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Adult 3 Unit 3 No Outside Sources > Kidneys Chronic And Acute > Flashcards

Kidneys Chronic And Acute Flashcards

1
Q

What are benign tumors?

A

Tumors in the wrong place at the wrong time. Shouldn’t cause major problems unless they are big enough to cause organ issues.

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2
Q

Characteristics of benign tumors?

A

Well differentiated, encapsulated, slow growth, no metastasis, does not cause death.

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3
Q

What are malignant tumors?

A

Abnormal tumors that serve no useful purpose and are harmful to normal tissues.

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4
Q

Characteristics of malignant tumors?

A

Undifferentiated, grows and overcomes contact inhibition, metastasizes, generalized effects like anemia and weight loss.

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5
Q

What is primary prevention in cancer?

A

Avoid carcinogens, modify associated factors, practice safe sex, limit alcohol/tobacco use, remove at-risk tissues, chemoprevention, vaccination.

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6
Q

What are some co-factors of cancer?

A

Type 2 diabetes, chronic inflammation, weakened immunity, poor diet, genetics, obesity, oxidative stress, toxins.

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7
Q

Early warning signs of cancer?

A

Change in bowel or bladder habits, sore that does not heal, unusual bleeding, thickening or lump, indigestion, change in wart or mole, nagging cough, unexplained anemia, sudden weight loss.

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8
Q

What are the stages of cancer?

A

0 - carcinoma in situ, I - localized, II - early locally advanced, III - late locally advanced, IV - metastasized.

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9
Q

What does cancer grading indicate?

A

Compares cancer cells to normal tissue: G0(Gx) = undetermined, G1 = well differentiated, G2 = moderately differentiated, G3 = poorly differentiated, G4 = poorly differentiated.

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10
Q

What are the types of surgery in cancer treatment?

A

Control/debulking, cure, diagnostic, prophylaxis, palliation, reconstructive.

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11
Q

What are the nursing priorities for surgery?

A

Preoperative: assess, intervene, support. Postoperative: complications, education, discharge.

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12
Q

What is radiation therapy?

A

External beam radiation is the most common method. Do not directly touch the patient.

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13
Q

What are acute effects of radiation toxicity?

A

Fatigue, hair loss, anorexia, nausea/vomiting, anemia, leukopenia, thrombocytopenia.

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14
Q

What are late effects of radiation therapy?

A

Fibrosis, necrosis to lungs and heart, dysphagia, incontinence, cognitive/sexual dysfunction.

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15
Q

What is chemotherapy?

A

A treatment using drugs to kill cancer cells, with various types including antimetabolites, antitumor antibiotics, and antimitotics.

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16
Q

What is bone marrow suppression?

A

Decreased levels of neutrophils, RBCs, or platelets, leading to increased risk of infection, fatigue, and bleeding.

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17
Q

What are the phases of acute kidney injury?

A

Onset, oliguric (anuric), diuretic, recovery.

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18
Q

What are common manifestations of acute kidney injury?

A

Fluid overload, decreased urine output, wacky electrolytes, shock, and altered mental status.

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19
Q

What is chronic kidney disease?

A

A progressive and irreversible decline in kidney function.

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20
Q

What are the indications for hemodialysis?

A

Severe fluid overload, continued hyperkalemia, metabolic acidosis.

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21
Q

What is peritoneal dialysis?

A

Utilizes the peritoneal cavity as a filter for waste products and fluids.

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22
Q

What is peritonitis?

A

Inflammation/infection of the peritoneal cavity, considered a borderline medical emergency.

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23
Q

What is the importance of lab tests in treatment?

A

Recognizing symptoms through lab results is an important step in treatment.

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24
Q

What are the goals of the lecture?

A

Cover 5 kidney maps, discuss acute kidney injury, chronic kidney failure, and related treatments, and use Kahoot for review questions.

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25
What is acute kidney injury (AKI)?
AKI is synonymous with acute renal failure.
26
What is the difference between acute and chronic kidney failure?
Acute is reversible if treated properly; kidneys can recover. Chronic is permanent kidney failure.
27
What are the functions of the kidneys?
Filtering blood, controlling blood pressure, regulating acid-base balance, drug metabolism and excretion, and producing erythropoietin.
28
What is the cause of pre-renal AKI?
Issues before the kidneys, such as hypovolemia and hypotension.
29
What is the cause of intra-renal AKI?
Direct injury or inflammation of kidney structures.
30
What is the cause of post-renal AKI?
Obstructions in urinary flow after the kidneys.
31
What are the phases of AKI?
Initiation, oliguric phase, diuretic phase, and recovery phase.
32
What occurs during the oliguric phase of AKI?
Reduced urine output, increased BUN and creatinine.
33
What are the lab expectations for AKI?
Electrolyte imbalances: High potassium, sodium (high or low), high magnesium, high phosphorus, low calcium. Elevated creatinine and BUN.
34
What are the manifestations of AKI?
Fluid overload, pulmonary symptoms, metabolic acidosis, Kussmaul's respirations, and mental status changes due to uremic encephalopathy.
35
What are the interventions for AKI?
Early recognition, maintain perfusion (MAP above 65), medications (Lasix, Insulin, Bicarb), and nutrition restrictions.
36
What are the indications for hemodialysis?
Hyperkalemia, metabolic acidosis, and fluid overload.
37
What are the access methods for hemodialysis?
AV fistula, AV graft, and Quentin catheter.
38
What are the post-dialysis interventions?
Check pulses, monitor for bleeding/infection.
39
What are the complications of hemodialysis?
Dialysis disequilibrium syndrome, hypotension, bleeding, and arrhythmias.
40
What are the major roles of healthy kidneys?
1. Filter blood: Remove excess fluid and waste products, maintaining fluid balance and electrolyte levels. 2. Vitamin D metabolism: Important role in vitamin D activation. 3. Blood pressure control: Regulates blood pressure via the renin-angiotensin-aldosterone system. 4. Drug metabolism and excretion: Kidneys play a role in drug excretion. 5. Blood pH regulation: Maintains acid-base balance. 6. Erythropoietin production: Stimulates red blood cell production.
41
What is acute kidney injury (AKI)?
Acute kidney injury (AKI) is also known as acute renal failure and is interchangeable with chronic kidney disease.
42
What are the types of kidney failure?
1. Pre-renal: Caused by decreased kidney perfusion (e.g., dehydration or low blood pressure), most common type (~60%). 2. Intra-renal: Direct injury to kidney tissue, including glomeruli and nephron damage. 3. Post-renal: Obstruction after kidneys, commonly due to urinary obstruction.
43
What are the phases of kidney failure?
1. Initiation: When injury occurs. 2. Oliguria: Reduced urine output (<400 ml/day) with waste buildup. 3. Diuresis: Recovery phase with high urine output; watch for electrolyte depletion. 4. Recovery: Lab levels return to baseline.
44
What are common lab findings in kidney failure?
Electrolyte imbalances include high potassium, magnesium, phosphorus, and low calcium. BUN (10-20) and creatinine (0.6-1.2) are elevated.
45
What are the complications of kidney failure?
Complications include fluid overload, decreased urine output, and electrolyte disturbances.
46
What is the importance of early recognition in kidney failure?
Early recognition involves tracking intake/output, daily weights, and lab monitoring.
47
How is Mean Arterial Pressure (MAP) calculated?
MAP is calculated using the formula: (Systolic BP + 2x Diastolic BP) / 3.
48
What is Furosemide (Lasix)?
Furosemide is a potassium-wasting diuretic; monitor electrolytes and EKG.
49
What is the role of insulin in kidney failure?
Insulin is used for hyperkalemia; it stimulates the sodium-potassium pump.
50
What dietary restrictions should be considered in kidney failure?
Restrict excess potassium, sodium, magnesium, and phosphorus; consider protein intake based on kidney function.
51
What are the characteristics of chronic kidney disease (CKD)?
CKD is progressive and irreversible, characterized by sustained hypertension and congestive heart failure (CHF).
52
What is the significance of GFR in CKD?
GFR is normal above 90; it is low in CKD.
53
What are common interventions for CKD?
Interventions include dialysis (hemodialysis or peritoneal) and strict fluid and dietary restrictions.
54
What is Sodium Polystyrene Sulfonate (Kayexalate)?
Kayexalate treats hyperkalemia by exchanging sodium for potassium in the gut.
55
What is Epoetin Alpha?
Epoetin Alpha is a synthetic erythropoietin used for anemia.
56
What are the indications for hemodialysis?
Hemodialysis is indicated for hyperkalemia, acidosis, and fluid overload.
57
What are the access types for hemodialysis?
Access types include AV fistula, AV graft, and Quinton catheter; monitor for complications like hypotension.
58
What is peritoneal dialysis?
Peritoneal dialysis uses a Tenckhoff catheter and involves phases: Fill, Dwell, Drain. Major complication is peritonitis (cloudy effluent, abdominal pain).
59
What are general complications of dialysis?
General complications include hypotension, infection, bleeding, and arrhythmias.
60
What is a specific complication of peritoneal dialysis?
Peritonitis, characterized by cloudy effluent.
61
What are key points in patient education and management for kidney failure?
Encourage dietary modifications, monitor vital signs and labs regularly, and promote patient understanding of treatment plans.
62
What is Acute Kidney Injury (AKI)?
Reversible; patients can recover fully.
63
What is Chronic Kidney Disease (CKD)?
Irreversible; permanent damage to kidney function. ## Footnote Staged from 1 (mild) to 5 (end-stage).
64
What are common manifestations of CKD related to electrolyte imbalances?
Hyperkalemia leading to arrhythmias and acidosis due to hydrogen retention.
65
What respiratory change is associated with CKD?
Kussmaul's respiration (increased rate and depth).
66
How does CKD affect bone health?
Chronic low calcium leading to risk of fractures.
67
What blood pressure issue is common in CKD?
Hypertension from Renin-Angiotensin-Aldosterone System (RAAS) activation.
68
What heart health risk is associated with CKD?
Congestive Heart Failure (CHF) risk due to fluid overload.
69
What neurological changes can occur in CKD?
Lethargy to comatose states, seizures.
70
How does urinary output change in CKD?
Progressive decline with CKD.
71
What skin changes may occur in CKD?
Uremic frost and yellowing (not jaundice).
72
What is the best indicator of kidney function?
Creatinine; expect elevated levels.
73
What laboratory indicator is elevated in CKD?
Blood Urea Nitrogen (BUN).
74
What is the Glomerular Filtration Rate (GFR) in CKD?
Lower in CKD; normal is above 90.
75
What metabolic condition is expected in CKD?
Expect metabolic acidosis.
76
How does CKD affect Hemoglobin and Hematocrit (H&H)?
Low due to lack of erythropoietin.
77
What is a key treatment for chronic kidney patients?
Dialysis; either hemodialysis or peritoneal dialysis.
78
What is important in fluid management for CKD patients?
Adjust according to patient's fluid status.
79
What medication is used for lower stages of CKD?
Sodium Polystyrene Sulfonate (KXLE).
80
What medication is used to treat anemia in CKD?
Epoetin Alpha; synthetic erythropoietin.
81
What should be monitored daily in CKD patients?
Weight and lab tests.
82
What complication involves pulmonary edema?
Managed with high fowler's position, oxygen, diuretics, and possibly dialysis.
83
What is a concern regarding drug toxicity in CKD?
Monitor dosages, especially for drugs like Digoxin, Phenytoin, certain antibiotics, Ibuprofen, and ACE inhibitors.
84
What dietary consideration is important in early CKD?
Protein should be restricted to lessen kidney strain.
85
What should be monitored in terms of vitamins and electrolytes in CKD?
Supplement vitamins and monitor potassium, sodium, and phosphorus intake.
86
What is a management strategy for pulmonary edema?
High fowler’s position, non-rebreather, diuretics, and possibly intubation.
87
What should be adjusted in renal compromised patients?
Adjust medication dosages.
88
What should patients avoid in terms of antacids?
Avoid antacids rich in magnesium.
89
What should be considered in emergency interventions for CKD?
Consider interventions like positioning and oxygen as simultaneous priorities.
90
What is the primary use of peritoneal dialysis?
Primarily utilized by chronic kidney disease patients.
91
What is a key advantage of peritoneal dialysis over hemodialysis?
Offers a lifestyle choice with flexibility compared to hemodialysis.
92
Where can patients perform peritoneal dialysis?
Patients can perform it at home, leading to greater convenience.
93
How often do patients typically attend hemodialysis sessions?
Patients typically attend sessions three times a week.
94
What is the main mechanism of blood purification in hemodialysis?
Involves a filter (artificial kidney) for blood purification.
95
What type of situations is hemodialysis more suitable for?
More aggressive, suitable for critical situations (e.g., high fluid overload or potassium levels).
96
What is the main filtering method used in peritoneal dialysis?
Uses the peritoneal cavity as a natural filter.
97
What is a key characteristic of peritoneal dialysis compared to hemodialysis?
Less aggressive and slower.
98
What is the access method for peritoneal dialysis?
Through a Tinkoff catheter into the peritoneal cavity.
99
What is the duration of the Fill Phase in peritoneal dialysis?
Takes 5-10 minutes.
100
What occurs during the Dwell Phase of peritoneal dialysis?
Period (3-6 hours) where diffusion and osmosis occurs.
101
What happens during the Drain Phase of peritoneal dialysis?
Waste solution is drained by gravity into a waste bag.
102
What should be monitored in peritoneal dialysis?
Record input and output volumes to ensure no fluid discrepancy.
103
What should be observed for patient tolerance during peritoneal dialysis?
Watch for pain, which might indicate complications like peritonitis.
104
What regular checks are needed for patients undergoing peritoneal dialysis?
Regular checks similar to hemodialysis.
105
What is recommended to prevent discomfort during peritoneal dialysis?
Use a fluid warmer to prevent discomfort and promote better exchange.
106
What is a significant risk associated with peritoneal dialysis?
Peritonitis, which can be an emergency.
107
What are some symptoms of peritonitis?
Pain, tender abdomen, fever, nausea, vomiting.
108
What are indicators of peritonitis?
Cloudy effluent, foul-smelling dialysate.
109
What action should be taken if peritonitis is suspected?
Terminate the procedure and contact healthcare provider.
110
How do chronic and acute patients differ in their dialysis options?
Chronic patients have the choice between hemodialysis and peritoneal dialysis; acute patients typically undergo hemodialysis due to its immediacy.
111
What medication may be used for kidney failure patients experiencing low blood pressure?
Vasopressors may be used.
112
What is emphasized regarding the procedure for peritoneal dialysis?
Emphasize sterile procedure when dealing with catheter and caps.
113
What is important to understand about effluent in peritoneal dialysis?
Ensure proper understanding of effluent and its significance.

Adult 3 Unit 3 No Outside Sources (5 decks)

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