Kidneys

Question 1

Pathological processes involved with AKI:

Answer 1

Hypovolemia and decreased renal blood flow
Ischemia
GFR is lowered
Decreased intratubular fluid flow.

Question 2

3 Phases of Acute tubular necrosis

Answer 2

1) initiation,
- Increased Cr, BUN and decreased urine output.

2) maintenance
- Can be anuric, oliguria or nonoliguric
- Urinary changes influid and electrolyte abnormalities and uremia

3) recovery
- Return of BUN, Cr. And GFR towards normal.
- May have a diuretic phase where there is fluid and electrolyte abnormalities

Question 3

Acute Kidney Injury Goals

Answer 3

• eliminate the cause, manage the signs and symptoms and prevent complications.
• Loop or osmotic diuretics
Intake and output
• Treatment of hyperkalemia
• Renal Replacement Therapy (RRT)
• Nutritional therapy

Question 4

Aging and Acute Kidney Injury

Answer 4

• less nephrons
• reduced compensation for changes in fluid volume
• Impaired function of other organ systems

Question 5

Chronic Kidney Disease Treatment

Answer 5

• Correction of extracellular fluid volume overload or deficit
• Nutritional therapy
• Erythropoietin therapy
• Calcium supplementation, phosphate binders
• Antihypertensive therapy
• Measures to lower potassium
• Adjustment of drug dosages to degree of renal function
• Drugs for: HYPERKALEMIA and hyperglycemia
Avoid NSAIDS

Question 6

Chronic Kidney Disease Nutrition

Answer 6

• Protein restriction
• Sodium and fluid restriction
• Potassium restriction
• Phosphate restriction

Question 7

Pathophysiology of Chronic Kidney Disease

Answer 7

• Damage happens to the nephrons

* commonly asymptomatic so not diagnosed till enough nephrons are destroyed

Question 8

CKD symptoms

Answer 8

• blood urea nitrogen (BUN) and serum creatinine levels increase.
• Faulty carbohydrate metabolism is caused by impaired glucose metabolism.
• Elevated Triglyceride
• anemia

Question 9

AKI three phases:

Answer 9

oliguric, diuretic, and recovery

Question 10

AKI Diet

Answer 10

• nrg from carbs/fat
• increase fat consumption
• regulate K/Na

Question 11

CKD Diet

Answer 11

• limit protein
• restricted fluids
• Na/K restriction
• avoid high P
• salt substitutes are often appealing to patients, but they are not acceptable for use because they contain potassium salts

Question 12

Dialysis is initiated when:

Answer 12

The patient’s uremia can no longer be adequately treated with conservative medical management.
The patient’s GFR is less than 15 mL/min/1.73 m2.