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Nursing IV > Chronic Renal Disease (Gas#7) > Flashcards

Chronic Renal Disease (Gas#7) Flashcards

1
Q

Uremia

A

intoxication caused by the bodys accumulation of metabolic by-products normally excreted by healthy kidneys

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2
Q

Non traditional risk factors of CRD

A

inflammation of kidneys (lupus), mineral-bone disorder that causes demineralization of bone, Anemia

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3
Q

What is BUN a measurement of

A

nitrogenous waste product of protein metabolism

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4
Q

what ratio do we look at when looking for renal function?

A

Bun & creatinine

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5
Q

what is creatinine a measurement of

A

a waste product of muscle metabolism

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6
Q

what follows diabetes as a major cause of ESRD?

A

HTN

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7
Q

s/s of patients at RISK for decreased renal reserve

A

nephrons that are unaffected compensate for the nephrons that stopped working, kidney function is 75+, BUN &Creatinine are normal, client is asymptomatic

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8
Q

s/s of patients who have renal insufficiency

A

kidney function is 15-74%, decreased urine concentration & erythropoeitin 9youll see anemia), polyurina, azotemia, HTN, increased BUN&Creatinine

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9
Q

s/s of patients who have renal failure

A

kidney function is <15%, sharp increase in BUN&Creatinine, hypocalcemia, increasing azotemia, metabolic acidosis, fluid overload, possible blood in urine

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10
Q

s.s of patients who have ESRF

A

kidney function <5%, kidney atrophy &fibrosis, overt uremia, must have dialysis

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11
Q

s/s of early uremia

A

N/V, weakness, fatigue, symptoms dismissed as viral infection or flu

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12
Q

2 major things you have to worry about if pt has uremia

A

fluid volume excess & metabolic acidosis

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13
Q

s/s of uremia progressing

A

decreased calcium & increased phosphate, bone tenderness, muscle weakness, pain, spontaneuos fractures, neurologic effects, tetany, seizures, restless leg syndrome

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14
Q

skin s/s of CRD

A

pale, grayish-bronze color, dry scaly, severe itching, bruise easily, uremic frost

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15
Q

eye s/s of CRD

A

visual blurring, blindness

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16
Q

fluid & electrolyte s/s of CRD

A

volume expansion & fluid overload, change in urine specific gravity, metabolic acidosis

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17
Q

what things will you see on an EKG with a K+ level of 6-7.5?

A

absent pwave & peaked twave

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18
Q

what things will you see on an EKG with a K+ level of >7.5

A

vtach or vfib

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19
Q

treatment for hyperkalemia?

A

kayexalate with sorbitol, IV calcium, Glucose &insulin &bicarbonate

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20
Q

with hperphosphatemia, is calcium levels increased or decreased

A

decreased, parathyroid hormone releases ca++ from the bone & deposits it in the kidneys, lungs. muscles, heart & eyes

21
Q

GI s/s of CRD

A

uremic fetor (oder), anorexia, n/v, GI bleeding

22
Q

hematologic s/s of CRD

A

anemia, platelet dysfunction

23
Q

Treatment for Anemia b/c of CRD

A

Epogen, folic acid, iron supplements, multivitiam, transfusions

24
Q

treatment for HTN b/c of CRD

A

diuretics, ACE inhibitors (or any antihypertensive)

25
Q

nervous system s/s of CRD

A

mood swings, impaired judgement, inability to concentrate & perform simple math functions, trmors, twitching, convulsions, peripheral neuropathy

26
Q

With ESRD, which nervous system s/s is a big one for ESRD

A

depression

27
Q

musculoskeletal s/s of CRD

A

muscle cramps,, soft tissue calcifications, weakness, renal osteodystrophy

28
Q

heart/lungs s/s of CRD

A

HTN, CHF, pericarditis, pulmonary edema, pleural effusion, atherosclerotic vascular disease, dysrhythmias

29
Q

Endocrine s/s of CRD

A

erythropoietin production decreased, hypothyroidism, insulin resistance, growth hormone decreased, gonadal dysfunction, parathyroid hormone & vit D, hyperlipidemia

30
Q

which electrolytes are highly effected by diuretics

A

sodium, magnesium, calcium, potassium

31
Q

Onset of IV diuretics

A

10-15 min

32
Q

onset of PO diuretics

A

30-45 mins

33
Q

diuretics can make you metabolic acidosis or alkalosis?

A

metabolic alkalosis

34
Q

what are you at risk for when pushing lasix too fast?

A

toxicity

35
Q

side effects of diuretic: spirolactone

A

hyperkalemia, gynocomastia, hyponatremia

36
Q

usually if K+ is low what else is low

A

mg

37
Q

what can be given to correct acidosis

A

sodium bicarb or calcium carbonate may be given

38
Q

what can be given to correct hyperphosphatemia/hypocalcemia

A

phosphate binders (give with meals) or vitamin D supplements to increase calcium absorption

39
Q

protein recommendations for CRD

A

moderate protein slow progression of CRD & reduces uremic symptoms

40
Q

carb recommendations for CRD

A

carb intake is increased to maintain energy requirements

41
Q

water recommendations for CRD

A

limited to 1-2 liters/day; if dry mouth give hard candy or cough drops

42
Q

sodium recommendations for CRD

A

2 grams/day

43
Q

restrictions for GFR that is <10-20

A

K+ and phosphorus is restricted, avoid salt substitutes b/c they are high in K+ & phosphorus

44
Q

what are salt substitutes high in?

A

K+ & phoshorus

45
Q

Polycystic kidney disease

A

hereditary disease, cysts cover kidneys, renal blood vessels & nephrons are obstructed & compressed & functional tissue is destroyed & replaced with fluid filled cysts

46
Q

in Autosomal dominant polycystic kidney disease what percentage of their kids will have it?

A

50%

47
Q

Autosomal recessive polycystic kidney disease

A

present at birth. RARE

48
Q

s/s of PKD

A

abd/flank pain, hematuria, proteinuria,polyuria, nocturia, HTN from isruption of renal vessels, UTI & renal calculi are common

49
Q

symptoms of PKD usually start at what age?

A

40-50

Nursing IV (20 decks)

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