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NUR 326 (Patho 1) > AKI and CKD Exam 2 > Flashcards

AKI and CKD Exam 2 Flashcards

1
Q

Kidney Functions

A

Main fluid and electrolyte homeostasis

Rid the body of water-sulable wastes via urine

3 important endocrine functions

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2
Q

Kidney: Three important endocrine functions

A

Produce erythropoietin - stimulates RBC production

Activates Vitamin D

Produces renin, which helps regulate blood pressure

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3
Q

Kidney Injury

A

Kidneys are NEEDY

Renal blood flow = 1 L per min = 20% CO

Kidney injury can be sudden and rapidly progress (can take a hit and happen in hours)

BUT: Can be reversible

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4
Q

Renal insufficiency

A

90 ml/hr is normal GFR in healthy

25% of normal GFR 25-30 ml/hr indicates Renal insufficiency

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5
Q

What is indicator of kidney injury

A

GFR <90 but GFR is not always indicator of acute kidney injury

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6
Q

AKI: Acute Kidney Injury

A

-Usually the result of ischemic injury r/t loss of volume –> decreased perfusion. (Toxin and sepsis common causes also)

-Kidney can function can be mildly affected to severely infected

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7
Q

3 Classifications of AKI

A

Based on where the injury is occuring

Pre-renal: Volumes loss related

Intrarenal: Acute tubular necrosis [chemical, kidney cell death] Drug overdose and Kidney diseases. DM or HTN

Post-renal: Not as common, obstruction causing cell death

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8
Q

AKI: Clinical Manifestations

A

Oliguria = <400 ml/24 hr period

Beings 1 day after hypotensive event and last 1-3 weeks (Surgery - Blood Loss - Dehydration)

Fluid volume excess

Metabolic acidosis

Hyponatremia

Hyperkalemia

Waste product accumulation

Neurologic disorders

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9
Q

Chronic Kidney Disease: 6 stages

A

The stages are determined by GFR in mL/min

Stage one and two = No symptoms

Moderates stages = Hypertension

Severes stages = Other clinical manifestations (stage 5 = Uremic)

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10
Q

Best way to treat chronic kidney disease

A

Prevent by controlling the things that cause it

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11
Q

Most cause of CKD

A

Diabetes - 50%
HTN - 30%
Glomerulonephritis - 10%
Other - 10%

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12
Q

Risk Factors for CKD

A

Family history

Increasing age > 60

Male

Black / African American

HTN, DM, Smoking

Overweight and obesity

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13
Q

CKD: Pathogenesis

A

PP slide

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14
Q

What indicates worsening chronic kidney disease

A

Increase in angiotensin II

Proteinuria

Watch blood pressure and monitor urine of these patients

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15
Q

CKD Manifestations

A

Neurologic

Cardiovascular

Gastrointestinal

Integumentary

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16
Q

Cardiovascular Manifestation of CKD

A

HTN

CAD

Pericarditis

PAD

17
Q

Neurological Manifestations of CKD

A

Fatigue

Headache

Sleep disturbances

Encephalopathy

18
Q

Gastrointestinal Manifestations of CKD

A

Anorexia

Nausea

Vomiting

GI bleed

Gastritis

19
Q

CKD: Manifestations: No longer maintains F & E Homestostatis

A

Edema (third spacing) (FVO)

Hyperkalemia

Hyperphosphatemia

Hypermagnesemia

Metabolic acidosis

20
Q

CKD manifestations: No longer rids the body of wastes via urine

A

Anorexia (lack of appetite)

Malnutrition

Itching (frost)

CNS changes

21
Q

CKD manifestations: Decreased erythropoietin

A

anemia

22
Q

CKD Manifestations: Decreased activations of Vitamin D

A

Renal osteodystrophy

23
Q

Drugs can be used for

A

Slowing the rate of progression of CKD

-Reduces BP to less than 140/90
-Treat hyperlipidemia (cholesterol less than 200)

Treating all the complications of CKD

24
Q

Slowing the progression of CKD: Blood pressure control

A

ACE or ARB

Other BP meds as needed to maintain SBP (110-130)

25
Q

Slowing the progression of CKD: Lipid control

A

statins as needed

26
Q

Complications of CKD: Volume overload treatment

A

Loop diuretic (Furosemide)

use with low salt diet

27
Q

Complications of CKD: Hyperkalemia

A

Multiple (Diuretic) (Kayexalate) (Dialysis)

Addressed with hemodialysis in ESRD

28
Q

Complications of CKD: Metabolic acidosis treatment

A

Sodium bicarbonate (lower PH)

An alkaline agent

29
Q

Complications of CKD Treatment hyperphosphatemia

A

Calcium carbonate (will lower phosphate levels)

Phosphate binder

30
Q

Complications of CKD Renal osteodystrophy treatment

A

Calcitriol

Activated vitamin D

31
Q

Complications of CKD Anemia treatment

A

Erythropoietin

BBW

32
Q

Complications of drug therapy

A

Many drugs are excreted through the kidneys

Drug doses and frequency may be adjusted

33
Q
A
34
Q

Drugs that have to be renal dosed

A

Digoxin
Diabetic agents
Antibiotics
Opioids

We do not want these drugs staying in the patient longer

NUR 326 (Patho 1) (27 decks)

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