Acute Uremic Crises Flashcards

1
Q

Pair the following patient descriptors with acute versus chronic azotemia:

  • Feeling sick with mild to moderate azotemia
  • Anemic
  • Good MCS
  • Small, irregular kidneys
  • Not anemic
  • Stable with moderate to severe azotemia
  • Painful and/or enlarged kidneys
  • Poor MCS
A
  • Feeling sick with mild to moderate azotemia (Acute)
  • Anemic (Chronic)
  • Good MCS (Acute)
  • Small, irregular kidneys (Chronic)
  • Not anemic (Acute)
  • Stable with moderate to severe azotemia (Chronic)
  • Painful and/or enlarged kidneys (Acute)
  • Poor MCS (Chronic)
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2
Q

What are common presenting complaints with CKD patients that are now newly/suddenly sick?

A

(Dehydration, anorexia, vomiting, weakness, lethargy)

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3
Q

(T/F) Prerenal azotemia is the only kind of azotemia that resolves with fluid therapy.

A

(T)

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4
Q

Why should maintenance fluids in a CKD patient be discontinued gradually, often over 2-3 days when possible?

A

(Avoids dehydration or hypovolemia and recurrence of prerenal azotemia)

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5
Q

Why is LRS better for the kidneys when rehydrating?

A

(It is balanced which means lower in chloride which can be not optimal for injured kidneys; make sure to stop LRS as soon as the CKD patient is no longer dehydrated)

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6
Q

What are the two administration options for supplemental at home fluids in CKD patients?

A

(Subq fluids or esophagostomy tube)

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7
Q

What are the pros and cons of at home subq fluids for tx of dehydration in CKD patients?

A

(Pros → easy, inexpensive initially; cons → excess salt (have to use an isotonic fluids for subq fluids), patient tolerance, and client abilities)

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8
Q

What are the pros and cons of at home fluids given via an esophagostomy tube?

A

(Pros → more physiologic (no extra salt, can literally use tap water), can adm meds easier, improved patient tolerance, and ease of administration; cons → requires general anesthesia, increased up-front cost, potential complications (stoma infection, dislodgement of tube, esophageal stricture))

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9
Q

Why are phosphorus binders included in treatment of CKD patients?

A

(Phosphorus clearing is dependent on GFR which is decreased with CKD, CKD patients will have high phosphorus and that contributes to nausea/discomfort and can worsen kidney function, phosphorus binders ameliorate that)

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10
Q

(T/F) Dietary changes to a prescription renal diet should be recommended to every CKD patient and that change may slow progression of CKD and extend life-expectancy.

A

(T)

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