Polycystic Kidney Disease

Question 1

PKD - Pathophysiology

Answer 1

• Genetic disorder characterized by the growth of numerous fluid-filled cysts in kidneys
  > cyst growth; destroy nephrons
  > destroying function of kidney: urine formation and waste elimination are impaired
  > nephron is functional unit

Question 2

PKD - CMs

Answer 2

• Abd distention
• Flank pain
• Incrd abd girth
• Hematuria
• Constipation (always)
• HTN

Question 3

PKD - Diagnostics

Answer 3

• Genetic testing for fam
• Personal hx (HTN)
• Labs
  > if urinalysis shows proteinuria
• Ultrasound
  > effective way to size kidenys

Question 4

PKD - Medical Surgical Treatment

Answer 4

• Managing BP
  > with antihypertensive; ACE-I or ARB
• Managing pain
• Preventing constipation
• Slowing progression
• Graft or shunt placement
• Renal replacement
  > dialysis
• Transplant
  > will still have PKD but hoping new kidney outlasts Pt

Question 5

PKD - Nursing Diagnosis

Answer 5

• Excess fluid vol
• Risk for electrolyte imbalance
• Health Promotion:
  > dietary adjustments
  > weight maintenance
  > smoking cessation
  > exercise
  > limitation of alcohol

Question 6

PKD - Nursing Interventions

Answer 6

• Daily weights
• Assessment:
  > fluid overload
  > lab values (Cr, BUN, Electrolytes)
  > neuro exam: at risk for stroke & encephalopathy
• Fluid/Na restrictions
• Dietary restrictions
• Pain management
• Medication admin
• Place on tele