Kidney Dysfunction Flashcards
Risk factors for kidney dysfunction
Diabetes, hypertension, nephrotoxic medications
Urine patterns that occur in kidney dysfunction
changes in amount/frequency, pain/burning with urination, duration of the issues
Urine character
odor, color, foamy
Urinalysis
examination of the urine, description of the character, microscopic analysis
Normal urine characteristics
colorless, clear/slightly hazy, yellow to amber in color, pH of 7
Abnormal findings in the urine
WBCs (bladder or kidney infection), protein (glomerular injury), blood/hematuria (infection or kidney stones), glucose, ketones
Urea nitrogen
waste product from the liver breaking down protein
Normal BUN levels
5-20 mg/dL
Azotemia
increased BUN in the bloodstream
What is increased BUN indicative of
decreased GFR, dehydration
Creatinine
product of muscle tissue breakdown
What is creatinine filtered by
the glomerulus
Normal creatinine levels
0.5-1.5 mg/dL
What is increased creatinine indicative of
decreased GFR
What lab value is the most reliable indicator of kidney dysfunction
serum creatinine
What do imaging studies provide information about
renal size and function
What imaging studies can be done to find kidney dysfunction
ultrasound, intravenous pyelography, abdominal x-ray, CT, MRI, biopsy
What is worrisome when using CT/MRI to find kidney dysfunction
contrast is nephrotoxic
What is worrisome when using biopsy to find kidney dysfunction
kidney bleeding because kidneys are very vascular
Diagnostics for kidney dysfunction
urinalysis, blood urea nitrogen (BUN), serum creatinine, imaging
What do medications maintain in cases of kidney dysfunction
pH, BP, RBC production, and fluid balance
What is the last resort intervention for kidney dysfunction
dialysis
Indicators of dialysis
persistent hyperkalemia, uncompensated metabolic acidosis, fluid volume excess, unresponsive to diuretics
Peritoneal dialysis (PD)
peritoneum is filled with solution that pulls wastes and extra fluids from the bloodstream into the abdominal cavity
What is peritoneal dialysis based on
diffusion, high to low concentration
Steps of peritoneal dialysis
instill, dwell, drain
Hemodialysis (HD)
blood is drawn out of the body, passed through a dialyzer to remove excess fluid and solutes, then returned to the patient
What does hemodialysis do to the blood
circulates the entire blood volume through the machine every 15 minutes
How often is hemodialysis done
3 times a week for 4-6 hours
Continuous renal replacement therapy (CRRT)
a slow, gentle process that purifies blood done in the ICU
How does CRRT work
it takes a small amount of blood and circulates it every hour for fluid to be pulled out
When is CRRT used
for patients that are hemodynamically unstable
Why is hypertension a risk factor for kidney dysfunction
constant high pressure can cause problems for the kidneys
Why is diabetes a risk factor for kidney dysfunction
high circulating glucose causes problems for the kidneys
