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Complex Care Concepts > Kidney > Flashcards

Kidney Flashcards

1
Q

Normal urine

A

No blood cells
No plasma
No protein

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2
Q

Glomerular filtration rate

A

Rate that blood is passed through nephron

125ml/min

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3
Q

Factors that increase GFR

A

Elevated BS

Increased protein intake

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4
Q

Mild disease

A

60-89

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5
Q

Moderate disease

A

Below 60

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6
Q

End stage kidney disease

A

15 or less

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7
Q

BUN

A

End product of protein metabolism

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8
Q

BUN normal

A

10-20

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9
Q

Digesting blood

A

GI bleed

Makes BUN rise

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10
Q

If BUN elevated

A

Either have a decrease in kidney function or less fluid

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11
Q

Creatinine normal

A

0.6-1.2

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12
Q

Creatinine

A

Byproduct of anaerobic metabolism in skeletal muscle

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13
Q

If creatinine elevated

A

GFR decreased

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14
Q

Oliguria

A

400 or less in 24 hours

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15
Q

Anuria

A

100 mL or less in 24 hours

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16
Q

Azotemia

A

Build up of nitrogenous wastes in blood

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17
Q

Uremic frost

A

White crystals that appear on skin composed of urea

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18
Q

Prerenal

A

Deceased blood supply

Shock, dehydration, vasoconstriction

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19
Q

Intrinsic

A

Kidney tubule function is decreased

Ischemia, toxins, intratubular obstruction

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20
Q

Postrenal

A 
Urine flow is blocked 
Stones
Tumors
Enlarged prostate
Catheter
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21
Q

When to report urine output

A

Less than 0.5/kg/hr for two hours

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22
Q

Onset (initiation) phase of AKI

A

Normal perfusion is abruptly diminished-hours to days

No symptoms yet

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23
Q

Oliguric phase of AKI

A

Urine output less than 400ml/24 hours
1-7 days
Lasts 1-3 weeks
Collection of debris/wastes/h2o in tubules

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24
Q

Oliguric phase labs

A 
Increased 
Creatinine 
BUN
K+
Phosphorus 
Mag
Sodium 
All masked by fluid retention
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25
Q

Diuretic phase of AKI

A 
Movement towards recovery 
Starts 2-6 weeks 
Lasts 1-3 weeks 
Renal perfusion and GFR increase 
LARGE DILUTE URINE 
Risk for dehydration and electrolytes 
10L/hr
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26
Q

Recovery phase of AKI

Convalescent phase

A

Takes up to a year

Damage does not grow back

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27
Q

Signs and symptoms of AKI

A 
Weight gain 
Decreased urine output 
Fluid volume overload 
Nausea 
HA, confusion 
Cramps, twitching 
Dysthymia
28
Q

Drug History that may lead to AKI

A

NSAIDS
Antibiotic
Some antifungals

29
Q

Treatment for AKI

A 
IV fluid challenge 
Calcium channel blockers 
Bicarbonate  infusion 
Renal diet 
Dialysis
30
Q

More drugs that hurt the kidney

A

Acetylcytetine
Dopamine
Diuretics

31
Q

Renal diet

A

Stay away from
Potassium
Sodium
Phosphorus

32
Q

Prevention and health maintenance

A

Avoid hypotension
Monitor labs
Monitor weight
Use touch nephrotoxic drugs

33
Q

Nursing care in AKI

A

Monitor fluid balance
Labs
Maintain MAP of 65
Educate

34
Q

Causes of CKD

A

Diabetes
HTN
AKI
Genetic

35
Q

CKD

A

Progressive, irreversible kidney injury
GFR 15 or less
Azotemia
Uremia

36
Q

Renal filtering function decreases fluid and electrolytes

A

Acidosis
Hyperkalemia
Hypertension

37
Q

Wastes build up in blood

Toxic to CNS, RBCs, platelets

A

Increased creatinine and BUN

38
Q

Kidney metabolic functions decrease

A

Erythropoietin

Vitamin D activation

39
Q

No symptoms of CRF until

A

75-80% loss of nephrons

40
Q

Chronic renal failure GFR

A

Less than 60ml/min for 3 months or more

41
Q

CRF difficult to diagnose

A

Healthy nephrons enlarge to compensate

42
Q

Stage 1

A

At risk

Greater than 90

43
Q

Stage 2

A

Mild 60-89

44
Q

Stage 3

A

Moderate 30-59

45
Q

Stage 4

A

Severe 15-29

46
Q

Stage 5

A

End stage

Less than 15

47
Q

Stage 2…..

What to do?

A

Control risk factors
No NSAIDS
No ACE/ARBS

48
Q

What happens to patient at stage 2

A 
75-90% loss
Polyuria
Nocturia 
Hyponatremia 
Increase in BUN
May be diet controlled
49
Q

Stage 3, what to do?

A

Same as #2

50
Q

Stage 4 what to do?

A

Initiate AV fistula

51
Q

RRT is considered for

A

Fluid overload
Really bad hyperkalemia
Symptoms from azotemia

52
Q

Stage 5, what to do ?

A

More than 90% loss
Hyperkalemia kills them
Death without transplant or RRT

53
Q

CKD manifestations

A

Kidney changes
Metabolic changes
Electrolyte changes

54
Q

Calcium can not be

A

Absorbed from food due to decrease production of vitamin D, also stimulated by kidneys

55
Q

Calcium is reabsorbed from the bones to

A

Balance the loss in the blood and pH of blood

Also need for muscle contraction

56
Q

Phosphate binders

A

Eat with food to decrease phosphorus

Keeps calcium up and bones in better shape

57
Q

Calcium and blood

A

Calcium is needed for clotting cascade

58
Q

Uremia manifestations

A 
Metallic taste in mouth
Anorexia
Nausea
Vomiting
Muscle cramps
Uremic frost
Itching
Fatigue
Hiccups
Edema
Dyspnea 
Paresthesias
59
Q

Creatinine

A

Comes from proteins in skeletal muscle

60
Q

BUN levels

A

Vary with protein intake

61
Q

Renal osteodystrophy

A

Less vitamin D from kidney= less calcium
Increased phosphorus
Increased parathyroid hormone
Bone mineral loss

62
Q

Pericarditis

A

Occurs with CKD

Pericardial sac becomes inflamed from toxins

63
Q

Decreased erythropoietin levels

A

Decreased RBC lifespan

Decreased platelets

64
Q

Calcium channel blockers best for

A

Improve GFR

65
Q

ACE inhibitors best for

A

Slow progression of pts with CKD and hypertension

Complex Care Concepts (25 decks)

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