F/E Flashcards
Acute weight gain > 5% Edema Crackles SOB Decreased BUN, hct JVD *** NI: fluid/NA RESTRICTION, diuretics, dialysis ***
Fluid volume excess
Nausea Malaise Lethargy Headache Abdm cramps Apprehension Seizures **** NI: diet N/S or hypertonic saline solution***
Hyponatremia
Dry sticky mucous membranes Thirst Rough dry tongue Fever Restlessness Weakness Disorientation **** NI: fluids, diuretics, dietary restriction***
Hypernatremia
Anorexia Abdm distention Paralytic ileus Muscle weakness ECG CHANGES, Dysthymia **** NI: duet, oral or Parental potassium replacement therapy ****
Hypokalemia
Diarrhea Colic Nausea Irritability Muscle weakness ECG CHANGES, Bradycardia *** dietary restrictions, diuretics, IV Glucose,Sodium bicarbonate, cation-resin, calcium gluconate, dialysis ****
Hyperkalemia
Abdominal/muscle cramps Stridor Carpopedal spasms \+ Chovisteks/Trouseau sign Tingling of fingers and around mouth ECG CHANGES **** NI: diet, oral or parental calcium salt replacement ***
Hypocalcemia
Deep bone pain flank pain muscle weakness depressed deep tendons reflexes Constipation Nausea/Vomiting Confusion Impaired memory Polyuria/polydypsia ECG changes **** NI: fluid replacement, etidronate, pamidronate, mithramycin, calcitonin, glucocorticoid, phosphate salts
Hypercalcemia
Describes kidney damage or a decrease in GFR for mor than 3 months
- decrease quality of life
CKD
Cardiovascular disease
**Diabetes
Hypertension
Obesity
Risk factors of CKD
Where kidneys cannot remove body’s metabolic waste or perform their regulatory functions
GFR
Stage 5 CKD
Deep bone pain Flank pain Muscle weakness/pain Parenthesia Apprehension Confusion Seizures
Hypophosphatemia
Tetany Tingling of fingers and around mouth Muscle spasms Soft tissue calcifications **** NI: diet restriction, phosphate binders, n/s solution, dextrose solution, insulin ****
Hyperphosoheptemia
Amount of plasma filtered through the glomeruli per unit time
GFR
Measure of the amount of creatinine the kidneys are able to to clear in a 24 hour period
Creatinine clearance
100-125 CC/min
Normal GFR
135-145 mEq/mL
Sodium
◦uremia metabolic acidosis •Kussmauls ◦hypervolemia (“A”) ◦hyperlipidemia ◦electrolyte imbalance •Na/H2O •Ca/Ph •hyperkalemia
Chem regs ESRD
◦HTN ◦CHF/ edema/pericarditis ◦pleuritic pain/SOB ◦thick secretions ◦Kussmaul’s Respiration ◦lung crackles
Gaseous transfers ESRD
◦anemia ◦bleeding tendencies ◦severe itching –pruritis ◦pallor ◦brittle nails ◦coarse thinning hair
Body defense ESRD
- lethargy, apathy, confusion, coma
- tremors
- peripheral neuropathy, muscle weakness
- restless leg
- seizures
Neurological depression of ESRD
HTN encephalopathy
HF
APE
Complications of glumerulonephritis
HCT less than 30%
Anemia
Less than 500 ml/day
Oliguria
↑ carbohydrates – unlimited sugars to prevent wasting
◦reduction of: •proteins- 40 - 80 g/d •K – 40 mEq •Na - 2000 mg/d •phosphorus/Ca - 500 - 600 mg/d
Management of ESRD
- Chocolate
- Dried fruit, nuts and seeds
- Oranges, bananas, apricots and cantaloupe
- Meat
- Beans, potatoes
- Tomatoes
- Celery
- Mushrooms
Potassium sources
Acute weight loss Decreased skin turgor Dry mucous membranes Oligura/Anuria Increased HCT, BUN, Increased creatinine Hypothermia
Fluid volume deficit
