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Adult Health 1 Exam > Guided Notes > Flashcards

Guided Notes Flashcards

1
Q

What is Acute Kidney Injury (AKI)?

A

The term used to encompass the entire scope of the syndrome, ranging from a slight deterioration in kidney function to a severe impairment.

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2
Q

What is Acute tubular necrosis (ATN)?

A

The most common intra-renal cause of AKI in hospitalized patients.
Primarily result of ischemia, nephrotoxins, or sepsis.

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3
Q

What is Acute tubular necrosis (ATN)?

A

The most common intra-renal cause of AKI in hospitalized patients.
Primarily result of ischemia, nephrotoxins, or sepsis.

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4
Q

What is Anuria?

A

No urine output, often seen with urinary tract obstructions.

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5
Q

What is Azotemia?

A

An accumulation of nitrogenous waste products (urea nitrogen, creatinine) in the blood.

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6
Q

What is Azotemia?

A

An accumulation of nitrogenous waste products (urea nitrogen, creatinine) in the blood.

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7
Q

What is Chronic Kidney Disease (CKD)?

A

This involves progressive, irreversible loss of kidney function.

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8
Q

What is diuresis?

A

Increased or excessive production of urine.

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9
Q

What is Extracellular fluid (ECF)?

A

Fluid found outside of the cell.

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10
Q

What is Glomerular filtration rate (GFR)?

A

The amount of blood filtered each minute by the glomeruli.
Normal is about 125mL/min

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11
Q

What does hypertonic mean?

A

Higher osmolality than blood.

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12
Q

What IV fluids are hypertonic?

A

D5NS
D51/2NS
D10W
3%NaCl

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13
Q

What are hypertonic fluids used for?

A

To move fluid from cells and interstitial spaces to the vascular space (blood stream).

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14
Q

What does hypotonic mean?

A

Lower osmolality than blood.

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15
Q

What type of IV fluids are Hypotonic?

A

0.45% NS

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16
Q

What are Hypotonic fluids used for?

A

“Blows up cells”
Used to treat cellular dehydration (DKA)

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17
Q

What does isotonic mean?

A

Same osmolality as blood

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18
Q

What type of fluids are isotonic?

A

0.9% NS
Lactated Ringers

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19
Q

What are isotonic fluids used for?

A

Used to expand vascular space.
Used for dehydration, hypovolemia, shock.

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20
Q

What is hypovolemia?

A

Loss of body fluids, inadequate fluid intake, or plasma to interstitial fluid shift
- Dehydration - Loss of water without loss of sodium.

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21
Q

How do we treat hypovolemia?

A

Correct the underlying cause and replace water and electrolytes with oral fluids, blood products, or proper IV solutions.

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22
Q

What is hypervolemia?

A

Excess intake of fluids, abnormal retention of fluids, or interstitial to plasma fluid shift.

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23
Q

What is a symptom of hypervolemia?

A

Weight gain is most common.

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24
Q

How do we treat hypervolemia?

A

Remove fluid without changing electrolyte composition or osmolality of ECF.
Diuretics, Fluid restrictions, Sodium restriction, Removal of fluid to treat ascites or pleural effusion.

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25
Q

What is Oliguria?

A

A reduction in urine output of less than 400mL/day
Is the most common initial manifestation of AKI.

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26
Q

What is Paresthesia?

A

Tickling or pins and needles caused by pressure on or damage to peripheral nerves.

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27
Q

What is tonicity?

A

The capability of a solution to modify the volume of cells by altering their water content.

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28
Q

What is Uremia?

A

A condition involving high levels of waste product in the blood. Likely occurs in final stage of CKD.

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29
Q

What is Diffusion?

A

Movement of molecules through a semipermeable membrane from a higher concentration area to a lower concentration.

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30
Q

What is Active Transport?

A

The process in which molecules move against the concentration gradient. External energy is needed for this process.

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31
Q

What is Omosis?

A

The movement of water down a concentration gradient from a region of low solute to one of high solute.

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32
Q

What is osmotic pressure?

A

The pressure needed to prevent osmosis?

33
Q

What is hydrostatic pressure?

A

The force of fluid in a compartment pushing against a cell membrane or vessel wall.

34
Q

What is oncotic pressure?

A

The osmotic pressure caused by plasma colloids in solution.

35
Q

What major colloids contribute to oncotic pressure?

A

Proteins such as albumin.

36
Q

What is a normal sodium level?

A

135-145mEq/L
A salty burger at lunch time 1:35-1:45”

37
Q

What is a normal Potassium level?

A

3.5-5
“I only really want to buy 3.5-5 bananas at time”

38
Q

What is a normal Calcium level?

A

9-10.5mg/dL
“Call 911!” - this worked better with the range being 9-11 but these are Hajari’s
numbers

39
Q

What is a normal Phosphorus level?

A

3-4.5mg/dL

40
Q

What is a normal Chloride level?

A

95-105mEq/L
“95-105 degrees is perfect swimming pool (chlorine sounds like chloride)
weather”

41
Q

What is a normal Magnesium level?

A

1.3-2.1mEq/L
“You should stop drinking after 1.3-2.1 beers” because hypomagnesemia can
occur with excessive drinking

42
Q

What is a normal BUN level?

A

10-20
10-20 hamburger BUNS for a party

43
Q

What is a normal GFR?

A

90-120
‘If your kidneys work really well you’ll be peeing every 90-120mins”

44
Q

What is a normal creatinine?

A

0.6-1.3
A CREATure would only get a 0.6-1.3 at a beauty pageant’

45
Q

What is a normal specific gravity?

A

1.005-1.030
I have to do a urine test between 10:05-10:30’

46
Q

What is fluid spacing?

A

The term used to describe the distribution of body water.

47
Q

What does first spacing mean?

A

Normal distribution of fluid in ICF and ECF compartments.

48
Q

What does second spacing mean?

A

Refers to an abnormal accumulation of interstitial fluid.

49
Q

What does third spacing mean?

A

Third spacing occurs when excess fluid collects in the nonfunctional area between the cells.

50
Q

What is hypernatremia?

A

Serum sodium above 145
Critical red flag above 160

51
Q

What are causes of hypernatremia?

A

Inadequate water intake
Excess water loss
or rarely sodium gain

52
Q

What are manifestations of Hypernatremia?

A

Restlessness
Lethargy
Seizures
Coma

53
Q

How do we treat a patient with hypernatremia?

A

If the cause is water deficit , replace orally or with IV isotonic solutions such as 0.9%NaCl
If the problem is sodium excess, dilute with sodium free IV solutions and promote excretion with diuretics.

54
Q

What is hyponatremia?

A

A loss of sodium-containing fluids, water excess in relation to the amount of sodium, or a combination of both.
Serum less than 135
Critical red flag less than 120

55
Q

What are common causes of hypnatremia?

A

Diarrhea
Draining wounds
Vomiting
Primary adrenal insufficiency
Can also be caused when giving too many fluids to a patient with kidney disease.

56
Q

What are manifestations of Hyponatremia?

A

Headache
Irritability
Difficulty concentrating
More severe is confusion, vomiting, seizures, and coma.

57
Q

How do we treat hyponatremia?

A

Sodium containing IV fluids
Lactated ringers
NS 0.9% or 3%

58
Q

What should we monitor with hyponatremia?

A

Electrolytes
Vitals
Neuro
Mental status
Headaches
Is&Os
Weights daily
CHF monitor
Musculoskeletal

59
Q

What should we monitor for with hypernatremia?

A

Electrolytes
Vitals
Mental status
Weights
Is&Os
Seizure precautions

60
Q

What is hypokalemia?

A

Serum potassium less than 3.5mEq/L
Critical red flag less than 2.5

61
Q

What are causes of hypokalemia?

A

Inadequate potassium intake
ETOH Abuse
CHF/HTN
GI loss
Renal loss
Diuretics-Loop
Furosemide
Bumex

62
Q

How do we treat hypokalemia?

A

Oral or parenteral potassium
Diets high in K+
Balanced electrolyte solutions
Pedialyte
Sports drinks

63
Q

What are common manifestations of hypokalemia?

A

Changes in cardiac and muscle function.

64
Q

What should we monitor with hypokalemia?

A

Electrolytes
Vital signs - Low BP
Cardiac responses
Heart rhythm

65
Q

What is hyperkalemia?

A

Serum potassium greater than 5
Critical red flag greater than 6

66
Q

What are causes of hyperkalemia?

A

Renal failure - Most common
Metabolic acidosis
Dehydration
Excess intake of potassium
Potassium sparing diuretics
Tissue damage

67
Q

How do we treat hyperkalemia?

A

Insulin - Moves K+ into the cell
D50 - Prevents hyperglycemia caused by insulin
IV calcium gluconate to counteract cardiac effects of potassium
Sodium bicarbonate to treat the acidosis causes when K+ moves into the cell

68
Q

What are manifestations of Hyperkalemia?

A

Fatigue
Confusion
Tetany
Muscle cramps
Paresthesia’s
Weakness

69
Q

What should we monitor for with hyperkalemia?

A

Think electricity
Electrolytes
Cardiac
Musculoskeletal
Peaked t wave/wide qrs
Neuro
Heart rates and rhythms

70
Q

How do we administer IV Potassium?

A

ALWAYS DILUTE and do not give in concentrate amounts.
Never give via IV push or as a bolus
Invert IV bags several times to insure even distribution
Do not add to a hang iv bag

71
Q

What is hypercalcemia?

A

Serum calcium greater than 10.6
Critical red flag 12

72
Q

What are causes of Hypercalcemia?

A

Prolonged immobilization
Dehydration
Cancer
Excess antacid intake

73
Q

How do we treat Hypercalcemia?

A

Eliminate calcium through kidneys via IV fluids
Loop diuretics to promote elimination of calcium

74
Q

What should we monitor with hypercalcemia?

A

THINK MUSCLE RESPONSE
Monitor electrolytes
Vitals
Hypertension
GI N&V
Dysrhythmias

75
Q

What is hypocalcemia?

A

Serum calcium less than 8.2
Critical red flag less than 7

76
Q

What are causes of hypocalcemia?

A

ETOH Abuse
Pancreatitis
Chronic Renal failure
Low vitamin D intake
Lack of weight bearing
Loop diuretics
Hypomagnesemia

77
Q

How do we treat hypocalcemia?

A

Oral calcium carbonate/gluconate
Calcium chloride

78
Q

What should we monitor for with hypocalcemia?

A

THINK MUSCLE RESPONSE
Electrolytes
Vitals
Cardiac output decrease
Hypotension
Dysrhythmias
Neuro

Adult Health 1 Exam (3 decks)

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