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307 Med Surg > CKD > Flashcards

CKD Flashcards

1
Q

Normal GFR rate

A

90mL/min (or more)

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2
Q

what is the GFR calculated by

A

GFR is calculated based on creatinine, clarence level, gender, age,race, and weight

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3
Q

Uria (output)

A

less than <400mL/day

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4
Q

olgiluria

A

urinary output less than <50mL/day

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5
Q

what are the normal phosphate levels?

A

(2.7-4.5mg/dL)

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6
Q

what are normal calcium levels

A

(8.6-10mg/dL)

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7
Q

what are normal magnesium levels

A

(1.6-2.6mg/dL)

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8
Q

what are normal potassium levels?

A

(3.5-5.0mg/dL)

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9
Q

what is the parathyrome?(what is the side effect)

A

the parathyroid is a hormone that stimulates the bones to release calcium from within to fo into the blood to increase the blood serum (makes our bones weak and brittle)

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10
Q

Stage 1 of CKD

A

GFR >90mL/min/1.73

kidney damage with normal or increased GFR

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11
Q

Stage 2 of CKD

A

GFR= 60-89mL/min/1.73

Mild decrease in GFR

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12
Q

Stage 3 of CKD

A

GFR= 30-59mL/min/1.73

moderate decrease in GFR

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13
Q

Stage 4 of CKD

A

GFR= 15-29mL/min/1.73

servere decrease in GFR

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14
Q

Stage 5 of CKD

A

GFR<15mL/min/1.73
end-stage kidney disease of chronic kidney disease
- stage 5 results when the kidneys cannot remove the body’s metabolic wastes or preform thier regulatory functions

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15
Q

what is Anemia and how can it occur in Kidney failure?

A

anemia occurs due to low EPO, hematuria in the blood plus deficiency in other minerals (such as iron, folic acid, vitamin B12, help production)

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16
Q

What is Uremic frost and what causes it?

A

uremic frost is the crystalize patch of the skin (white frost) due to the deposits of urea crystals and waste in the blood

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17
Q

what is Uria?

A

Uria is the waste product from protein breakdown in the liver

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18
Q

what type of signs and symptoms would you see on a patient with high urea and creatinine in their system?

A

you would see nerologic problems and itching

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19
Q

what is creatinine?

A

creatinine is the waste product from the break down of muscle

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20
Q

what do you see in a patient with CKD? ion levels?

A

(high) phosphate
(high) potassium
(high)magnesium
(low) calcium
protein and Hematuria would be present (when is shouldn’t)

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21
Q

high amounts of fluid (hypervolemic) could lead to..

A

a lot of pressure in the heart leading to pulmonary edema and cardiac issues

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22
Q

what are some causes of CKD?

A
  • Diabeties mellitus
  • high blood pressure
  • nephrotoxic drugs
  • polycystic kidney disease
  • infection
  • acute kidney injury
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23
Q

what does diabetes do to the kidneys?

A

due to the uncontrolled hyperglycemia, glucose start to stick to the artery walls resulting in damage supply to the lungs

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24
Q

what does high blood pressure do to the kidney?

A

uncontrolled hypertension= high pressure on artery walls to kidney and become damaged resulting to less blood to nephrons

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25
Q

what are some nursing interventions for uremia?

A

encourage patient to follow a low protein diet due to high amounts of waste in the blood from urea
(you want to have some protein!!! but not high amounts)

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26
Q

what medications could lower the blood pressure?

A

ACE inhibitors “prill”
ARBS “sartan”
MONITER GFR + BP regularly

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27
Q

what could a patient do during the early stage of CKD?

A

control blood pressure + glucose

-take medication to lower blood pressure and protect kidney

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28
Q

during advance stages of CKD what might be recommended to patients?

A

abnormal GFR

  • doing dialysis on a regular schedule
  • kidney transplant
29
Q

what MUST you check for with a patient who has high amounts of urea in their system

A

Asses for nero statues (patient might be at risk of falls)

30
Q

due to the high PH level, what type of respirations might you see present on a patient?

A

Kusmall breathing Metabolic acidosis

31
Q

what might an anemic patient look like?

A

Pallor skin, tired, short production of breath, confused

32
Q

what are some treatments for patients with progressive CKD at risk of low blood sugar intake?

A
  • supplement iron
  • erythropoetien (given subcutaneously) helps stimulate bone marrow
  • blood transfusion
33
Q

due to the low urinary output, as a nurse, what MUST you monitor? and asses for?

A

Monitor intake +output

  • get daily weight (great indicator for fluid retention)
  • swelling status in extremities (abdomen, face)
  • lung sounds “crackles” (pulmonary edema)
  • monitor blood pressure and assessing respiratory status
34
Q

what role does potassium play, and how can that affect the kidney?

A

potassium plays a role in muscle potassium, higher -> high risk for a cardiac event (high T wave)

35
Q

what should a patient with high amounts of potassium avoid?

A

Potassium!! such as potatoes, avocados, strawberries, banana, spinach oranges

36
Q

what is Kayexalate?

A

Medication given orally or rectally which helps lower potassium and exit out the body

37
Q

what ion might be high causing the decrease of vitamin D activation?

A

High amounts of phosphate decreases vitamin D activation (due to the damage of nephrons)

38
Q

what are some treatments for a high amount of phosphate levels?

A

-PHYSICIAN would order calcium carbonate/ calcium acetate (use to bind phosphate in food and excrete in stool)

39
Q

what are phosphate binders and? and what are they given/ what diet should they be on?

A

phosphate binders such as carbonate/ calcium acetate are given 5 minutes before or right after meals to excrete phosphate in food.
-encourage patient to go in a low protein diet ( so no PULTRY, no fish, no, dairy, no nuts, soda, oatmeal)

40
Q

whats the primary leading cause of CKD?

A

Diabetes

41
Q

Whats the secondary leading cause?

A

Hypertension

42
Q

What results in stage 5 in CKD

A

The kidney cannot remove the body’s metabolic wastes or preform their regular Tory functions, thus renal placement therapies are required to sustain life

43
Q

What is GFR

A

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

44
Q

What are some prevention of some CKD complications?

A

Controlling cardiovascular risk, treating hyperglycemia, managing anemia, smoking cessation, weight loss, exercise programs as needed and reduction in salt and alcohol intake

45
Q

What are normal sodium levels?

A

135-145

46
Q

acute kidney injury (AKI)

A

rapid loss of renal function due to damage to the kidneys; formerly called acute kidney injury

47
Q

acute nephritic syndrome

A

type of kidney disease with glomerular inflammation

48
Q

acute tubular necrosis (ATN)

A

type of acute kidney injury in which

there is damage to the kidney tubules

49
Q

anuria

A

total urine output less than 50 mL in 24 hours

50
Q

arteriovenous fistula

A

type of vascular access for dialysis; created by

surgically connecting an artery to a vein

51
Q

arteriovenous graft

A

type of surgically created vascular access for
dialysis by which a piece of biologic, semibiologic, or synthetic graft
material connects the patient’s artery to a vein

52
Q

azotemia

A

abnormal concentration of nitrogenous waste products in the

blood

53
Q

chronic kidney disease

A

kidney damage or a decrease in the

glomerular filtration rate lasting for 3 or more months

54
Q

continuous ambulatory peritoneal dialysis (CAPD)

A

method of
peritoneal dialysis whereby a patient manually performs exchanges
or cycles throughout the day

55
Q

continuous cyclic peritoneal dialysis (CCPD)

A

method of peritoneal
dialysis in which a peritoneal dialysis machine (cycler) automatically
performs exchanges, usually while the patient sleeps

56
Q

continuous renal replacement therapy (CRRT)

A

method used to
replace normal kidney function in patients who are hemodynamically unstable by circulating the patient’s blood through a hemofilter and returning it to the patient

57
Q

dialysate

A

the electrolyte solution that circulates through the dialyzer in hemodialysis and through the peritoneal membrane in peritoneal dialysis

58
Q

dialyzer

A

artificial kidney; contains a semipermeable membrane through which particles of a certain size can pass

59
Q

end-stage kidney disease (ESKD)

A

final stage of chronic kidney disease that results in retention of uremic waste products and the need for renal replacement therapies

60
Q

glomerulonephritis

A

inflammation of the glomerular capillaries

61
Q

hemodialysis

A

procedure during which a patient’s blood is circulated

through a dialyzer to remove waste products and excess fluid

62
Q

nephrotic syndrome

A

type of kidney disease with increased

glomerular permeability and massive proteinuria

63
Q

Most accurate indicator of fluid loss or gain, in an acutely ill patient, is

A

weight

64
Q

A key monitoring tool is monitoring and documenting all

A

intakes and outputs including fluid losses such as diarrhea, pulmonary edema, vomiting.

65
Q

in primary glomerular diseases, what part is involved?

A

glomerular capillaries

66
Q

clinical manifestations of glomerular injury include

A

proteinuria, hematuria, decreased GFR, decreased excretion of sodium, edema, and hypertension

67
Q

nephrotic syndrome

A

changes to the glomerulus due to the leaking of massive amounts of protein

68
Q

Because magnesium levels rise and calcium levels decrease it can affect what? And what should you not give the patient

A

Higher magnesium levels and lower calcium levels could affect the tendon reflects as well as absolutely flexes patience could also be lethargic. So do not give them any magnesium-based anti-acids or laxatives

307 Med Surg (2 decks)

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