Acute Uremic Crises Flashcards
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
- 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)
What are common presenting complaints with CKD patients that are now newly/suddenly sick?
(Dehydration, anorexia, vomiting, weakness, lethargy)
(T/F) Prerenal azotemia is the only kind of azotemia that resolves with fluid therapy.
(T)
Why should maintenance fluids in a CKD patient be discontinued gradually, often over 2-3 days when possible?
(Avoids dehydration or hypovolemia and recurrence of prerenal azotemia)
Why is LRS better for the kidneys when rehydrating?
(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)
What are the two administration options for supplemental at home fluids in CKD patients?
(Subq fluids or esophagostomy tube)
What are the pros and cons of at home subq fluids for tx of dehydration in CKD patients?
(Pros → easy, inexpensive initially; cons → excess salt (have to use an isotonic fluids for subq fluids), patient tolerance, and client abilities)
What are the pros and cons of at home fluids given via an esophagostomy tube?
(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))
Why are phosphorus binders included in treatment of CKD patients?
(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)
(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.
(T)