Renal Flashcards
GFR
Volume of plasma filtered thru glom Capps into Bowman’s capsule
Inverse relationship to Creatinine
125ml/min
BUN
Amount of nitrogen in blood from waste product of urea
10-23
Creatinine
Non protein waste
Better indicator of renal fn than BUN
0.6-1.4
Specific Gravity urine
1.01-1.02
Urine sodium
20mEQ/L
Prerenal fail
Poor kidney perfusion
BUN:20-40:1 Urine NA: <20 Urine conc Urine osm ⬆️ (>500) Spec grav ⬆️(>1.02) Urine sed normal
Intrarental
From cortical issues(infection/inflammation) or ATN (drugs, rhabdo, surg, poor perfusion)
Tx with diuretics, fluid volume mgmt, dialysis, address anemia
Candidate for dialysis
A-acidemia E-electrolyte disorders I-intoxication(ASA, lithium, theophylline) O-overload (HF) U-uremia(⬆️BUN and AMS)
Intrarenal labs
BUN/creat 10-15:1 Urine NA >20 Urine diluted Urine osm ⬇️ (<300) Spec grav ⬇️(<1.01) Urine sed abnormal
Postrenal
Obstruction from collection duct ie stones, neurogenic bladder, tumor
Tx-fix obstruction
Calcium
8.5-1.5
⬆️Ca++
From renal issue, ⬇️K, tumors, bed rest
Lethargic, AMS, DTR reduced, abd pain, constipation, stones
Tx fluids and diuretics, steroids, calcitonin
⬇️Ca++
From acute panc, ⬆️K, vit d deficient, alkalosis, infection
Sx, Chvostek sign, trousseau sign, torsades, twitching, anxiety
Iv fluid, calcium supp
Chvostek sign
Spasm of cheek on side of poke from hypocalcemia
Trusseau sign
Flex arm with BP cuff, carpopedal spams, hypocalcemia
Potassium
3.5-5
K⬆️
From renal fail, burns, crush injuries, met acid, adrenal insuff
Muscle weakness, NV, cramp, ekg change peak t wave, wide QRS, loss of p wave, Brady, PEA
calcium supp, bicarbonate, insulin gluc, albuterol, Kaye a late, dialysis
K⬇️
From diuresis, met alk with ⬇️Cl, uncontrolled DM, cirrhosis, alchoholism
Muscle weak, NV, and distention, ⬇️LOC, ekg change: VT, Vfib
⬆️Na
From dehydration, diuresis, DKA, HHS, DI
restless, hypovolemia, change LOC
check urine Na, correct slowly, vasopressin for DI
⬇️Na
From fluid excess, HF, cirrhosis, SIADH
Edema, fatigue, cramps, diarrhea, sx, coma
restrict water, loop diuretic, 0.9, 3% saline
⬆️Mg
From renal fail, laxative and antacid abuse
⬇️DTR, ⬇️RR, bradyardhythmia, ⬇️BP, lethargic, flushing
Calcium supp, then lsixc to correct ⬆️Ca, dialysis
⬇️Mg
From alcoholism, VD, NGT, DKA,CABG, malnutrition
Hyperreflexia(chvostek and trusseau),psVT,insulin resistance, ⬇️K,⬇️Ca,⬇️phosphate, agitation
Mag supp max of 1g/min
⬇️phosphate
From alcohol, increase reuptake from TPN or glucose
Lethargic, AMS, weak, constipation, ⬇️RR
Phosphate supp
⬆️phosphate
From poor renal excretion
Anxiety, irritable, twitching at mouth, sx, laryngospam
Give phosphate binders, calcium carb
