Kidney Management Flashcards
Fluid and Electrolyte Balance
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
Chronic Kidney Disease
decrease in GFR lasting 3 or more months
Diabetes primary cause of CKD
Risk factors: DM, HTN, and obesity
ESKD
final stage of ESKD retention of uremic waste products need for renal replacement therapies dialysis or kidney transplant
CKD : SYMPTOMS
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
CKD: Dx
Creatinine Clearance 24 hour collection test test to test the amount of creatinine the kidney are able to clear in 24 hours
CKD: Medical Managment
reduce complications tx hyperglycemia , manage anemia , smoking cessation weight loss and excersie program redcue salt and alchol intake and weight loss
CKD: OLDER PATIENTS
alrerations in renal flow and gfr renal clearance risk medication associated changes in renal function
Acute Nephritic Syndrome
with glomerular inflammation , KIDNEY BECOMES LARGE AND EDEMATOUS AND CONGESTED
ACUTE NEPHRITIC SYNDROME: SYMPTOMS
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
ACUTE NEPHTIC SYNDROME: COMPLICATIONS
HT,N ENCEPHALOPATHY HEART FAILURE AND PULMONARY EDEMA MEDICAL EMERGENCY REDUCE BP
Nephrotic Syndrome
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
Nephrotic syndrome : NURSING MANAGEMENT
Same as glomerutios
Renal Cancer
.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
Nephrectomy
Removal of kidney and tumor adernal gland lymph nodes
RENAL ARTERY EMBOLISM
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
Renal Artery Embolization:NURSING MANAGEMENT
Maintain patent urinary tract remove drainage to to get accurate intake and output continuous analgesics inventive spirometery deep breathing
ACUTE KIDNEY INJURY
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)
Prerenal AKI
Caused by volume depletion burns hemmorhage , GI losses hypotension shock sepsis
Intrarenal AKI
Result of actual parenchyma damage to glomeruli or kidney tubules
Postrenal Failure
Urinary tract obstruction Blood clots Calculi Strictures Tumors
FOUR PHASES OF AKI
Initation ,oliguria diuresis and recovery
- Iniatation: oliguria
- Oliguria - increases serum concentration uremia symptoms began
- diureis DEHYDRATION
- RECOVERY
S/s : drowsiness headache , muscle twitching and seizures LOW SPECFIc gravity
Earliest sign of tubular damage is inability to concentrate the urine
ANEMIA
Hemodialysis
A procedure that circulates the patients blood through an artificial kidney daily we to remove waste products and excess fluid
Peritoneal Dialysis
A procedure that uses the patients peritoneal membrane the lining of the peritoneal cavity
Hyperkalemia
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
