Exam 3

Question 1

End-stage renal disease (ESRD), occurs when?

Answer 1

The GFR is less than 15 mL/min

-Tx: renal replacement (dialysis or transplantation) to maintain life

Question 2

CKD is either?

Answer 2

The presence of kidney damage or a decreased GFR less than 60 mL/min/1.73 m2 for longer than 3 months

Question 3

Uremia

Answer 3

A syndrome in which kidney function declines to the point that symptoms may develop in multiple body systems
-occurs when GFR is 15 mL/min or less

Question 4

Clinical manifestations for CKD seen in the urinary system

Answer 4

• polyuria (diabetes)
• increasing difficulty with fluid retention and require diuretic therapy
• may develop anuria after dialysis

Question 5

Metabolic disturbances seen in CKD

Answer 5

-As GFR decreases, the BUN and serum creatinine levels increase

Question 6

CKD potassium

Answer 6

-Fatal dysrhythmias reported when serum potassium levels reach 7-8 mEq/L

Question 7

CKD sodium

Answer 7

• restricted to 2g/day

Question 8

What type of anemia is associated with CKD?

Answer 8

Normocytic, normochromic

Question 9

CKD: Sufficient iron stores are needed for erythopoiesis.

Answer 9

• Medications such as proton pump inhibitors or phosphate binders decrease absorption.
• Patients on dialysis may require IV iron to restore iron levels
• Folic acid must be supplemented in the diet (folic acid 1mg/day)

Question 10

CKD:

• For patients undergoing dialysis, protein is not routinely restricted. For CKD stages 1-4, many HCPs?
• Dietary protein guidelines for PD differ from those for HD because of?

Answer 10

• encourage a diet with normal protein intake. Teach patients to avoid high-protein diets and supplements because they may overburden the diseased kidneys.
• protein loss through the peritoneal membrane. During PD, protein intake must be high enough to compensate for the losses so that the nitrogen balance is maintained. The recommended protein intake is at least 1.2 g/kg of ideal body weight per day.