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Critically Ill > Hemodialysis > Flashcards

Hemodialysis Flashcards

1
Q

What are indications for RRT if someone has a AKI?

A

A: Acid-base abnormality
E: electrolyte imbalances
I: intoxications
O: fluid overload
U: uremia, increased BUN

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2
Q

When do we start planning for RRT in patients with CKD?

A
  1. stage 4
  2. GFR <30
  3. graft preparation/ education
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3
Q

What are the primary indicators for beginning RRT?

A
  1. serositis
  2. acid/base abnormalities
  3. puritus
  4. inability to control volume status/BP
  5. Deterioration of nutritional status/ anorexia
  6. N/V
  7. declining serum albumin
  8. cognitive impairment
  9. GFR<15
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4
Q

What are the 3 options for RRT?

A
  1. HD
  2. peritoneal dialysis
  3. kidney transplant
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5
Q

How long does it take for an AV fistula to mature before using for HD?

A

1-2 months

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6
Q

How long does it take for an AV graft to mature before using for HD?

A

2-3 week

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7
Q

What is the least desirable HD access?

A

Venous HD Catheter

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8
Q

What method of dialysis removes fluid and wastes in a slow manner that is less likely to cause hypotension?

A

Continuous Renal Replacement Therapy (CRRT)

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9
Q

What are complications with peritoneal dialysis (at home)?

A
  1. exacerbation of DM
  2. chemical peritonitis
  3. malnutrition
  4. hernias
  5. Hemorrhoids
  6. back pain
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10
Q

What are reliable references for drug dosing in renal impairment?

A
  1. Drug Prescribing in renal failure ( green book)
  2. Goodman and Gilman’s
  3. American Hospital Formulary Service Drug Information
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11
Q

Which drugs are dosed according to CrCl using actual body weight?

A
  1. Dabigatran
  2. Dofetilide
  3. Edoxaban
  4. Pemetrexed
  5. Xarelto
  6. Betrixaban
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12
Q

What drugs are dosed according to GFR using MDRD?

A
  1. Glipizide
  2. Glimepiride
  3. Metformin
  4. Alogliptin
  5. Saxagliptin
  6. Sitagliptin
  7. SGLT2i
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13
Q

What factors lead to drugs more likely being removed during dialysis?

A
  1. smaller molecules
  2. large Vd
  3. higher blood flow rate
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14
Q

What factors lead to drugs being less likely being removed during dialysis?

A

highly protein-bound drugs

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15
Q

What principle of dialysis utilizes positive pressure on the blood side of the semi permeable membrane and negative pressures on the dialysate (filtrate side of the membrane to force water out of the patient during dialysis treatment?

A

ultrafiltration

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Critically Ill (20 decks)

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