Exam 2: Fluid and Electrolytes Flashcards

1
Q

Acute Kidney Failure

A

Sudden reduction in kidney function:
Decreased GFR ( normal is 90-120 )
GFR decreased leads to retention of nitro waste
Increased creatinine and BUN
Decreased urine output

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2
Q

Acute Kidney Failure
Urine Output

A

Normal: 30 ml/hour
Oliguria: Less than 0.5
Anuria: Absence
Polyuria: Excess
Uremia: Waste

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3
Q

Acute Kidney Failure
Causes

A

Reduced perfusion to kidneys
Damage to kidney tissue
Obstruction

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4
Q

Acute Kidney Failure
Assessment

A

Assess for:
Urinary output –> decreased
Azotemia
Fluid status –> fluid overload and weight gain can lead to heart failure
Dehydration reduces perfusion
Evaluate vital signs to recognize hypo-perfusion and hypoxemia
-MAP below 65
-HTN
-Tachycardia
-Thready pulse
-SPO2 below 88%

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5
Q

Acute Kidney Failure
Labs

A
  • Increased serum creatinine and BUN
  • Decreased GFR
  • Decreased calcium
  • Metabolic acidosis
  • Abnormal blood electrolytes
  • Hyperkalemia: D/t impaired ability of kidneys to excrete potassium
  • ECG changes –> peaked t waves, widened QRS, ST depression
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6
Q

Acute Kidney Failure
Interventions

A
  • Identify and correct cause!
  • Optimize cardiac output and renal blood flow –> maintain adequate BP
  • Fluid Overload: Fluid restriction, diuretics, dialysis
  • Nutritional support due to catabolism protein breakdown
  • Prevent further injury –> avoid nephrotoxic agents
    : NSAIDS and contrast NO!
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7
Q

Acute Kidney Failure
Interventions

A
  • Hyperkalemia: Limit K+ intake, meds: sodium polystyrene, insulin plus D50, biocarbonate
  • Sodium imbalances: Fluid restrict, diuretics
  • Metabolic acidosis: Biocarbonate, diaylsis
  • AKI can be reversed!
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8
Q

Stage 5 CKD Diet

A
  • Protein restriction
  • Fluid restriction
  • Low sodium
  • Limit phosphate and potassium
  • Inc vit d and calcium `
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9
Q

Stage 5 CKD
Complications

A
  • Anemia
  • Bone health
  • Cardiovascular issues
  • Vit D deficiency
  • Electro imbalances
  • Fluid overload
  • GERD
  • Hypoalbuminemia
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