Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Urinary System Asses chap 45 TEST 3 > Acute Kidney Injury > Flashcards

Acute Kidney Injury Flashcards

1
Q

Kidney stone diet **

A

look in blue box on page 2 of the kidney stone diet handout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute kidney injury

A

almost always recoverable - rapid loss of kidney function
elevated serum creatinine
decreased urine output (oliguria)
potentially reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

azotemia

A

too much nitrogen in the blood

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

3 types of kidney injury

A

pre-renal
inter-renal
post-renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

prerenal causes

A 
caused by:  Ischemia- whats causing it? 
severe dehydration
heart failure (or anything that decreases cardiac output) 
arythmias/tachycardia/ ect 
anything that decreases CO

ischemia decreases GFR
causes oliguria
autoregulatory mechanisms attempt to prevent blood flow (only as effective as the blood flow)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

intrarenal damage

A 
tissue damaged by conditions 
prolonged ischemia
NEPHROTOXINS
abx (gentamycin) 
NSAIDS
Hgb released from hemolyzed RBC 
Myoglobin released from necrotic muscle cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ATN acute tubular necrosis

A

results from ischemia, nephrotoxins, or sepsis

potentially reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

only need about % of one kidney to survive

A

40%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Post renal causes (5) :

A 
BPH
Prostate cancer 
calculi   
trauma (ex bike injury on urethra) 
extrarenal tumors
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

AKI
RIFLE classification-
how much filtration rate is lost?

A 
Risk for injury? 
Injury ( start having scant urine) 
Failure  (lost all but  50% GFR) 
Loss (lost all but 25% GFR)
End stage kidney disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

oliguric phase urine output?

A

urine output <400mL/day
occurs 1-7 days after insult
lasts 10-14 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

oliguric phase UA may show?

A

UA may show casts, RBC WBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

oliguric phase =fluid retention

sx are-

A 
neck veins distended 
bounding pulse 
pulmonary edema 
HTN 
anasarca
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Kussmaul respiration

A

lungs try to make pt take deeper breaths faster

trying to maintain acid pH balance in body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

hyponatremia can lead to

A

cerebral edema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

anasarca becomes life threatening when:

A

it spreads to brain tissue-the swelling has no where to go (cerebral edema limits amount of blood that can get into the brain)
33:03

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

quickest way to die from renal prob?

A

potassium excess

affects electrocardiac activity of heart= EKG changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what happens to lab value from waste product accumulation?

A

Elevated BUN ans serum creatinine levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Diuretic phase of AKI-
how much urine?
what should you monitor?

A

daily urine output 1-3L
May reach 5L or more

monitor for hyponatremia, hypokalemia, and dehydration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

AKI - diagnostic studies?

A

UA
serum creatinine
kidney ultrasonography- looking for hydronephrosis fluid buildup in kidney
renal scan-
CT of abdomen with contrast dye (risk to kidneys from dye)
renal biopsy 14G needle apply pressure dressing and keep pt on that side to limit bleeding

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

therapy for hyperkalemia ( biggest life or death)

A

Kayexalate med- very sweet pulls K+ from colon thru pooping
combo of IV insulin/ IV dextrose/ Ca Gluconate
47:50

22
Q

osmotic diuretic

A

mannitol or albumin

23
Q

CRRT continuous renal replacement therapy

A

ICU 1 nurse monitors pt- 1 nurse monitor machine to verify I and O

24
Q

nutrition therapy for AKI

A

adequate caloric intake
restrict Na, K
increase dietary fat ( so they still get amino acids)
enteral nutrition
LIMIT protein= causes higher nitrogenous wastes

25
Q

Assessment for AKI

A

VS
I and O
examine urine
assess appearance of pt (itching? skin turgor? dehydration?)
observe access site for dialysis
LOC
oral mucosa
lung sounds (crackles? sign of pulonary edema)
heart rythym (irregular = hyper/hypo kalemia)

26
Q

Nusing DX for AKI

A

excess fluid volume
risk for infection
fatique
anxiety

27
Q

1KG water = how much water retained?

A

1L

28
Q

chronic kidney disease

****see table 47-6
memorize the TABLE!

A

progressive irreversible loss of kidney function

SEE TABLE 47-6 stages of kidney disease++

29
Q

leading cause of ESKD

A

diabetes
HTN leads to atherosclerosis= succession of blood flow
glomulonephritis
interstitial nephritis
polycystic kidney disease (cysts increase size of kidney/decrease function)
prolonged obstuction of urinary tract
vesicoureter reflux
chronic pyelonepritis (infection leads to inflammation and scarring)

30
Q

oliguria

A

scant urine

31
Q

isothenuria

A

large qty of very dilute urine

32
Q

anuria

A

producing almost no urine

33
Q

which dialysis is least extreme?

A

peritoneal dialysis- aka continuous ambulatory dialysis- peritoneum of body is used as a permeable membrane as pt ambulates

34
Q

peritoneal dialysis is started when-

A

pt GFR is 15mL or less

begun when pt uremia can no longer be managed conservatively

35
Q

peritoneal dialysis is done by

A

inserting a catheter thru the abdominal wall= direct access into inner part of body STERILE TECHNIQUE MANDATORY!

36
Q

peritoneal dialysis based on pt

A

weight and BP

37
Q

Dialysis solutions

A

1, 2, or 3L bags
concentration of 1.5%, 2.5%, or 4.25% dextrose
must be warmed slowly to BODY TEMP
do not microwave!!!!!!!!
Pt takes BP and dry weight (empty) in the AM to determine fluid deficient 1.5%/ neutral2.5% /overload 4.25%

38
Q

dialysate should be:

A 
clear (no infection)
no strings (fibrin starting to form clotting cascade- dr would give heparin to prevent that from progressing)
39
Q

dialysate should be:

A 
clear (no infection)
no strings (fibrin starting to form clotting cascade- dr would give heparin to prevent that from progressing)
allows independence 
allows travel 
short training program 
fewer dietary restrictions 
greater mobility than with hemodialysis
40
Q

benefit of peritoneal dialysis

A

allows freedom of movement , go about life

41
Q

complications of peritoneal dialysis

A 
exit site infection
hernia   (walking around with 3KG of fluid in abdomen) 
peritonitis 
lower back problem (from the weight of the 3KG of fluid) 
clog in tubing 
bleeding 
pulmonary complications 
protein loss
42
Q

hemodialysis complication

A 
Complications:
Thrombosis 
Infection
Aneurysm
Ischemia – “steal syndrome”
43
Q

dialyzer

A

artificial kidney

44
Q

access sight for hemodialysis

A

arteriovenous fistula and graft,
temporary vascular access
** risk for infection, clotting

45
Q

hemodialysis vascular access

A

fistula - surgically created anastamosis of artery and vein - much less likely to blow like a vein would do (more common- but if poor blood supply or cant use large enough needle)

shunt/graft- same process, but using teflon or dacron but deaing with a foreign substance in the body

46
Q

Dialyzer/blood lines are primed with saline solution to eliminate air/blood in the line T or F?

A

TRUE

47
Q

Fill a thrill means?

A

turbulance that can be felt at site

48
Q

hemodialysis complications?

A 
Hypotension
Muscle cramps
Loss of blood
Hepatitis  (getting lower) 
Disequilibrium syndrome
49
Q

nursing considerations for pt with hemodiallysis:

A

NEVER use HD catheter without a physician order
NO….. In affected extremity
Blood pressure measurements
Insertion of IVs
Phlebotomy
Palpate for thrills and auscultate for bruits every 4 hours while pt is awake
Assess the patient’s distal pulses and circulation in the arm with the access
Elevate the affected extremity post operatively
Encourage routine range of motion exercises
Check for bleeding at needle insertion sites
Assess for s/s of infection at the needle insertion site.
Instruct pt not to carry heavy loads in the affected arm
Instruct pt not to sleep with the body weight on the affected arm

50
Q

more nursing considerations for hemodialysis

A

Monitor vital signs
Monitor laboratory values before, during and after dialysis
Assess the client for fluid overload prior to the procedure
Assess patency of the blood access device
Weigh the client before and after the procedure to determine fluid loss. Know the Patient’s dry weight.
Assess the patient’s LOC
Assess for headache, nausea or vomiting.

51
Q

MORE nursing considerations for hemodialysis

A

Hold antihypertensives and other medications that can affect the BP prior to the procedure, as prescribed
Hold medications that could be dialyzed off, such as water-soluble vitamins and certain antibiotics
Monitor for shock and hypovolemia during the procedure
Provide adequate nutrition (client may eat prior to the procedure)

Urinary System Asses chap 45 TEST 3 (3 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions