Disorders Of Renal Failure & Kidney—USE** Flashcards

Question

What are the hallmark electrolyte imbalances in chronic kidney disease?

Answer 1

Elevated potassium; elevated phosphorus, elevated magnesium; decreased calcium

Answer 2

Accumulation of nitrogenous wastes in the blood

Answer 3

Fatigue, nausea, mental changes, uremic frost

Answer 4

Bruit: whooshing sound Thrill: vibration —Both indicate a patent AV fistula

Answer 5

Headache, confusion, seizures, blurred vision

Answer 6

Elevated antistreptolysin O (ASO) titer

Answer 7

Pink/Cola-colored urine (Hematuria) and foamy urine (proteinuria)

Answer 8

Infection of the peritoneum; major complication of peritoneal dialysis

Answer 9

Nephrectomy

Answer 10

Diabetes mellitus

Answer 11

#2 hypertension #3 Glomerulonephritis

Answer 12

BUN & creatinine

Answer 13

Uremia includes symptoms; azotemia refers to lab findings of nitrogen waste accumulation

Answer 14

Proteinuria, sediment, casts, RBCs, WBCs

Answer 15

Reduced glomerular filtration rate (GFR)

Answer 16

Chest x-ray, echocardiogram, ECG

Answer 17

Tall, peaked T waves

Answer 18

Anasarca, fatigue, HTN, nocturia, dizziness, visual disturbances

Answer 19

Generalized body swelling from fluid retention

Answer 20

Streptococcal infection

Answer 21

Flank pain, fever, chills, malaise, cloudy/foul-smelling urine

Answer 22

Hematuria, proteinuria, pyuria

Answer 23

Increased abdominal girth and palpable kidney enlargement

Answer 24

CAPD (continuous ambulatory) and APD (automated nighttime)

Answer 25

Fever, nausea, vomiting, severe abdominal pain, rigidity, tenderness

Answer 26

DMSA scintigraphy

Answer 27

Acute: sudden infection with inflammation Chronic: recurrent infections leading to scarring

Answer 28

Palatable thrill and auscultated bruit

Answer 29

Disequilibrium syndrome and hypotension

Answer 30

C. Administer subcutaneous erthyropoietin -Erythropoietin helps stimulate RBC production to correct anemia of CKD

Answer 31

C. Palpable thrill and auscultated bruit —A functioning AV fistula will have a bruit and a thrill

Answer 32

B. Notify the provider —Cloudy drainage and pain are signs of peritonitis, a complication requiring immediate attention

Answer 33

B. Acute Glomerulonephritis —Post-streptococcal acute Glomerulonephritis presents with Hematuria, edema, and hypertension

Answer 34

B. Elevated uric acid and BUN, presence of urinary casts —CGN causes progressive nephron damage, increasing waste products and producing casts in urine

Answer 35

C. Tall, peaked T waves —Hyperkalemia causes tall, peaked T waves and can lead to dangerous Dysrhythmias

Answer 36

A. Disequilibrium syndrome —Rapid shifts in solutes can lead to cerebral edema known as dialysis disequilibrium syndrome

Answer 37

B. Flank pain and increased abdominal girth —PKD leads to multiple renal cysts causing abdominal distention and flank pain

Answer 38

C. A DMSA scan reveals structural changes and scarring in renal tissues —A DMSA scan reveals structural changes and scarring in renal tissues

Answer 39

C. Elevated BUN and serum creatinine with minimal urine output —Oliguric phase is marked by sharply decreased urine output and rising nitrogenous wastes

Answer 40

B. Hemoglobin —Erythropoietin stimulates RBC production; monitor hemoglobin to assess effectiveness and avoid overcorrection (>12 g/dL).

Answer 41

B. Vitamin B12 —Vitamin B12 deficiency causes neurological issues like parenthesis and coordination problems, common in renal failure patients

Answer 42

C. Notify the provider of the increased bleeding risk —A platelet count <50,000 increases the risk of bleeding; provider must be notified before any invasive procedure

Answer 43

B. Thrombocytopenia —These are hallmark signs of thrombocytopenia (low platelets), a common side effect of chemotherapy

Answer 44

B. Erythropoietin —Anemia due to impaired erythropoietin production is common in PKD and managed synthetic erythropoietin

Answer 45

C. Sulfamethoxazole —Sulfa drugs, NSAIDs, and aspirin impair platelet function and increase bleeding risk in ITP patients

Answer 46

A. Decreased creatinine clearance, increased BUN and uric acid —Progressive nephron damage causes reduced filtration and retention of nitrogenous wastes

Answer 47

C. Cheese and dairy —Dairy products are high in phosphorus and should be limited to prevent worsening of CKD complications

Answer 48

B. Decrease the rate of ultrafiltration and notify the provider —These are symptoms of dialysis disequilibrium syndrome. Slowing the rate helps reduce cerebral edema

Answer 49

A. Transfusions are avoided to prevent iron overload and antibody formation —Frequent transfusions can lead to iron overload and increase the risk of sensitization before transplant

Answer 50

Goal: client will demonstrate fluid balance as evidenced by stable weight, decreased edema, and normal breath sounds within 72 hours Interventions: Weigh daily: monitors fluid retention or loss accurately Assess lung sounds and monitor for crackles: detects fluid volume & risk for pulmonary edema Restrict fluid and sodium intake as ordered: Reduces fluid volume & helps control blood pressure Monitor intake and output strictly: ensures fluid balance and guides further therapy Administer prescribed diuretics or dialysis as indicated: removes excess fluid & improves respiratory function

Answer 51

Goal: Client will maintain electrolyte balance as evidenced by serum potassium and sodium within normal range Interventions: Monitor serum electrolyte levels daily: Identifies imbalances early, especially hyperkalemia Observe for ECG changes (tall T waves, arrhythmias): Detects early signs of hyperkalemia Administer electrolyte replacement or binders as ordered: Helps normalize levels and reduce complications Restrict food high in potassium and phosphorus: Prevents worsening of imbalances Prepare for dialysis if conservation measures fail: Used to rapidly remove excess electrolytes

Answer 52

Goal: Client will remain free of signs and symptoms of infection throughout dialysis treatment Intervention: Assess AV fistula site for redness, swelling, or drainage: early detection of infection at access site Palpate for thrill and auscultated for bruit each shift: ensures patience and functioning of the fistula Maintain strict aseptic technique when handling catheters: prevents introduction of pathogens Teach client not to sleep or carry heavy items on fistula arm: Prevents damage and clotting of the access site Monitor temperature & WBC count: systemic signs of infection must be promptly addressed

Answer 53

Goal: Client will verbalize improved energy and tolerance to activity within one week Interventions: Assess fatigue level and daily activity pattern: Helps tailor energy-conserving measure Allow frequent rest periods between activities: prevents overexertion and preserves energy Encourage iron-rich foods and vitamin C intake: support hemoglobin synthesis and improves absorption Administer iron supplements as prescribed: corrects iron deficiency and supports oxygen delivery Monitor hemoglobin and hematocrit regularly: tracks effectiveness of treatment and recovery progress

Answer 54

Goal: Client will remain free of active bleeding episodes during hospitalization Interventions: Monitor for petechiae, ecchymosis, and gum/nose bleeding: early signs of hemorrhage in thrombocytopenia Avoid injections, use smallest needle gauge if necessary: minimizes trauma and bleeding Educate client to avoid NSAIDS or aspirin: these impair platelet function further Implement fall precautions: prevents injury that could result in serious bleeding Administer IVIG or corticosteroids as ordered: reduces autoimmune platelet destruction

Answer 55

Goal: Client will verbalize a reduction in pain level to 3/10 with medication and comfort measure Interventions: Assess pain level using 0-10 scale routinely: evaluates response to therapy and need for adjustment Administer prescribed analgesics: controls discomfort from abdominal/flank pain Encourage positioning to relieve pressure (side-lying): minimizes pressure from enlarged kidneys Monitor for sings of cyst rupture or infection: May require urgent intervention Teach client about avoiding contact sports or trauma: prevents potential rupture of cysts

Answer 56

B. Hemoglobin 13.2 —Erythropoietin should be withheld if hemoglobin exceeds 12 due to increased risk for thromboembolic events

Answer 57

C. If my stools turns black, I’ll stop taking the iron —Black stools are a normal and expected effect of oral iron supplements, not a reason to stop

Answer 58

B. Stop the infusion and notify the provider C —These are signs of ototoxicity, a serious side effect of aminoglycosides like gentamicin, especially in renal impairment

Answer 59

B. Ibuprofen —NSAIDs like ibuprofen interfere with platelet function and increase bleeding risk in ITP.

Answer 60

A. Take it with meals —Phosphate binders are taken with meals to bind dietary phosphorus and prevent hyperphosphatemia

Answer 61

C. Frequent transfusions cause cause iron overload and immune sensitization —Erythropoietin is preferred over transfusions to avoid complication like iron overload and alloimmunization

Answer 62

C. Watch for signs of infection and report fever immediately —Prednisone suppresses the immune system, increasing infection risk. Sudden discontinuation can also cause adrenal crisis.

Answer 63

C. iron supplement with beef liver and orange juice —Iron-rich foods plus vitamin C (like orange juice) enhance absorption. Dairy inhibits it

Answer 64

C. Ibuprofen 600 mg PO every 6 hours PRN pain —NSAIDs like ibuprofen should be avoided in CKD due to nephrotoxicity and impaired renal perfusion

Answer 65

C. Absolute neutrophil count of 900 —-Hydroxyurea can cause severe bone marrow suppression; neutropenia <1000 requires immediate evaluation

Answer 66

-Onset phase -Oliguric (anuric) phase -Diuretic phase -Recovery phase

Answer 67

Time frame: 1-7 days Glomerulus decreases the ability to filter blood = decreases urine output Strict I&Os, daily weight, dialysis may be needed until kidney function returns Monitor EKG & labs (watch for hyperkalemia), low-protein diet, limit fluid intake

Answer 68

Time frame: 1-3 weeks Cause of AKI is corrected, gradual increase in urinary output (large amount of diluted urine with electrolytes) Monitor for dehydration & hypokalemia

Answer 69

Time frame: 3-12 months Increase in kidney function Treatment: some develop chronic kidney disease (CKD)—Needs dialysis or kidney transplant

Answer 70

Low protein diet and limit fluid intake

Answer 71

Monitor for dehydration & hypokalemia (potassium under 3.5)

Answer 72

Post-streptococcal Glomerulonephritis

Answer 73

14 days after infection

Answer 74

Presence of fluid in the lungs

Answer 75

Based on the glomerular filtration rate

Answer 76

Stage 1 = Over 90 Stage 2 = 89-60 Stage 3A = 59-45 Stage 3B = 44-30 Stage 4 = 29-15 End stage (ESRD) = under 15

Answer 77

As CKD worsens, GFR decreases because the glomeruli can not function and filter out

Answer 78

Fluid volume excess (hypervolemia) Hypertension Heart failure

Answer 79

Anemia, increased risk for bleeding and amenorrhea

Answer 80

Uremic frost and pruritus due to crystallized urea deposits

Answer 81

Fistula infection or thrombosis

Answer 82

Rare complication caused by rapid removal of urea during the filtration process, leading to neurological symptoms like nausea/vomiting, altered level of consciousness, restlessness, and seizures

Answer 83

Filter waste products from the blood

Answer 84

Dialyzer (artificial kidney) to remove excess fluids and toxins Most common method of dialysis

Answer 85

Blood is filtered —> removing toxins/waste Blood with toxins/waste is brought to the dialyzer (artificial kidney) Clean blood is brought back to the body

Answer 86

Means they need help removing excess waste from the blood; otherwise, waste accumulates and becomes toxic and harmful to the body

Answer 87

Joining an artery and a vein

Answer 88

Joining an artery and a vein using a synthetic graft material. Increased risk for infection due to the synthetic graft insertion

Answer 89

Drains into the peritoneum to remove excess fluids and toxins (Inside the body, fluid gets through the abdominal wall) Can be done at home; performed daily 7x a week

Answer 90

Dialysate is a solution infused into the peritoneal cavity by gravity The clamp is closed on the infusion line, and dialysate dwells for a set amount of time (dwell time) The drainage tube is unclamped, and fluid drains from the peritoneal cavity gravity A new container of dialysate is infused as soon as drainage is complete

Answer 91

Hyperglycemia & peritonitis—which has an increased risk for infection in the peritoneum