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module 4 > CKD > Flashcards

CKD Flashcards

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1
Q

CKD

A

Progressive, irreversible loss of kidney function

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2
Q

Two common causes

A

Diabetes and hyper tension

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3
Q

Risk factors CKD

A

Older than 60
CVD
Diabetes
Ethnicity
Nephrotoxic drugs
Family history
Hypertension

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4
Q

Diabetic nephropathy

A

Damage to the small vessels that supply the Glomeruli due to underlying diabetic condition

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5
Q

Individuals with CKD are frequently

A

Asymptomatic , under diagnosed and untreated

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6
Q

How many stages is CKD

A

5

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7
Q

Stage 1

A

Gfr of 90 or greater

Structural changes that indicate renal damage

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8
Q

Stage 2

A

Kidney damage with mild decrease in gfr

60-89
Undetectable

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9
Q

Stage 3

A

Moderate to poor kidney function

Gfr 30-59

BECAREFUL with nephrotoxic drugs
Will start to see an increase creatine level
Will see this on our labs

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10
Q

Stage 4

A

Moderate to poor kidney function

Prepare pt for renal replacement therapy but pt not there yet
Low potassium diet

Gfr 15-29

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11
Q

Stage 5

A

ESRD
Gfr 15 or less
Renal replacement needed if there is a build up of toxins in the blood and if the pt desires treatment

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12
Q

CKD manifestation

A

Effects every body system
Sodium and fluid balance altered
Altered potassium excretion
Impaired metabolic waste elimination
Neurological symptoms
Altered calcium and phosphorous levels
Metabolic acidosis
Chronic anemia

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13
Q

Serum creatine/bun/potassium

A

Increase in ckd

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14
Q

General sodium rule CKD

A

2 g a day

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15
Q

Creatine clearance

A

Decrease

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16
Q

Serum sodium/calcium

A

Decrease

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17
Q

Co2/hemoglobin& hematocrit

A

Decrease

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18
Q

Overall goal

A

Preserve existing kidney
Reduce risk of CVD
Prevent complications
Provide for pt comfort

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19
Q

Nursing management CVD

A

Nutrition /glycemic control
Fluid management
Meds
Monitor vs and lab values
Monitor I&O and daily weight
Skin care

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20
Q

CRF hemodialysis

A

Evaluate , assess site for latency and s/s of infection do not take bp or obtain blood samples from extremities that has access site

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21
Q

Nutrional therapy

A

Monitor /restrict protien
Fluid restriction
Sodium /potassium restrictions
Phosphate restriction (ESRD)

Maintain good nutrient
Monitor labs

Dietary to help hypertension

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22
Q

Dash diet

A

Lowers bp and red

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23
Q

Periteneal pt diet

A

Increase BP

24
Q

Hemodialysis patient diet

A

Moderate or low protien diet

25
Q

Why is citrus or orange juice contraindicated in pt with renal failure

A

Has 480 mg of potassium per serving

26
Q

What foods should you avoid in ckd

A

High in potassium , fats and alcohol

27
Q

What foods should we stress CKD eat

A

Fruits, veggies, fat free or low fat milk and milk products whole grains, fish , poultry, beans , seeds and nuts

28
Q

CKD with phosphorous and calcium

A

high phosphorous =low calcium

Monitor for bone disease(CKDMBD)

29
Q

10% ca glutamate

A

First line treatment when there is ekg changes seen renal pt

30
Q

CKD erythropoietin

A

Makes less results in anemia so watch for anemia

31
Q

IV glucose and urine

A

Can bring down potassium

32
Q

Sodium polystyrene sulfonate

A

Helps excrete potassium

33
Q

What else may be need CKD

A

Dialysis

34
Q

Why should you not infuse potassium fast

A

Lethal injection

35
Q

Antihypertensive drugs

A

Ace & arbs

36
Q

MBD

A

Calcium and phosphorous out of control
Affects most people with kidney failure recieving dialysis in end stage

37
Q

When do you start restricting phosphorous in pt

A

Till we start seeing it in the lab

38
Q

When we start seeing phosphorous labs out of control what do we use

A

Phosphorous binders
Supplement vitamin d
Avoid aluminum prep ( antacids and other products that contain aluminum, Deo (rare))

39
Q

Phosphate binders

A

Calcium acetate (phoslo)
Calcium carbon (Caltrate)

Bind phosphate in bowel and excrete

Sevelamer hydrochloride

40
Q

phosphate binder sevelamer hydrochloride

A

Lowers cholesterol , ldl and phosphate

41
Q

Anemia drug therapy

A

Erythropoietin epoetin Alfa
Helps increase Hgb and Hct in 2-3 weeks

Glycoprotein hormone
EPOstimulates the bone marrow to increase RBC production

42
Q

Side effects of epoetin Alfa

A

Thromboembolism
Hypertension

43
Q

When epoetin Alfa is administer what should we also supplement with

A

Iron, folic acid, vit b12

44
Q

Iron supplements

A

Use if plasma ferritin level is less than 100 (abnormal lab)
Causes gastric irritation , constipation
Makes stool dark in color

45
Q

Folic acid supplements

A

Needed for RBC formation
Removed by dialysis

46
Q

Blood transfusions

A

Anemia
Try to avoid
Increase the develop of antibodies
May lead to iron overload

47
Q

What happens when blood transfusion increases the development of antibodies

A

Makes it harder to find something compatible for them

48
Q

If pt is recieving several blood products and not in ESRD and just in CKD

A

We can give LASIX in between.

ESRD - blood transfusion does in dialysis so they can monitor fluid

49
Q

Drug toxicity

A

Digoxin
Diabetic agents
Antibiotics
Insulin
Opioid medication

50
Q

Furosemide

A

Most frequently used loop diuretic

PO,IV,IM

51
Q

Oral admin furosemide

A

Diuresis begins within 60 min -persist 8 hours

52
Q

Iv admin

A

Diuresis begins within 5 min and last 2 hours

53
Q

When do you use IV furosemide

A

Critical situations(pulmonary edema)

54
Q

Pt with acute or chronic kidney disease with med overdose

A

Sent down to dialysis to pull it out

55
Q

CKD-MBD

A

Monitor for bone disease

module 4 (47 decks)

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