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Exam 1 NRS 202 > Management of Patients with Kidney Disorders > Flashcards

Management of Patients with Kidney Disorders Flashcards

1
Q

Acute kidney injury

A

rapid loss of renal function due to damage to the kidneys

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2
Q

What is the greatest indicator of kidney damage in AKI?

A

50% or greater increase in serum creatinine above baseline

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3
Q

Causes of AKI

A

Hypovolemia
Hypotension
Reduced cardiac output
Heart failure
Obstruction of kidney or lower urinary tract
Obstruction of renal arteries or veins
Nephrotoxic agents

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4
Q

3 Categories of an Acute Kidney Injury

A

Prerenal
Intrarenal
Postrenal

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5
Q

4 Phases of an Acute Kidney Injury

A

Initiation
Oliguria
Diuresis
Recovery

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6
Q

Prerenal AKIs are often due to what?

A

Hypoperfusion from shock

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7
Q

Intrarenal AKIs are often due to what?

A

Nephrotoxic drugs or agents

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8
Q

Postrenal AKIs are often due to what?

A

Stone or tumor

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9
Q

How long can recovery take in an acute AKI?

A

up to 12 months

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10
Q

Chronic kidney disease

A

umbrella term that describes kidney damage or a decrease in the GFD lasting for 3 months or more

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11
Q

Untreated CKD leads to what?

A

ESKD

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12
Q

Causes of chronic kidney disease

A

DM
HTN
Chronic glomerulonephritis
Pyelonephritis
Hereditary lesions
Vascular disorders
Medications or toxic agents

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13
Q

What is nephrosclerosis?

A

Hardening of renal arteries

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14
Q

What is the main cause of CKD?

A

DM

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15
Q

What is the second main cause of CKD?

A

HTN

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16
Q

2 types of nephrosclerosis

A

Acute hypertensive
Benign

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17
Q

How is nephrosclerosis treated?

A

Treat HTN

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18
Q

Acute nephritic syndrome

A

glomerular diseases where kidneys become large and congested

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19
Q

Manifestations of Acute Nephritic Syndrome

A

Hematuria
Edema
Azotemia
Proteinuria
HTN

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20
Q

Nursing interventions for acute nephritic syndrome

A

Support
Dietary changes
Treat cause if known

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21
Q

Glomerulonephritis

A

glomerular disease where kidneys shrink and become fibrous

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22
Q

Manifestations of glomerulonephritis

A

Fixed SG
Casts in urine
Proteinuria
Electrolyte imbalances
Hypoalbuminemia

23
Q

Nephrotic syndrome

A

Glomerular diseases in which there is an increase in glomerular permeability

24
Q

Manifestations of nephrotic syndrome

A

Massive proteinuria
Edema
Hypercoaguable state

25
Q

Causes of nephrotic syndrome

A

Lupus
Glomerulonephritis
DM

26
Q

Polycystic Kidney Disease

A

kidney disease involving the growth of fluid filled cysts that destroy nephrons

27
Q

What is the most commonly inherited cause of kidney failure?

A

Polycystic kidney disease

28
Q

What other organs most commonly have cysts with polycystic kidney disease?

A

Liver and spleen

29
Q

When does kidney failure happen?

A

When kidneys cannot remove wastes or perform regulatory functions

30
Q

Acute kidney injury

A

a reversible syndrome that results in decreased glomerular filtration rate and oliguria

31
Q

ESRD AKA

A

chronic renal disease

32
Q

ESRD

A

progressive, irreversible deterioration of renal function that results in azotemia

33
Q

azotemia

A

elevated levels of urea and other nitrogenous wastes in blood

34
Q

What is assessed in a patient with CKD and AKI?

A

Fluid status
Nutritional status
Patient knowledge
Activity tolerance
Self-esteem
Potential complications

35
Q

Complications of CKD or AKI

A

Hyperkalemia
Pericarditis
Pericardial effusion
Pericardial tamponade
HTN
Anemia
Bone disease with metastatic calcifications

36
Q

When is hemodialysis used?

A

For acutely ill patients with AKI until kidneys resume function and LT replacement therapy in CKD or ESKD

37
Q

What is objective of hemodialysis?

A

Extract toxic nitrogenous substances from the blood and to remove excess fluid

38
Q

What kind of access is needed during hemodialysis?

A

vascular

39
Q

What type of vascular access is used during hemodialysis?

A

Arteriovenous fistula
Arteriovenous graft

40
Q

How often is vascular access assessed for AV fistula or graft?

A

Once a shift

41
Q

Types of peritoneal dialysis

A

Acute intermittent
Continuous ambulatory
Continuous cyclic

42
Q

Complications of PD

A

Peritonitis
Leakage
Bleeding

43
Q

What medications must be held prior to hemodialysis?

A

Cardiovascular medications

44
Q

Why must CV meds be held prior to hemodialysis?

A

Due to rapid fluid shifts that can cause hypotension

45
Q

Describe the onset phase of an AKI

A

Triggering event occurs
Duration can be hours or days
Kidney perfusion decreases
Urine output drops below 0.5mL/kg/hr

46
Q

Describe the oliguric phase of an AKI

A

10-14 days, sometimes longer
Urine output <400 mL/day

47
Q

Describe the diuretic phase of an AKI

A

1-3 weeks
Increased output
Kidneys regain ability to excrete urine but not concentrate it
Hypovolemia
Hypotension

48
Q

Describe the Recovery phase of an AKI

A

Can last up to 12 months
Gradual return to normal function

49
Q

What is the GFR range in stage 1 of CKD?

A

> 90 mL/min

50
Q

What is the GFR range in stage 2 of CKD?

A

60-89 mL/min

51
Q

What is the GFR range in stage 3 of CKD?

A

30-59 mL/min

52
Q

What is the GFR range in stage 4 of CKD?

A

15-29 mL/min

53
Q

What is the GFR range in stage 5 of CKD?

A

<15 mL/min

Exam 1 NRS 202 (7 decks)

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