Chronic Kidney Disease (all but dialysis)

Question 1

What is GFR of Stage 1 CKD?

Answer 1

> or equal to 90

Question 2

What is GFR of Stage 2 CKD?

Answer 2

60-89

Question 3

What is GFR of Stage 3A CKD?

Answer 3

45-59

Question 4

What is GFR of Stage 3B CKD?

Answer 4

30-44

Question 5

What is GFR of Stage 4 CKD?

Answer 5

15-29

Question 6

What is GFR of Stage 5 CKD?

Answer 6

<15 (or dialysis)

Question 7

Manifestations of Stage 1 CKD?

Answer 7

Asymptomatic

Question 8

Manifestations of Stage 2 CKD?

Answer 8

Asymptomatic, possible HTN

Question 9

Manifestations of Stage 3A & 3B CKD?

Answer 9

HTN, otherwise asymptomatic

Question 10

Manifestations of Stage 4 CKD?

Answer 10

Manifestations becoming apparent- dx often occurs here

Question 11

Manifestations of Stage 5 CKD?

Answer 11

“Uremic”

Question 12

Description of Stage 1 CKD

Answer 12

Kidney damage with normal or increased GFR

Question 13

Description of Stage 2 CKD

Answer 13

Kidney damage with mild decreased GFR

Question 14

Description of Stage 3A & 3B CKD

Answer 14

Moderate decreased GFR

Question 15

Description of Stage 4 CKD

Answer 15

Severe decreased GFR

Question 16

Description of Stage 5 CKD

Answer 16

Kidney failure

Question 17

Action plan for Stage 1 CKD?

Answer 17

Diagnose and treat
CVD risk reduction
Slow progression

Question 18

Action plan for Stage 2 CKD?

Answer 18

Estimation of progression

Question 19

Action plan for Stage 3A CKD?

Answer 19

Evaluation and treatment of complications

Question 20

Action plan for Stage 3B CKD?

Answer 20

More aggressive treatment of complications

Question 21

Action plan for Stage 4 CKD?

Answer 21

Prep for renal replacement therapy ( dialysis, kidney transplant)

Question 22

Action plan for Stage 5 CKD?

Answer 22

Renal replacement therapy (if uremia present and patient desires treatment)

Question 23

No longer maintaining F & E homeostasis =

Answer 23

Edema
Hyperkalemia
Hyperphosphatemia
Hypermagnesemia
Metabolic Acidosis

Question 24

No longer rids the body of wastes via urine =

Answer 24

Anorexia
Malnutrition
Itching
CNS changes

Question 25

Decreased production of erythropoietin =

Answer 25

Anemia

Question 26

Decreased activation of Vitamin D =

Answer 26

Renal osteodystrophy

Question 27

How to prevent CKD?

Answer 27

Diagnose and control underlying problems like: HTN & DM | Early detection and treatment of CKD

Question 28

Nursing Problems r/t CKD

Answer 28

``` Excess Fluid Volume Malnourishment Risk for Injury Grieving Risk for Infection Activity Intolerance ```

Question 29

Collaborative Care for CKD (NOT Dialysis)

Answer 29

Prevention: control HTN, DM If needing contrast dye: Acetylcysteine, Force Fluids Monitor nephrotoxic drugs: NSAIDS, aminoglycosides Monitor F & E levels I&Os, daily weight Treat the symptoms

Question 30

Symptoms of CKD

Answer 30

``` Volume Overload Hyperkalemia Metabolic acidosis Mineral and Bone disorders (PO4 and Ca) HTN Anemia Dyslipidemia Malnutrition ```

Question 31

CKD Drug Therapy | Want to treat:

Answer 31

``` Overload Hyperkalemia HTN Mineral and bone disorders Anemia Dyslipidemia Acidosis ```

Question 32

What is the renal diet?

Answer 32

Decreased protein, decreased potassium, decreased sodium (possibly decreased magnesium, decreased phosphorus) and fluid restriction

Question 33

Goals with CKD?

Answer 33

Meet nutritional needs | Meet F & E needs

Question 34

CKD: Teach patient to report:

Answer 34

``` Weight gain > 4lbs Increasing BP SOA Edema Increasing fatigue/weakness Confusion/lethargy ```

Question 35

CKD: Teach alternate ways to reduce thirst:

Answer 35

suck on ice cubes, lemon, hard candy

Question 36

Teach:

Answer 36

medications and common side effects

Question 37

CKD: Teach:

Answer 37

dietary restrictions, dietary modifications, fluid restrictions and fluid intake

Question 38

CKD: Teach importance of :

Answer 38

support and encouragement | r/t lifestyle changes, living with chronic illness, decisions about type of dialysis, etc

Question 39

Important for CKD patients to comply with these 3 things:

Answer 39

Nutritional consult and follow up Good written resources Good support system