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adult health nursing > Kidney Disorders > Flashcards

Kidney Disorders Flashcards

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1
Q

anuria

A

less than 50 ml UOP in 24 hours

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2
Q

oliguria

A

less than 400 ml UOP in 24 hours

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3
Q

what is normal GFR

A

> 60 mL per minute

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4
Q

what is normal BUN

A

6-24 mg/dL

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5
Q

what is normal creatinine

A

0.7-1.3 mg/dL

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6
Q

azotemia

A

abnormally concentrated nitrogen waste in the blood

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7
Q

urinary casts

A

proteins secreted from damaged kidney tubules

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8
Q

what substances are normally filtered by the kidneys?

A

electrolytes - sodium, chloride, potassium, calcium, bicarbonate, magnesium, phosphorous

waste products - urea, creatinine, uric acid

glucose

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9
Q

manifestations of fluid deficit

A

weight loss
decreased skin turgor
dry membranes
oliguria
increased hematocrit and BUN

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10
Q

manifestations of potassium deficit

A

anorexia
paralytic ileus
EKG changes
dysrhythmias

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11
Q

manifestations of potassium excess

A

diarrhea
nausea
irritability
EKG changes
weakness

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12
Q

manifestations of hyponatremia

A

nausea
malaise
lethargy
headache
seizures

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13
Q

manifestations of hypernatremia

A

dry mucous membranes
thirst
dry tongue
fever
disorientation

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14
Q

what is glomerulonephritis?

A

inflammation from antibody complexes being deposited in glomeruli

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15
Q

what can cause glomerulonephritis?

A

GAS
viral infections
autoimmunity

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16
Q

what is the other name for glomerulonephritis?

A

acute nephritic syndrome

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17
Q

manifestations of glomerulonephritis

A

azotemia - high nitrogen waste in blood
hematuria, proteinuria, cola colored urine
oliguria
edema, HTN, flank pain, headache, malaise

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18
Q

lab findings for glomerulonephritis

A

elevated BUN and creatinine
hypoalbuminemia
hyperlipidemia

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19
Q

complications of glomerulonephritis (think fluid excess)

A

hypertensive encephalopathy
heart failure
pulmonary edema

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20
Q

management of glomerulonephritis

A

corticosteroids
hypertension management
antibiotics if caused by infection
protein restriction
sodium restriction
strict I/O, daily weight

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21
Q

what is chronic glomerulonephritis?

A

repeated episodes of acute nephritic syndrome causes kidneys to shrink and develop scar tissue

can progress to stage 5 CKD

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22
Q

symptoms of chronic glomerulonephritis

A

weight loss
fatigue
irritability
headache, dizziness
GI disturbances

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23
Q

treatment of chronic glomerulonephritis

A

dialysis
treat fluid and electrolyte imbalances

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24
Q

what is nephrotic syndrome?

A

glomeruli become more permeable
massive proteinuria

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25
Q

manifestations of nephrotic syndrome

A

hypoalbuminemia -> generalized edema
hyperlipidemia

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26
Q

complications of nephrotic syndrome

A

infection
thromboembolism
AKI
atherosclerosis

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27
Q

what is the cause of polycystic kidney disease?

A

90% of cases are caused by autosomal dominant genetic trait

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28
Q

what is PKD?

A

fluid filled cysts on the kidneys that cause them to enlarge

this is the most common cause of kidney failure

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29
Q

manifestations of PKD

A

abdominal fullness and flank pain
hematuria
polyuria
hypertension
renal calculi
UTIs
proteinuria

30
Q

diagnosing PKD

A

family history
ultrasound
palpation

31
Q

PKD treatment

A

BP control
pain control
dialysis
kidney transplant

32
Q

mortality rate of AKI

A

40-90%

33
Q

what is prerenal AKI?

A

occurs due to hypoperfusion

caused by decreased CO, hypotension, hypovolemia

34
Q

what is infrarenal AKI?

A

occurs due to damage of glomeruli or tubules
can cause acute tubular necrosis

35
Q

what is postrenal AKI?

A

occurs due to urinary obstruction

36
Q

what is the most common category of causes of AKI?

A

prerenal - hypoperfusion

37
Q

what are the four phases of AKI?

A

initiation
oliguria
diuresis
recovery

38
Q

lab findings for AKI

A

elevated BUN and creatinine
decreased GFR
elevated potassium and phosphorus
metabolic acidosis

39
Q

manifestations of AKI

A

dry mucous membranes
anemia
SOB, edema

40
Q

managing AKI

A

fluid balance:
daily weight
I/Os
IVF and blood products
diuretics

41
Q

preventing AKI

A

limit use of contrast agents
take care when using nephrotoxic meds
hydration
shock management
monitor output
assess BUN and creatinine
prevent UTI

42
Q

what causes CKD?

A

diabetes - #1 cause
hypertension - #2 cause
prolonged inflammation
and kidney condition - infections, PKD, kidney stones

43
Q

what is normal GFR?

A

125 mL per minute

44
Q

how are stages of kidney disease defined?

A

percent of normal function
stage 1 - 90% function
stage 2 - >60% function
stage 3 - >30% function
stage 4 - >15% function
stage 5 - <15% function

45
Q

clinical manifestations of CKD

A

anemia
metabolic acidosis
hyperkalemia
sodium and water retention, HTN
calacium and phosphorus imbalance - bone disease
decreased GFR
increased BUN and creatinine

46
Q

CKD treatment

A

control BP and hyperglycemia
treat anemia
smoking cessation
weight loss
decrease sodium, alcohol, nephrotoxic meds
hydration

47
Q

medications for CKD

A

calcium supplement and phosphate binder
antihypertensives
diuretics
erythropoietin

48
Q

renal diet

A

restriction on protein, sodium, potassium, phosphorus
vitamin supplement
fluid restriction

49
Q

hematologic manifestations of ESRD

A

anemia, thrombocytopenia

50
Q

integumentary manifestations of ESRD

A

thin hair and dry flaky skin

51
Q

cardio manifestations of ESRD

A

HTN, hyperkalemia, hyperlipidemia

52
Q

pulmonary manifestations of ESRD

A

crackles, SOB, tachypnea

53
Q

musculoskeletal manifestations of ESRD

A

bone fractures, muscle cramps, loss of muscle strength

54
Q

GI manifestations of ESRD

A

anorexia, ammonia odor

55
Q

schedule for long term dialysis

A

3 days per week - every other day
takes 3-5 hours per session

56
Q

what is the goal of dialysis?

A

remove toxic nitrogen waste
remove excess fluid
correct electrolyte balance

57
Q

what is dialysate?

A

solution that circulates through dialyzer to remove fluids, balance electrolytes, correct acidosis

58
Q

how does AV fistula work?

A

surgically joins artery and vein in forearm
must mature 2-3 months before use
two large-bore IVs are inserted during dialysis

59
Q

what is an AV graft?

A

synthetic graft used to connect artery and vein for hemodialysis

60
Q

what is a hemodialysis catheter?

A

inserted into subclavian or jugular vein for hemodialysis

61
Q

complications of hemodialysis

A

anemia
SOB between treatments
hypotension
NV
muscle cramping
blood loss
air embolism
dysrhythmias
chest pain
neuro - decreased LOC, seizure

62
Q

what is peritoneal dialysis?

A

dialysate inserted into abdomen with catheter, then drained

diffusion and osmosis occurs through the semi permeable peritoneal membrane

63
Q

what should dialysate look like when it is drained out of the abdomen?

A

clear - cloudy is bad

64
Q

what kind of procedure is peritoneal dialysis?

A

sterile procedure

65
Q

what is continuous ambulatory peritoneal diaalysis?

A

dialysate is infused 4-5 times a day, drained after 4-5 hours = 24/7 dialysate

66
Q

what is continuous cyclic peritoneal dialysis?

A

machine provides fluid exchange during sleep

extended dwell time of dialysate during the day, no daytime exchanges

67
Q

acute complications of peritoneal dialysis

A

peritonitis
leakage
bleeding

68
Q

what does it mean if dialysate drainage is cloudy?

A

peritonitis

69
Q

signs and symptoms of peritonitis

A

abdominal pain
hypotension
shock

70
Q

how is peritonitis treated?

A

intraperitoneal antibiotics

71
Q

what are long-term complications of peritoneal dialysis?

A

abdominal hernias
low back pain
anorexia
clots in catheter
CV disease

72
Q

what consideration should be taken with BP meds and hemodialysis?

A

hypotension common during hemodialysis, so BP meds should be held prior

adult health nursing (10 decks)

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