Renal Flashcards
Normal GFR
over 90
How to perform creatinine clearance test?
collect urine for 24hr in one container
- discard first urine specimen
- place on ice, if not throw away and start over
Chronic kidney failure symptoms
- oliguria
- increased hydrogen ions= metabolic acidosis
- uremic frost and pruitis
- creatine and BUN elevated
- sodium, phosphorus, and k- elevated
treatment of high k
IV calcium gluconate- cardiac protection
IV dextrose 50 with insulin
Polystyrene Sulfonate- kayexalate
1 kilo of weight =
1 liter of fluid retained
drugs to avoid with renal failure
-NSAIDS
- Mycin anitibiotics
- CT contrast dye- assess creatinine before
foods to avoid for renal failure
potassium rich foods- green leafy veggies, melon, salt substitute,
phosphorus- dairy, chicken, tuna, seeds, beans
apples are a good option
Hemodialysis nursing interventions
- feel for thrill and listen for bruit on fistula
- no bp cuff or iv’s on fistula arm
- weigh before doing hemodialysis
- hold anti HTN meds- washes out meds and water soluble vitamins
Dialysis Disequilibrium Syndrome and key signs
Solutes are moved out of body to quickly from the blood which cause brain cells to swell with fluid= ICP
key signs: restlessness and disoriented
-treat by slowing or stopping dialysis then report
Fistula nursing interventions
- squeeze or grib rubber ball
- pitting edema normal at first
- no tight clothing, jewelry
- no bp or iv on arm
- no creams or lotion
- no lifting over 5lbs
report: - pale color
- parathesia
- pulses diminished
Peritoneal dialysis and nursing interventions
peritoneal cavity is filled with hypertonic solution to pull out solutes
-weigh before
- warm solution
- sterile technique
- report fever, tachycardia, or cloudy drainage
- monitor for resp distress- too much fluid too fast
Insufficient outflow for peritoneal dialysis
low or slow ouptut
- assess pt abdominal area
then assess device
reposition client to side lying
Urolithiasis or renal lithiasis
kidney stones
Shock wave lithotripsy
sends shockwaves to break up kidney stones
teach to increase fluids, normal findings include bruising, pain and bloody urine
Nephrolithotripsy or nephrolithotomy
nursing interventions and diet
needle suck into kidney to suction out large stones, stones can get clogged so irrigate with sterile normal saline
after procedure temporary tube and page placed for any loose stone fragment
stone and sediment collects at the bottom
teach to: report back pain, strain urine, encourage ambulating and never massage area
no protein or alcohol