Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nur 336 > Kidney/Pudenda - Unit 4 - AKI and CDK > Flashcards

Kidney/Pudenda - Unit 4 - AKI and CDK Flashcards

1
Q

What is acute renal failure?

A

Abrupt loss of kidney function

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute Renal Failure - not reversible. T/F?

A

False - it is if you have prompt medical intervention.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is azotemia?

A

the accumulation of nitrogen and waste products in blood.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is uremia?

A

Azotemia WITH symptoms.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the mortality rate for acute renal failure?

A

50-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the Pre-Renal cause of AKI?

A

Perfusion to kidney’s is decreased (map

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the intra-renal cause of AKI?

A

damage to kidney itself, like acute tubular necrosis (nephrotoxic chemicals, meds, etc), infections (cytomeglovirus), diseases that precipitate vascular changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the post-renal cause of AKI?

A

Obstruction of urinary collecting system - urethral stricture, BPH, bladder cancer, ureteral obstruction, abdominal tumor, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the most common causes of AKI?

A

Medication, hypovolemia, hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some nursing things to watch for with AKI?

A

Watch for low U/O

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 4 phases of AKI?

A

Onset, oliguric, diuretic, recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What happens during “onset” ?

A

Insult - may occur hours or days before oliguria

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What happens during the “oliguric” phase?

A

May lass 7-14 days,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What happens during the diuretic phase?

A

Urinary output greater than 500CC/24 hours. Tubule system unable to concentrate urine, hypovolemia and hypotension, BUN stops increasing, watch for hypovolemia and hyponatremia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens during the recovery phase?

A

Continues until renal function is fully restored, although some permanent loss of possible.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are some symptoms of AKI?

A

sudden or decrease in urine output, low BP, tachycardia, pulmonary edema, kussmaul respirations, anemia, leukocytosis, altered platelet function, decrease in LOC, fluid retention, hyperkalemia, hyponatremia, metabolic acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Should we worry about decreasing the potassium level for AKI?

A

YES

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is sodium bicarb the antidote for K+?

A

Bicarb brings it back out to the cell.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are some dietary things for AKI?

A

Fluid restriction, intake of protein, potassium and sodium is regulated according to blood work, increase intake of carbs.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

When is dialysis indicated?

A

Volume overload, BUN >120, metabolic acidosis, increased potassium w/EKG changes, pericardial effusion, cardiac tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are some nursing considerations for patients with AKI?

A

Daily weight, VS, daily lab, fluid balance, fluid restriction, restrict protein, K+, sodium, fluid, encourage carbs and fats, prevent infection, prevent skin breakdown, emotional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is Chronic Kidney Disease?

A

Progressive irreversible destruction of kidney tissue.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How much damage can the kidney’s handle?

A

75-80%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

ESRD (End-stage-renal-disease) more common in what nationalities?

A

African Americans, Native Americans and Asian Americans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the relationship between chronic kidney disease and diabetes?

A

The vascular damage of DM causes the problems in CKD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are some risk factors for CKD?

A

Acute renal failure, poorly controlled diabeetus, chronic glomerularnephritis, chronic HTN, lupus, polycystic kidney disease, etc.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What happens in stage 1 of CKD?

A

Minimal kidney damage with normal GFR (greater than 90 mL/Min)

28
Q

What happens in stage 2 of CKD?

A

Mild kidney damage with mildly decreased GFR (60-90 mL/min)

29
Q

What happens in stage 3 of CKD?

A

Moderate kidney damage with moderate decrease in GFR (30-60 mL/min) - decreases renal reserve and 50% of nephrons lost - SYMPTOMS can start here.

30
Q

Stage 1-3 of CKD - do diuretics work?

A

Yes

31
Q

Stage 4 CDK - what happens?

A

severe kidney damage with severe decrease in GFR (15-30 ml/min) - renal insufficiency and 75-80% of nephrons lost.

32
Q

What happens in stage 5 CKD?

A

Kidney failure with little or no GFR taking place (less than 15 ml/min) - ESRD - 90-100% nephrons lost.

33
Q

what are some clinical manifestations of CKD?

A

GFR

34
Q

Is hyperkalemia a problem with CKD?

A

YES - give Ca carbonate to protect the heart!

35
Q

What are some meds given for patients with renal failure?

A

Antihypertensives, iron supplements and folic acid, kayexalate (gets rid of K+), erythropoietin alfa (for Hct’s less than 30), alkalizers, vitamin d supplements, stool softeners, diuretics

36
Q

What are the 4 goals of dialysis?

A

remove end products and waste, control potassium, remove excess fluid, correct acid/base balance

37
Q

What is hemodialysis?

A

It’s when you’re hooked up and your blood is filtered. 200-500 ml/hr. 3 x a week for 2-3hours.

38
Q

What’s a fistula for dialysis? what must you feel/hear?

A

It’s when they take a vein/artery and combine them. Takes about 6 weeks to mature. NEED TO HEAR A BRUIT AND FEEL A THRILL!

39
Q

What’s a graft?

A

Dacron shunt placed in arm, leg, or chest.

40
Q

What’s a temporary quinton catheter?

A

Catheter for dialysis used for the short term. Stick in an artery..

41
Q

What is a perm cath?

A

More permanent - 2-4 weeks but can go longer.

42
Q

What should we do before dialysis?

A

Bun, Creat, BP, hold h20 soluble meds, vitals, weight

43
Q

What do we do during dialysis?

A

LOC, vitals, monitor fistula, headache (from pulling fluid too fast)

44
Q

What are some nursing considerations after dialysis?

A

LOC, BP, warm patient, they may be tired, could be cold from vasoconstriction, weight (how much came off)

45
Q

What are some complications of hemodialysis?

A

Clotting/infection of access site, anemia, hypotension, disequilibrium syndrome, sepsis

46
Q

What is disequilibrium syndrome?

A

Caused by rapid exchange of F/E, our blood becomes hypoosmotic - too much fluid in blood so it leaks into CSF causing cerebral edema. N/V, confusion, headache, restlessness, seizures, etc - STOP DIALYSIS, infuse hypertonic solution!

47
Q

What is peritoneal dialysis?

A

Began in the 20’s - uses peritoneum.

48
Q

What is the procedure for peritoneal dialysis?

A
  1. Infuse peritoneum for 30min-2hours.
  2. Dwell (leave it for 30-min-2hours)
  3. Place bag on floor and let it all drain out.
49
Q

What are indications for peritoneal dialysis?

A

Treatment for older clients, those who can’t handle the anticoagulation need for hemodialysis, clients with poor blood vessels, those with infections, etc.

50
Q

What are some contraindications for peritoneal dialysis?

A

H/O multiple abdominal surgeries, etc, recurrent hernia’s, obesity, chronic back pain, severe COPD, cognitive problems, etc.

51
Q

If no fluid comes out for peritoneal dialysis, what do we do?

A

Move the patient, take a laxative, etc.

52
Q

What should we do pre-peritoneal dialysis?

A

Weight, edema, ten-cough catheter, vitals, heart sounds, LOC, Bun/Creat, heating pad, etc.

53
Q

What do we do during peritoneal dialysis?

A

Watch LOC, vitals, drainage (white/yellow/clear = normal, cloudy = infection)

54
Q

Protein is lost during peritoneal dialysis, so patients should have more protein. T/F?

A

TRUE

55
Q

what are the two peritoneal dialysis systems?

A

CAPD (continuous ambulatory peritoneal dialysis - throughout the day, the patient does it)

CCPD (continuous cyclic, the patient hooks up to a machine at night)

56
Q

What are some complications of peritoneal dialysis?

A

Peritonitis, protein loss, flow problems, respiratory distress, access site infections, hyperglycemia, hyperlipidemia, pain

57
Q

What are some complications for renal failure?

A

Hyperkalemia, HTN, seizures, cardiac dysrhythmias, pulmonary edema, infection, acidosis (metabolic), uremia

58
Q

Where do osmotic diuretics (mannitol) work?

A

Proximal tubule

59
Q

Where do loop diuretics (lasix, bumex) work?

A

Loop of henle

60
Q

Where do HCTZ/Zaroxolyn (Thiazide diuretics) work?

A

Distal tubule

61
Q

Where do K sparing diuretics (Aldactone) work?

A

someplace awesome. ha!

62
Q

If a client feels sick, with like the flu, should dialysis be held?

A

NO

63
Q

Where is a transplanted kidney place?

A

Near the hip - it’s more protected and easier to transplant here.

64
Q

Kidney donor - it’s okay if they’ve been dead for a while and have a major infection. T/F?

A

FALSE - soon after death and they can’t have an active infection.

65
Q

After kidney transplant, it’s okay that the urine is pink - T/F?

A

TRUE

66
Q

Why is a patient on a stool softener following a kidney transplant?

A

They have to go through the bowel to get to the kidney.

Nur 336 (26 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions