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adult health nursing > Kidney Disorders > Flashcards

Kidney Disorders Flashcards

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
manifestations of nephrotic syndrome
hypoalbuminemia -> generalized edema hyperlipidemia
26
complications of nephrotic syndrome
infection thromboembolism AKI atherosclerosis
27
what is the cause of polycystic kidney disease?
90% of cases are caused by autosomal dominant genetic trait
28
what is PKD?
fluid filled cysts on the kidneys that cause them to enlarge this is the most common cause of kidney failure
29
manifestations of PKD
abdominal fullness and flank pain hematuria polyuria hypertension renal calculi UTIs proteinuria
30
diagnosing PKD
family history ultrasound palpation
31
PKD treatment
BP control pain control dialysis kidney transplant
32
mortality rate of AKI
40-90%
33
what is prerenal AKI?
occurs due to hypoperfusion caused by decreased CO, hypotension, hypovolemia
34
what is infrarenal AKI?
occurs due to damage of glomeruli or tubules can cause acute tubular necrosis
35
what is postrenal AKI?
occurs due to urinary obstruction
36
what is the most common category of causes of AKI?
prerenal - hypoperfusion
37
what are the four phases of AKI?
initiation oliguria diuresis recovery
38
lab findings for AKI
elevated BUN and creatinine decreased GFR elevated potassium and phosphorus metabolic acidosis
39
manifestations of AKI
dry mucous membranes anemia SOB, edema
40
managing AKI
fluid balance: daily weight I/Os IVF and blood products diuretics
41
preventing AKI
limit use of contrast agents take care when using nephrotoxic meds hydration shock management monitor output assess BUN and creatinine prevent UTI
42
what causes CKD?
diabetes - #1 cause hypertension - #2 cause prolonged inflammation and kidney condition - infections, PKD, kidney stones
43
what is normal GFR?
125 mL per minute
44
how are stages of kidney disease defined?
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
clinical manifestations of CKD
anemia metabolic acidosis hyperkalemia sodium and water retention, HTN calacium and phosphorus imbalance - bone disease decreased GFR increased BUN and creatinine
46
CKD treatment
control BP and hyperglycemia treat anemia smoking cessation weight loss decrease sodium, alcohol, nephrotoxic meds hydration
47
medications for CKD
calcium supplement and phosphate binder antihypertensives diuretics erythropoietin
48
renal diet
restriction on protein, sodium, potassium, phosphorus vitamin supplement fluid restriction
49
hematologic manifestations of ESRD
anemia, thrombocytopenia
50
integumentary manifestations of ESRD
thin hair and dry flaky skin
51
cardio manifestations of ESRD
HTN, hyperkalemia, hyperlipidemia
52
pulmonary manifestations of ESRD
crackles, SOB, tachypnea
53
musculoskeletal manifestations of ESRD
bone fractures, muscle cramps, loss of muscle strength
54
GI manifestations of ESRD
anorexia, ammonia odor
55
schedule for long term dialysis
3 days per week - every other day takes 3-5 hours per session
56
what is the goal of dialysis?
remove toxic nitrogen waste remove excess fluid correct electrolyte balance
57
what is dialysate?
solution that circulates through dialyzer to remove fluids, balance electrolytes, correct acidosis
58
how does AV fistula work?
surgically joins artery and vein in forearm must mature 2-3 months before use two large-bore IVs are inserted during dialysis
59
what is an AV graft?
synthetic graft used to connect artery and vein for hemodialysis
60
what is a hemodialysis catheter?
inserted into subclavian or jugular vein for hemodialysis
61
complications of hemodialysis
anemia SOB between treatments hypotension NV muscle cramping blood loss air embolism dysrhythmias chest pain neuro - decreased LOC, seizure
62
what is peritoneal dialysis?
dialysate inserted into abdomen with catheter, then drained diffusion and osmosis occurs through the semi permeable peritoneal membrane
63
what should dialysate look like when it is drained out of the abdomen?
clear - cloudy is bad
64
what kind of procedure is peritoneal dialysis?
sterile procedure
65
what is continuous ambulatory peritoneal diaalysis?
dialysate is infused 4-5 times a day, drained after 4-5 hours = 24/7 dialysate
66
what is continuous cyclic peritoneal dialysis?
machine provides fluid exchange during sleep extended dwell time of dialysate during the day, no daytime exchanges
67
acute complications of peritoneal dialysis
peritonitis leakage bleeding
68
what does it mean if dialysate drainage is cloudy?
peritonitis
69
signs and symptoms of peritonitis
abdominal pain hypotension shock
70
how is peritonitis treated?
intraperitoneal antibiotics
71
what are long-term complications of peritoneal dialysis?
abdominal hernias low back pain anorexia clots in catheter CV disease
72
what consideration should be taken with BP meds and hemodialysis?
hypotension common during hemodialysis, so BP meds should be held prior

adult health nursing (10 decks)

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