Kidney Management

Question 1

Fluid and Electrolyte Balance

Answer 1

most accurate indicator of fluid loss or gain in patients are acutely ill is weight . DAILY WIEGHT
I&O, amount of fluid taken in and fluid loss

Question 2

Chronic Kidney Disease

Answer 2

decrease in GFR lasting 3 or more months
Diabetes primary cause of CKD
Risk factors: DM, HTN, and obesity

Question 3

ESKD

Answer 3

final stage of ESKD retention of uremic waste products need for renal replacement therapies dialysis or kidney transplant

Question 4

CKD : SYMPTOMS

Answer 4

elevated creatinine levels indicate as level increase CKD begin
anemia - decreased erythropoietin production by kidney
fluid retention edema and congestive heart failure electrolytes occur HTN

Question 5

CKD: Dx

Answer 5

Creatinine Clearance 24 hour collection test test to test the amount of creatinine the kidney are able to clear in 24 hours

Question 6

CKD: Medical Managment

Answer 6

reduce complications tx hyperglycemia , manage anemia , smoking cessation weight loss and excersie program redcue salt and alchol intake and weight loss

Question 7

CKD: OLDER PATIENTS

Answer 7

alrerations in renal flow and gfr renal clearance risk medication associated changes in renal function

Question 8

Acute Nephritic Syndrome

Answer 8

with glomerular inflammation , KIDNEY BECOMES LARGE AND EDEMATOUS AND CONGESTED

Question 9

ACUTE NEPHRITIC SYNDROME: SYMPTOMS

Answer 9

HEMATURIA, edema, aztoemia(abnormal concentration of nitrogeous gas wasts in blood) and PROTEINURA (excess protein ) may apear cola colored , oliguria
EDEMA AND HTN
H/A malaise and FLANK PAIN CONFUSION AND SEIZUERES

Question 10

ACUTE NEPHTIC SYNDROME: COMPLICATIONS

Answer 10

HT,N ENCEPHALOPATHY HEART FAILURE AND PULMONARY EDEMA MEDICAL EMERGENCY REDUCE BP

Question 11

Nephrotic Syndrome

Answer 11

Type of kidney disease increased GFR permeability and has massive proteinuria
proteinuria, (albumin), hypoalbuminea ,hyperlipdemia , diffuse edema , high serum cholesterol DAILY LOSS of ALBUMIN through the kidneys
S/S: EDEMA soft pitting and commonly around EYES- periorbital, dependent areas (sacrum ankles and hands) and is abdomen (ascites) irritability headache and malaise
NEEDLE BIOPSY
COMPLICATIONS: INFECTION, THROMBOEMBOLISM(renal veins), pulmonary embolism, AKI (hypobolemia) and atherosclerosis (hyperlipidema)
TX: diuretics ACE (proteinuria) lipid lowering

Question 12

Nephrotic syndrome : NURSING MANAGEMENT

Answer 12

Same as glomerutios

Question 13

Renal Cancer

Answer 13

.Routine physical examination as a palpable abdominal mass
S/s: hematuria, pain , MASS FLANK PAIN
1st SIGN : PAINLESS HEMATURIA intermittent and microscopic or continuous or gross . Dull pain in back into perineal area
MESTASIS: weight loss increase weakness and anemia
TX: IV urography renal angiograms MONITOR for dehydration and exhaustion
SURGERY, RADIATION, CHEMO

Question 14

Nephrectomy

Answer 14

Removal of kidney and tumor adernal gland lymph nodes

Question 15

RENAL ARTERY EMBOLISM

Answer 15

Renal artery may be occluded to impeded the blood supply to the tumor
Catheter advanced in renal artery embolizinf materials injected into the artery

Or may have pain localized flank pain abdomen elevated temperature and GI symptoms antiemetic s medications restriction of oral intake and IV fluids are used to treat GI symptoms

Question 16

Renal Artery Embolization:NURSING MANAGEMENT

Answer 16

Maintain patent urinary tract remove drainage to to get accurate intake and output continuous analgesics inventive spirometery deep breathing

Question 17

ACUTE KIDNEY INJURY

Answer 17

Rapid loss of renal function due to damage to the kidney
Metabolic, and fluid and electrolyte I’m imbalances can occur nonoliguria : greater than 800ml and oliguria - less then 0.5 Anuria - less 50mL a day
Reduce blood flow to kidney
Hypovelmia , hypotension , reduce cardiac output and heart failure , obstruction of kidney or lower urinay tract by tumor blood clot or kidney stone
INCREASED BUN CREATNINE and OLIGURIA

HYPOPERFUSION of kidney , intrarenal(actually damage to kidney) postrenal (obstruction of urine flow)

Question 18

Prerenal AKI

Answer 18

Caused by volume depletion burns hemmorhage , GI losses hypotension shock sepsis

Question 19

Intrarenal AKI

Answer 19

Result of actual parenchyma damage to glomeruli or kidney tubules

Question 20

Postrenal Failure

Answer 20

Urinary tract obstruction 
Blood clots 
Calculi 
Strictures 
Tumors

Question 21

FOUR PHASES OF AKI

Answer 21

Initation ,oliguria diuresis and recovery

1. Iniatation: oliguria
2. Oliguria - increases serum concentration uremia symptoms began
3. diureis DEHYDRATION
4. RECOVERY

S/s : drowsiness headache , muscle twitching and seizures LOW SPECFIc gravity
Earliest sign of tubular damage is inability to concentrate the urine
ANEMIA

Question 22

Hemodialysis

Answer 22

A procedure that circulates the patients blood through an artificial kidney daily we to remove waste products and excess fluid

Question 23

Peritoneal Dialysis

Answer 23

A procedure that uses the patients peritoneal membrane the lining of the peritoneal cavity

Question 24

Hyperkalemia

Answer 24

Most life threatening of the fluid and electrolyte changes that occur in patients with kidney disorders of above 5
S/s: irritability abdominal cramping diarrhea parenthesis and generalized muscle weakness
Muscle weakness slurs speech difficulty breathing parr’s thesis. And paralysis

Kayexalate sorbitol dosages May be decrease wotb AKI most medications is eliminated through kidneys

EMERGENCY FLUID and ELECTROLYTE IMBALANCES