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CCRN > CCRN: Renal > Flashcards

CCRN: Renal Flashcards

1
Q

acute renal failure or chronic renal failure has a higher mortality rate?

A

acute renal failure - (40%)… acute is secondary to something else… ex. sepsis, mi

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2
Q

whats the best dialysis schedule for someone in acute renal failure?

A

daily

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3
Q

whats the primary etiology of hyperphosphatemia?

A

renal failure

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4
Q

whats the relationship between calcium and phosphate?

A

inverse

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5
Q

bradycardia, tremors, and twitching muscles are associated with which electrolyte disorder?

A

hyperkalemia!!

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6
Q

treatment for hypercalcemia

A

fluids and diuretics… flush the calcium out of the kidneys because it could block them.

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7
Q

use for amphogel?

A

decreases high phosphate

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8
Q

hyponatremia is usually associate with…?

A

fluid overload

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9
Q

what can cause hypernatremia?

A

too much normal saline, diuretics, dehydration

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10
Q

best diagnostic test to eval renal trauma?

A

CT…. evaluates outside of kidney

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11
Q

which of the following would NOT cause renal failure? sepsis, shock, hypertension, bladder tumor

A

hypertension

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12
Q

causes of pre-renal failure?

A

low cardiac output, shock, renal artery stenosis…… a decrease flow to kidneys ->decrease pressure in renal artery->decrease filtration-> decrease GFR.. kidney response is vasoconstriction… end result is ischemic damage to kidney

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13
Q

intra-renal failure is caused by…

A

glomerulonephritis, antibiotics, myoglobinemia, diabetes…. damaged filter

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14
Q

which type of renal failure is caused by damage to filter (glomerulus)?

A

intra-renal kidney failure

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15
Q

post-renal failure

A

complete obstruction in urine flow

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16
Q

causes of post-renal failure?

A

bladder cancer, BPH, urethral calculi, urethral stricture, neurogenic bladder

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17
Q

during diuretic phase what happens to electrolytes?

A

dumps K and Na… but not filtering waste products so still might need dialysis

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18
Q

when you have diabetes and hypertension, you are at risk for 10x the risk of what?

A

renal failure

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19
Q

acute renal patients dont use peritoneal dialysis because….

A

if we infect the peritoneal membrane, it will be lost and we wont be able to use it later on if he becomes a chronic renal failure patient

20
Q

hollow organs fair better in trauma than solid organs. T or F

A

True

21
Q

best diagnostic test for kidney trauma

A

CT scan

22
Q

what happens in diabetic ketoacidosis?

A

nsulin insufficient - leaves too much glucose in blood…pH acidotic so it takes potassium out of cell and into the blood and d/t concentration of K+ and glucose, body diureses - - lose your potassium storage - always check potassium after correcting sugar in DKA patient

23
Q

too much potassium and you will see…

A

bradycardia, tremors/twitching, n/v, EKG changes (increased potassium supresses SA node)

24
Q

why give Ca++ along with HCO3?

A

when moving towards alkalosis, potassium goes back into cell and can stimulate the heart… Ca++ stabilizes the heart

25
Q

what to look for in hyperkalemia?

A

bradycardia, tremors/twitching/ n/v, peaked t-waves, shortened ST-segment, falttened P-wave, Long PR interval, blocks, PVC, Ventr. arryhthmias

26
Q

Digoxin and low potassium can cause what?

A

Dig. Toxicity

27
Q

when Calcium comes out of bone… it splits in half and does what?

A

half binds to albumin, and the other half is free ionized calcium

28
Q

with Hypercalcemia, look at …

A

central nervous system (coma), peripheral nervous system (flaccid muscles), heart (EKG changes: short ST, short QT, steep drop off of T-Wave, anorexia, n/v, ARF…. treat with fluids and lasix and phosphate

29
Q

causes of hypercalcemia…

A

hyperparathyroidism, paget’s disease, excessive vitamin D

30
Q

Chvostek’s sign (hypocalcemia)

A

tap the facial nerve just below the temple and a twitch of the lip or nose is a positive sign

31
Q

Trousseau’s sign (hypocalcemia)

A

contraction of the hand or fingers when arterial flow is occluded for 5 mins

32
Q

causes of hypocalcemia…

A

malabsorption, acute pancreatitis, renal failure, vit. D deficiency, hypoparathyroidism

33
Q

signs of hypocalcemia…

A

hypotension, hyperactive reflexes, trousseau’s sign, chvostek’s sign, laryngeal spasm, seizures/muscle cramps, EKG changes: prolonged QT, flat ST, small T-wave

34
Q

relationship between pH and ionized calcium

A

inverse

35
Q

magnesium is needed to help absorb other electrolytes so give it first if you have to choose replacements. T or F

A

true

36
Q

calcium causes the heart and the vasculature to do what?

A

contract

37
Q

magnesium allows the heart and vasculature to do what?

A

relax and vasodialate

38
Q

hypomagnesium occurs with what conditions?

A

CRF, pancreatitis, hepatic cirrhosis, GI losses, alcoholism, treatment of DKA

39
Q

magnesium and insulin sensitivity

A

hypomagnesium decreases insulin sensitivity… in DKA, insulin will lower magnesium levels causing hypomag.

40
Q

hypomagnesium symptoms….

A

increased relfexes, +chvosteks, +trouseaus, tachycardia, EKG changes: PR & QT prolongation, widened QRS, ST depression, T-wave inversion, decreased levels of K+,Ca++, PO4 d/t absorption related to hypomag.

41
Q

Phosphorus is extremely important for the…

A

respiratory system (ATP used up by the lungs then builds up lactic acid.

42
Q

only concern with hyperphosphatemia is…

A

the inverse relationship with Ca++.

43
Q

sometimes you will see Diabetes Insipidus in patients with…

A

head traumas because it can effect the hypothalamus where ADH (Anti-Diuretic Hormone) is released, or tumor or infection

44
Q

severe hyponatremia (Na<110) symptoms

A

coma, seizures, death, replace with hypertonic 3% or NS, do not increase serum Na+ by more than 1 mEq/L/h or 10 a day.

45
Q

free water deficit formula…

A

(kg. wt. x 0.6) x [(Na/140) - 1]

46
Q

serum osmolality formula…

A

2 x Na + Glu/18 + BUN/ 2.8

CCRN (5 decks)

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