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CJA > acute renal failure > Flashcards

acute renal failure Flashcards

1
Q

what is not a function of the kidney?

A

synthesize cholesterol, that’s the liver’s job

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2
Q

Functions of the kidneys

A

-regulate blood pressure
-secretion of prostaglandins
-release erythropoietin

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3
Q

best approximation of Kidney function?

A

24 hour urine

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4
Q

is a minor increase in creatinine alarming?

A

yes

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5
Q

what is CKD

A

-kidney damage or a decrease in GFR for 3 or more months
-associated with decreased quality of life
-can progress to ESKD

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6
Q

manifestations of CKD

A

increased creatinine
anemia
fluid retention
electrolyte imbalances

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7
Q

CKD interventions

A

-keep BP below 130/80
-control cardiac risk factors
-treat hyperglycemia
-manage anemia
-smoking cestation
-weight loss

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8
Q

which lab test is the best approximation of kidney function?

A

creatinine clearance

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9
Q

which lab value indicates if someone is dehydrated?

A

specific gravity

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10
Q

Acute Nephritic Syndrome clinical manifestations

A

-hematuria
-edema
-azotemia
-proteinuria
-cola-colored urine
-HTN

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11
Q

Acute Nephritic Syndrome treatment

A

-corticosteroids
-manage HTN
-ABX is infection still present
-I&O
-fluids as needed

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12
Q

Nephrotic syndrome

A

-increased glomerular permeability leading to massive proteinuria
-hypoalbuminemia
-hyperlipidemia
-hypercoagulable state
-edema

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13
Q

Nephrotic syndrome treatment

A

-diuretics
-ACE-Is
-lipid lowering agents
-sodium restriction

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14
Q

ESKD

A

-can be mistaken for stroke like symptoms
-uremia develops, the more build up the greater the symptoms
-metabolic acidosis occurs

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15
Q

ESKD complications

A

-anemia
-calcium - phosphorus imbalance
-hyperkalemia
-HTN
-pericarditis, pericardial effusion, pericardial tamponade

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16
Q

ESKD medications

A

-calcium & phosphate binders
-antihypertensives
-cardiovascular agents (ion tropics)
-erythropoietin

17
Q

Hemodialysis goal

A

extract nitrogenous substances from the blood and to remove excess fluid

18
Q

HD access

A

-arteriovenous fistula (preferred, vein to artery)
-arteriovenous graft (synthetic connection vein to artery
-HD catheter (double-lumen catheter that only dialysis can touch

19
Q

how often do you assess artery/venous graft/fistula?

A

every 8-12 hours

20
Q

what complications are you looking for for a patient who received HD?

A

bleeding at fistula/graft - apply pressure
infection central line

21
Q

CRRT

A

-continous HD for patients too unstable for HD
-can be run on a critical care unit by trained critical care RN

22
Q

Peritoneal Dialysis

A

-pt has PD catheter inserted on abdomen
-dwells dialysate into peritoneum
-drainage of dialysate into drainage bag

23
Q

can you manipulate the catheter for peritoneal dialysis?

A

no

24
Q

complications of peritoneal dialysis

A

peritonitis
leakage
bleeding

25
Q

criteria for AKI

A

50% of greater increase in serum creatinine above baseline

26
Q

what is pre-renal AKI?

A

-volume depletion (severe blood loss)
-impaired cardiac efficiency
-vasodilation

27
Q

what is a intrarenal AKI?

A

-physical injury (trauma to kidney)
-hypoxic injury (prolonged ischemia)
-chemical injury (ACE-inhibitors)
-immunologic injury

28
Q

Post renal AKI?

A

-urinary obstruction (kidney stone, BPH, tumors, SCI)

29
Q

AKI stages

A

-initiation (when urine output starts to slow down)
-oliguria (400 mLs or less in 24 hours)
-diuresis
-recovery (can take months)

30
Q

AKI complications

A

-fluid retention (daily weights)
-electrolyte imbalances
-uremia

31
Q

AKI focused assessment

A

-dyspnea
-rhonchi
-tachycardia
-JVD
-edema
-decreased urine output
-ekg changes

32
Q
A
32
Q

AKI prevention

A

-monitor renal function
-monitor vital sign changes
-watch for signs/symptoms of sepsis
-provide & treat infections promptly
-provide adequate hydration to patient at risk for dehydration

33
Q

Risk factors for kidney disease

A

-advanced age
-bph
-diabetes

34
Q

nutritional considerations

A

-utilize daily weights during the oliguric and diuresis phase to determine appropriate dietary requirements

CJA (31 decks)

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