Brainscape's Knowledge GenomeTM

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


See full index

Nursing Semester 2 > Monica - Week 13 - Exam 4 > Flashcards

Monica - Week 13 - Exam 4 Flashcards

You may prefer our related Brainscape-certified flashcards:
Nursing Mental Health flashcards Nursing Management of Care flashcards NCLEX-PN® flashcards NCLEX-RN® flashcards Nursing Fundamentals flashcards Nursing Pediatrics flashcards Nursing Safety & Infection flashcards Nursing Pharmacology flashcards Nursing Maternity flashcards Family Nurse Practitioner (FNP) flashcards
1
Q

Review: what are the 5 parts of the nephron?

A
  • glomerulus (bowman’s capsule)
  • proximal convoluted tubule
  • loop of henle
  • distal convoluted tubule
  • collecting duct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what are the three main functions of the kidneys?

A
  • regulatory
  • excretory
  • endocrine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are the main characteristics of the regulatory functions?

A
  • regulates blood pressure via RAAS
  • maintains fluid and electrolyte balance through RAAS and anti-diuretic hormone
  • regulates acid-base balance excretes acid load and makes bicarb. to ensure 7.4 pH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is the one excretory characteristic?

A

excretes waste products (filters out metabolic waste, excess ions, and water)

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

what are the three hormones made by the kidneys? what do they do?

A
  • erythropoetin (stimulates bone marrow → RBCs → ↑ hgb)
  • renin (helps regulate BP through RAAS)
  • calcitriol (active Vitamin D - absorption of calcium via GI; holds calcium in the kidneys and excretes phosphorus)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

what stimulates the secretion of erythropoetin?

A

↓ O2 supply

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

what stimulates the RAAS system?

A

↓ blood volume, hemorrhage, dehydration

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

CKD is an _______, _________ disease.

A

irreversible, progressive

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

CKD develops over __________- to __________

A

months, years

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

people with CKD are unable to: (3)

A
  • excrete waste products
  • respond to acid-base imbalance
  • control blood pressure and fluid volume
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

T/F: CKD progresses to end stage renal disease

A

TRUE; 90 - 95% of nephrons are effected

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

what are the 3 non-modifiable risk factors for CKD?

A
  • family hx of kidney disease, DM, HTN, CVD
  • age > 60 (as we age, kidney function ↓)
  • ethnicity (African Americans and Hispanics)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

African Americans - ____ times ↑ incidence of CKD - Incidence and complications r/t ____
Hispanics ____times higher incidence of CKD

A

2.7; HTN; 1.5

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

what are the two modifiable risk factors for CKD?

A

HTN and DM

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

what are three reasons HTN is a risk factor?

A
  • cause and consequence
  • kidney arteries narrow, weaken, and harden
  • gradual deterioration of glomerulus (not able to filter as well - non-reversible)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are 4 reasons DM is a risk factor?

A
  • damage to glomerular capillaries
  • ↑ permeability of proteins → diabetic nephropathy
  • Small amounts of protein → microalbuminuria
  • Larger amounts of protein → proteinuria
  • *proteinuria on at least 2 occasions 3-6 mos. apart
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

DM is the ____ _____ of CKD

A

leading cause

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

what is the treatment for DM and HTN? Why?

A

ACE Inhibitors and ARBs (angiotension receptor blockers)

because they are ~renoprotective~

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

what are the names of the three lab data related to CKD?

A

BUN, Creatinine, and Glomerular filtration rate (GFR)

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

what is BUN?

A
  • urea nitrogen in blood
  • made when protein broken down by liver. excreted by kidneys (not specific to kidney)
  • used w/ Cr and GFR for kidney disease process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

BUN is used to assess _____ and ______ function

A

kidney AND liver

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

what is creatinine?

A
  • waste product of muscle metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

creatinine is specific to ____________ function

A

KIDNEY

24
Q

what is AKI?

A

acute kidney injury; sudden injury to kidney caused by dehydration, infection (shock)

25
Q

what is the glomerulus and what is GFR?

A
  • glomerulus - semi-permeable membrane

- GFR - amt of blood filtered per minute

26
Q

glomerulus has the ability to _____ ______.

A

filter wastes; 90-120mL/min

27
Q

what occurs when kidney disease progresses?

A

GFR ↓

28
Q

what is the best indicator of kidney function?

A

GFR!

29
Q

T/F: African Americans have higher GFR than other races d/t ↑ muscle mass

A

TRUE

30
Q

how many stages are there of kidney disease?

A

5 stages

31
Q

what are the characteristics of stage 1?

A

kidney damage w/ normal or ↑ GFR; GFR > 90; diagnosis/tx; asymptomatic

32
Q

what are the characteristics of stage 2?

A

kidney damage with mildly ↓ GFR; GFR 60 - 89; estimating progression; asymptomatic

33
Q

what are the characteristics of stage 3?

A

moderately ↓ GFR; GFR 30 - 59; evaluating and tx of complications; clinical and lab complications of CKD

34
Q

what are the characteristics of stage 4?

A

severely ↓ GFR; GFR 15 - 39; prep for kidney replacement; dialysis, kidney transplant; clinical and lab complications of CKD

35
Q

what are the characteristics of stage 5?

A

kidney failure; GFR <15; replacement; uremic symptoms become prominent and need to accept replacement tx

36
Q

what is creatinine clearance?

A
  • total amt of creatinine in urine
37
Q

what does ↓ creatinine clearance mean?

A

↓ GFR and impaired renal function

**evaluate kidney function

38
Q

what does 24 hr urine collection do?

A
  • creatinine, proteins, and electrolytes excreted over a 24hr period
  • captures maximal excretion of substance
39
Q

what are the 5 characteristics of the collection process for 24hr urine?

A
  • keep container in ice
  • note start time on container
  • discard first void
  • end time 24-hr from start time
  • must restart if any void is
    discarded during 24-hr period
40
Q

what are the 8 clinical manifestations of CKD?

A 
mineral disorder
hyperparathyroidism 
hyperphosphatemia 
hypertension 
proteinuria &amp; diapetic nephropathy 
peripheral edema 
anemia of chronic disease 
metabolic acidosis &amp; hyperkalemia
41
Q

what occurs in mineral disorder?

A
  • Less vitamin D converted to calcitriol
  • Can’t absorb calcium → hypocalcemia → muscle twitching and osteoporosis
  • Calcitriol and hypocalcemia deficiency (PTH release → bone breakdown)
42
Q

what is the treatment for mineral disorder?

A

calcitriol and calcium supplements

43
Q

what occurs in hyperparathyroidism?

A
  • parathyroid gland secrets more PTH (kidneys rid phosphorus; retain Cal+; GI retains Cal+)
  • Bone resorption → ↑ risk of bone fractures
44
Q

what occurs in hyperphosphatemia? what is the treatment?

A
  • ↓ phosphate excretion
  • Tx: phosphate binders PhosLo (contains cal+) and sevelamer
  • ↓ phosphate foods intake (dairy, nuts, meat, fish, poultry, beans)
45
Q

what occurs in HTN? what is the treatment?

A

• renin release via RAAS (not enough perfusion → aldosterone release → Na+, H2O retention

46
Q

what occurs in proteinuria & diabetic nephropathy?

A
  • glomerular permeability ↑
  • protein in urine
  • loss of colloidal osmotic pressure → edema and third spacing
47
Q

what occurs in peripheral edema?

A

• hypervolemia and inadequate filtration

48
Q

what occurs in anemia of chronic disease?

A
  • erythropoietin production deficiency
  • bone marrow makes fewer red blood cells
  • normocytic and normochromic anemia
  • lower Hgb and Hct
49
Q

what is the tx for anemia of chronic disease?

A

erythropoietin stimulating agents and iron supplements

50
Q

what occurs in metabolic acidosis and hyperkalemia?

A

• impaired ability to excrete acid load
• defective reabsorption and making of more HCO3
• shift of H+ into the cells and K+ out of the cell
→ hyperkalemia
• Hyperkalemia d/t impaired kidney excretion
• K+ foods, supplements, drug

51
Q

what is pharmacologic intervention for hyperkalemia?

A

sodium polysterene sulfonate

52
Q

what is the indication for sodium polysterene sulfonate ?

A

mild to moderate hyperkalemia

53
Q

what does Na+ polysterene sulfonate do?

A
  • exchanges Na+ for K+ ions in the intestine

- eliminated in feces

54
Q

when is Na+ polysterene sulfonate contraindicated?

A

abnormal bowel function or history of bowel disorders

55
Q

what forms does Na+ polysterene sulfonate come in?

A

PO and retention enema

56
Q

what is the expected outcome for Na+ polysterene sulfonate?

A

normalized serum K+ levels

57
Q

8 Collaborative Care & Lifestyle Modifications

A
  • Managing HTN ( ACE-I and ARBs)
  • Diet: Low Na+, K+ Monitoring, Protein Intake (protein hard on kidneys),
    + Phosphorus Restrictions
  • Lowering cholesterol (statins)
  • Achieving optimal glycemic control (7% or less A1C)
  • Exercise routine (↑ insulin sensitivity)
  • Limiting or avoiding exposure to nephrotoxic drugs (antibiotics)
  • Avoiding alcohol (causes kidney to filter less)
  • Smoking cessation (vasoconstriction → ↑ BP)

Nursing Semester 2 (21 decks)

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