions to dialyzers
37
Q

peritoneal dialysis procedure

A
  • 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
Q

types of peritoneal dialysis

A
  • continuous ambulatory peritoneal
  • intermittent peritoneal
  • intermittent perutoneal
39
Q

peritoneal dialysis complications

A

peritonitis
pain
do not microwave fluid

40
Q

peritoneal dialysis nursing care

A
  • 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
Q

kidney transplantation: candidate selection

A
  • advanced kidney disease
  • reasonable life expectancy
  • medically and surgically fit
  • in u.s waiting list when gfr <20 ml
42
Q

kidney transplantation donors

A
  • living donors (highest rate of graft survival)
  • non-heart beating donors
  • cadaveric donars
43
Q

kidney transplantation preoperative care

A
  • immunologic studies
  • dialysis 24 hours before surgery
  • blood transfusion before surgery
44
Q

kidney transplantation operative procedures

A
  • varies depending on status of donar
  • failed kidneys are left in place
  • new kidneys placed in right or left anterior iliac fossa
45
Q

kidney transplantation post operative care

A
  • urologic management
  • assess hourly urine output x 48 hours
  • cbi
  • monitor i/o
  • immunosuppressive drug therapy
46
Q

kidney transplantation post operative care complications

A
  • rejection
  • thrombosis
  • renal artery stenosis
47
Q

specific gravity

A

the concentration of particles, electrolytes and waste

- test done thru urine

48
Q

specific gravity normal range

A

1.005- 1.030

49
Q

serum cr. male range

A

.6-1.2

50
Q

serum cr. normal range female

A

.5-1.1

51
Q

blood urea nitrogen normal range

A

10-20

Med Surg 1 (25 decks)

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