Concepts Exam #3 Ch 68

Question 1

Causes of decreased renal perfusion

Answer 1

Age (65)
Obstruction (crystals, casts, tumors)
Diuretics (hard on kidneys)
Pressors 
Cyclosporine (toxic to kidneys
Dye (CT dye is toxic to kidneys)
Glucophage (increase risk of lactic acidosis)

Question 2

Normal BUN

Answer 2

7 to 20 mg/dL

Question 3

Normal Creatinine

Answer 3

0.5 to 1.2 mg/dL

Question 4

Prerenal (Patient is dry)

Answer 4

20:1 ratio

Question 5

Renal (Patient has kidney disease)

Answer 5

10:1 ratio

Question 6

Calculation is BUN/Creatinine

Answer 6

If answer is 10 patient is renal, if answer is 20 patient is prerenal

Question 7

Acute Kidney Injury (AKI)

Answer 7

Rapid reduction in kidney function resulting in a failure to maintain fluid and electrolytes

Question 8

azotemia

Answer 8

The retention and buildup of nitrogenous wastes in the blood

Question 9

Hyperkalemia

Answer 9

Peaked t waves, prolonged PR, loss of p-wave, the widened QRS

Question 10

Cardiac Complicatoin

Answer 10

Pericarditis
Pulmonary Edema
Heart failure
Hyperlipidemia

Question 11

Hematologic changes

Answer 11

bleeding

bruising

Question 12

Dietary Restrictions

Answer 12

Low sodium, low potassium, low protein

Question 13

Education needs

Answer 13

Diet, Exercise

Question 14

Nursing interventions

Answer 14

Monitor fluids for overload or decrease
Vital signs
Breath sounds
Monitor electrolytes
Assess for abdominal pain
Monitor hygiene and bleeding

Question 15

Complications of Renal Failure

Answer 15

Neurologic (confusion, peripheral neuropathy)
Cardiovascular (hyperkalemia, dysrrhythmias)
Pulmonary (pleural fusions)
GI (ulcers, malabsorbsion, nausea)
Hematologic (hematuria)
Endocrine (acidosis)
General (muscle weakness)
Psych (denial, dependency, non-compliance)

Question 16

HemoDialysis catheter

Answer 16

Dual or Triple lumen, or AV shunt for temporary access

Question 17

Precautions of pt on Dialysis

Answer 17

Risk for bleeding, dont take blood pressure on same arm as fistula

Question 18

Complications of Hemodialysis

Answer 18

Dialysis disequilibrium syndrome (fluid/electrolyte imbalance)
Infectious disease
Hepatitis B and C
HIV

Question 19

Kidney Transplant Selection Criteria

Answer 19

Age between 2 and 70
Free of medical problems
Donor must have same blood type

Question 20

Pre-Operative Care for Kidney Transplant

Answer 20

Education
Assessment that is in depth
Coordination
Treatment Plans

Question 21

Kidney transplants are …

Answer 21

Not a cure and success depends on immunology response