renal Flashcards
what is continuous renal replacement therapy (CRRT)?
treats AKI by removing uremic toxins & fluids while maintaining acid-base balance & electrolytes are adjusted slowly & continuously
what is AKI (acute kidney injury)?
a sudden & often reversible reduction in kidney function
what is the most common manifestation of AKI?
decreased glomerular filtration rate
what are the categories of AKI?
(3)
- prerenal
- intrarenal
- postrenal
what is CKD?
a gradual & irreverisble loss of kidney function
what causes prerenal injury?
marked decrease in renal blood flow
what is intrarenal injury?
damage within kidney structures
how does postrenal injury manifest?
obstructed urine flow
what is a significant lab result for AKI?
elevated Cr
what are the significant lab results for CKD?
- decreased RBC (anemia)
- decreased GFR
- increased phosphate
what is the duration of time for which CKD will be classified as such?
3 months or more
what is ESRD?
a condition in which kidneys cease functioning on a permanent basis, leading to dialysis or transplant
what are causes for a prerenal injury?
(5)
- hypovolemia
- vasodilation
- decreased cardiac output
- sepsis
- dehydration
decreased blood flow
what are causes for intrarenal injury?
- prolonged ischemia
- medical nephrotoxins
- acute tubular necrosis
direct renal injury
what are causes for postrenal injury?
(5)
- BPH
- prostate cancer
- renal calculi
- extrerenal tumors
- urethral stricture
obstruct urine outflow
what is the RAAS?
it is a hormonal system feedback loop with the kidneys that is essential for blood pressure regulation & fluid balance
what are the hormones involved in RAAS?
- renin
- angiotensin II
- aldosterone
what is the role of renin?
controls the production of aldosterone & is released in response to hyponatremia or hypovolemia
what is the role of angiotensin II?
vasoconstriction
what is the role of aldosterone?
increases sodium retention & potassium excretion
what are the hormones that are mainly produced by the kidneys?
- erythropoietin
- calcitriol
a patient finds out they are hyperparathyroidic due to their kidney problems and asks the nurse, “how are they related?”
what does the nurse say?
kidneys produce calcitriol
once kidneys are impaired there will be decreased calcitriol (calcium) that the PT gland will recognize as a cue to release more PTH
what are the types of conditions that occur wtih renal dysfunction?
(5)
- FV overload
- metabolic acidosis
- hyperkalemia
- hypermagnesemia
- hypernatremia
interventions
FV overload
- increase diuresis
- CRRY
- aquapheresis
interventions
metabolic acidosis
sodium bicarb supplements
interventions
hyperkalemia
- IV insulin
- potassium binders for fecal excretion
interventions
hypermagnesemia
IV calcium gluconate
interventions
hypernatremia
increase diuresis
what is considered the gold standard for hemodialysis access?
AV fistula
where is an AV fistula typically located?
- radial artery
- brachiocephalic artery
