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Module 4 > CKD > Flashcards

CKD Flashcards

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
Why is citrus or orange juice contraindicated in pt with renal failure
Has 480 mg of potassium per serving
26
What foods should you avoid in ckd
High in potassium , fats and alcohol
27
What foods should we stress CKD eat
Fruits, veggies, fat free or low fat milk and milk products whole grains, fish , poultry, beans , seeds and nuts
28
CKD with phosphorous and calcium
high phosphorous =low calcium Monitor for bone disease(CKDMBD)
29
10% ca glutamate
First line treatment when there is ekg changes seen renal pt
30
CKD erythropoietin
Makes less results in anemia so watch for anemia
31
IV glucose and urine
Can bring down potassium
32
Sodium polystyrene sulfonate
Helps excrete potassium
33
What else may be need CKD
Dialysis
34
Why should you not infuse potassium fast
Lethal injection
35
Antihypertensive drugs
Ace & arbs
36
MBD
Calcium and phosphorous out of control Affects most people with kidney failure recieving dialysis in end stage
37
When do you start restricting phosphorous in pt
Till we start seeing it in the lab
38
When we start seeing phosphorous labs out of control what do we use
Phosphorous binders Supplement vitamin d Avoid aluminum prep ( antacids and other products that contain aluminum, Deo (rare))
39
Phosphate binders
Calcium acetate (phoslo) Calcium carbon (Caltrate) Bind phosphate in bowel and excrete Sevelamer hydrochloride
40
phosphate binder sevelamer hydrochloride
Lowers cholesterol , ldl and phosphate
41
Anemia drug therapy
Erythropoietin epoetin Alfa Helps increase Hgb and Hct in 2-3 weeks Glycoprotein hormone EPOstimulates the bone marrow to increase RBC production
42
Side effects of epoetin Alfa
Thromboembolism Hypertension
43
When epoetin Alfa is administer what should we also supplement with
Iron, folic acid, vit b12
44
Iron supplements
Use if plasma ferritin level is less than 100 (abnormal lab) Causes gastric irritation , constipation Makes stool dark in color
45
Folic acid supplements
Needed for RBC formation Removed by dialysis
46
Blood transfusions
Anemia Try to avoid Increase the develop of antibodies May lead to iron overload
47
What happens when blood transfusion increases the development of antibodies
Makes it harder to find something compatible for them
48
If pt is recieving several blood products and not in ESRD and just in CKD
We can give LASIX in between. ESRD - blood transfusion does in dialysis so they can monitor fluid
49
Drug toxicity
Digoxin Diabetic agents Antibiotics Insulin Opioid medication
50
Furosemide
Most frequently used loop diuretic PO,IV,IM
51
Oral admin furosemide
Diuresis begins within 60 min -persist 8 hours
52
Iv admin
Diuresis begins within 5 min and last 2 hours
53
When do you use IV furosemide
Critical situations(pulmonary edema)
54
Pt with acute or chronic kidney disease with med overdose
Sent down to dialysis to pull it out
55
CKD-MBD
Monitor for bone disease

Module 4 (47 decks)

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