Kidney Function

Question 1

Acute Kidney Injury

Answer 1

rapid reduction in renal function resulting in a failure to maintain fluid, electrolytes, and acid base hemostasis

Question 2

Changes in labs during AKI

Answer 2

increase in BUN, increase in creatinine, decreased GFR, increased azotemia

Question 3

Changes in I&Os in AKI

Answer 3

oliguria (decreased urine output)

Question 4

Medical diagnoses that increase risk of AKI

Answer 4

pre-existing CKD, renal problems, heart disease, diabetes, HTN

Question 5

Medication use that increase risk of AKI

Answer 5

NSAID, ace inhibitor, diuretics, contrast dyes

Question 6

Why does old age increase risk of AKI

Answer 6

loss of nephrons

Question 7

Medical situations that increase risk of AKI

Answer 7

post surgical, trauma, hypotensive episodes, septic shock (major cause)

Question 8

Prerenal AKI

Answer 8

inadequate blood flow to the kidneys

Question 9

Causes of prerenal AKI

Answer 9

decreased CO, blood shunted from kidneys, low volume due to blood/fluid loss, decreased perfusion from sepsis/meds, occlusion to kidneys

Question 10

Causes of intrarenal AKI

Answer 10

acute tublar necrosis!!!, nephrotoxic agents

Question 11

Post renal AKI

Answer 11

obstruction in the urinary tract

Question 12

Post renal AKI causes

Answer 12

stones, tumor, BPH, clots

Question 13

What is the absolute minimum urine output

Answer 13

30mL/hr

Question 14

Oliguria measurement

Answer 14

<20mL/hr, <500mL/day

Question 15

Anuria measurement

Answer 15

<100mL/day

Question 16

Common electrolyte imbalance with AKI

Answer 16

hyperkalemia

Question 17

What type of acid base imbalance is common with AKI

Answer 17

metabolic acidosis due to renal tubules not being able to excrete hydrogen ions and reabsorb bicarbonate

Question 18

Purpose of renal replacement therapy

Answer 18

ultrafiltration, removal of excess fluid, removal of waste

Question 19

What is the most aggressive and quick type of hemodialysis

Answer 19

intermittent hemodialysis

Question 20

Common venous sites for dialysis

Answer 20

internal jugular, femoral veins

Question 21

What common venous site poses the greatest risk for stenosis/thrombosis

Answer 21

subclavian vein

Question 22

Diet while on dialysis

Answer 22

increase carbs, limit protein and fluids

Question 23

Complications of dialysis

Answer 23

hypokalemia, dehydration

Question 24

Arteriovenous fistula

Answer 24

graft between artery and vein for long term/permanent dialysis access

Question 25

Considerations for fistulas

Answer 25

no bp or blood draws on arm with fistula, avoid tight clothing, thrill and bruit assessments daily, CMS assessments

Question 26

Peritoneal dialysis

Answer 26

dialysis is introduced through tenckhoff cath, done at home, risk of periotnitis, used for chronic kidney disease

Question 27

Chronic kidney failure

Answer 27

occurs when the kidney cannot remove waste or perform regulatory functions for at least 3 months

Question 28

What is the best measure of kidney function

Answer 28

GFR

Question 29

Clinical manifestations of CKD

Answer 29

anemia, metabolic acidosis, calcium/phosphorus imbalances but asymptomatic until later stages

Question 30

Uremia

Answer 30

kidney function declines to the point that all body systems are affected because waste products are not taken care of properly

Question 31

When is dialysis required

Answer 31

CKD

Question 32

What affects respiratory function with CKD

Answer 32

hypoxia associated with anemia