CH 54 Patients with Kidney disease

Question 1

The most accurate indicator of fluid loss or gain

Answer 1

weight gain of 1kg= 1,000 mL of retained fluid

Question 2

kidney damage or a decrease in GFR lasting for 3 months of more.
-Diabetes is the main cause

Answer 2

Chronic kidney disease

Question 3

results in retention of uremia waste products and the need for renal replacement therapies, dialysis, or kidney transplantation.

Answer 3

ESKD

Question 4

GFR >90

Kidney damage with normal or increased GFR

Answer 4

stage 1

Question 5

GFR= 60-89

Mild decrease in GFR

Answer 5

stage 2

Question 6

GFR=30-59

Moderate decrease in GFR

Answer 6

stage 3

Question 7

GFR=15-29

Severe decrease in GFR

Answer 7

stage 4

Question 8

GFR< 15

ESKD or Chronic renal failure

Answer 8

stage 5

Question 9

tx of anemia, hyperglycemia, HTN, and detection of proteinuria help to slow the progression.

Answer 9

CKD

Question 10

• elevated creatnine
• anemia due to decreased erythropoietin
• metabolic acidosis
• abnormalities in calcium and phosphorus
• edema and congestive HF
• HTN becomes hard to control

Answer 10

clinical manifestations of CKD

Question 11

The amount of plasma filtered through the glomeruli per unit of time

Answer 11

GFR

Question 12

a measure of the amount of creating the kidneys are able to clear in a 24 hour period.

Answer 12

creatinine clearance

Question 13

• Tx the underlying causes
• keep BP within 130/80
• early initiation for renal replacement therapy
• Controlling cardiovascular risk factors
• treating hyperglycemia, managing anemia, smoking cessation, weight loss, and exercise programs as needed
• reduction of salt and alcohol intake

Answer 13

medical management of CKD

Question 14

hardening of the renal arteries

Tx of this includes aggressive anti-hypertensive therapy usually with ACE inhibitors

Answer 14

nephrosclerosis

Question 15

The primary presenting features of an acute glomerular inflammation.

Answer 15

hematuria, edema, azotemia, and proteinuria

Question 16

A rapid loss of function due to damage to the kidneys

Answer 16

Acute kidney injury

Question 17

This type of dialysis is for patients who are acutely ill and require short term dialysis for days to weeks until kidney function resumes and for patients with advanced CKD and ESKD who require long term or permanent renal replacement therapy

Answer 17

hemodialysis

Question 18

The preferred method of permanent vascular access from dialysis. It is created surgically usually in the forearm by joining an artery with a vein.

Answer 18

AVF arteriovenous fistula

Question 19

This can be created subcutaneously interposing a biologic, semi biologic or synthetic graft material between the artery and vein.

• commonly used in patients with diabetes
• Usually in the arm may be on the thigh or chest wall.
• Stenosis, infection and thrombus are common complications

Answer 19

Av graft

Question 20

Anemia, gastric ulcers, uremia, vomiting, hypotension, poor calcium metabolism resulting in bone pain and fractures,SOB, painful muscle cramping, dysrhythimas, air embolism, chest pain, disequilibrum

Answer 20

Side effects of dialysis

Question 21

diet includes restricted protein(1.2 to 1.3 g/kg), sodium(2-3 g), potassium, phosphorus, and fluid intake( amount of urine output plus 500mL)

Answer 21

diet changes for patient on hemodialysis