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NCLEX > renal > Flashcards

renal Flashcards

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1
Q

functional unit of the kidney is the

A

nephron

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2
Q

glomerulus

A

bundle of capillaries where filtration occurs in nephron

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3
Q

Function of kidneys

A

remove toxins from blood, maintain electrolyte balance, regulate water balance

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4
Q

Renin Angiotensin Aldosterone System

A

regulates water balance and controls blood pressure; renin released by kidneys -> angiotensinogen -> angiotensin I -> angiotensin II -> aldosterone

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5
Q

renin is released when

A

decrease renal blood flow, sympathetic input, epi/norepi, early in day, when standing

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6
Q

Inhibits renin:

A

adenosine, angiotensin II, Adrenalin. lockers, aldosterone, later in day, lying down

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7
Q

Angiotensin II Receptor Blockers

A

Losartan; inhibits vasoconstrictor properties of angiotensin II

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8
Q

ACE inhibitor

A

blocks concessions of angiotensin I to angiotensin II, increases renin levels and decrease aldosterone leading to vasodilation

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9
Q

Loop diuretics

A

“ide”; act on loop of Henle to increase urine output by affecting sodium reabsorption within the nephron

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10
Q

Loop diuretics uses and monitoring

A

increase UO, edema, CHF, bp management; monitor potassium levels (considered potassium wasting), most effective of all diuretics

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11
Q

Thiazide diuretics

A

“thiazide”; decreases sodium reabsorption causing more
fluid loss in urine; htn, CHF; monitor electrolyte levels and bp

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12
Q

potassium sparing diuretics

A

spares potassium; htn, edema, swelling, hypokalemia; monitor potassium; not as strong as other diuretics so are often combine with a different diuretic

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13
Q

when kidneys have poor perfusion we will see

A

urine output go down

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14
Q

normal urine output

A

30ml/hr

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15
Q

UTI S&S

A

dark, cloudy urine, blood in urine, pain in pelvis, pain or burning while urinating (dysuria), strong or foul smelling, increase frequency or urgency

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16
Q

pyelonephritis

A

UTI that has reached the kidneys

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17
Q

UTI treatment

A

hydration (more fluids being filtered and put out bacteria will be flushed out), antibiotics

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18
Q

glomerulonephritis

A

acute inflammation of kidneys at level of nephron; happens d/t inflammatory reaction, antibodies get lodged into glomerulus, #1 cause is strep

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19
Q

glomerulonephritis S&S

A

sore throat, malaise, headache, flank pain, htn, edema, decreased UOP, increased BUN and Cr, increase specific gravity, dark, cloudy, sediment

20
Q

glomerulonephritis tx

A

abx for strep, struck I&Os, bp, decrease protein and sodium, increased carbs

21
Q

nephrotic syndrome

A

causes body to pass too much protein in urine; no protein in the blood = not being able to hold onto fluid which leads to third spacing - bp still low but RAAS activated due to low perfusion to kidneys water and sodium retained but not in cells = tons of edema

22
Q

causes of nephrotic syndrome

A

anything that causes inflammation; infection, cancer, NSAID overuse, diabetes, lupus, diabetes, strep throat

23
Q

Nephrotic Syndrome S&S

A

anasarca, blood clots, high cholesterol, proteinuria, hypoalbuminemia, edema, hyperlipidemia

24
Q

nephrotic syndrome tx

A

fix the cause, prednisone, diuretics, ACE inhibitors, statins, anti coagulation, dialysis, high protein low sodium diet

25
Q

pre renal failure

A

blood cannot get to the kidneys; hypotension, hypovolemia, shock

26
Q

intra renal failure

A

damage inside the kidney; golemerulonephritis, nephrotic syndrome, nephrotoxic drugs

27
Q

post renal failure

A

something is blocking urine from leaving the kidneys; kidney stone, tumor, urethral obstruction, enlarged prostate

28
Q

Acute kidney injury

A

sudden, happens over few hours to few days, causes build up of waste products in blood

29
Q

Phases of AKI

A

onset, oliguric, diuretic, recovery

30
Q

onset phase of AKI

A

Injury occurs and output decreases, hours to days

31
Q

oliguric phase

A

decreased output, becomes fluid volume overload, 10-14 days, oliguria, edema, SOB, increased BUN and Cr, metabolic acidosis, anemia, hyperkalemia, hyperphosphatemia, hypocalcemia, fatigue, confusion, nausea

32
Q

Diuretic phase AKI

A

diuresis, 1-3 weeks, 3-5 L dilute urine per day, hypotension and hypovolemia, hypokalemka, hyponatremia, BUN and Cr begin to normalize

33
Q

CKD

A

happens slowly over a long period of time, damage to kidneys accumulates over time, can no longer filter waste properly, and waste products build up

34
Q

HTN and CKD

A

high bp put pressure on renal artery causes thickening of opening from blood vessels to kidneys = less blood flow to kidneys = kidneys ask for more blood and activate RAAS = causes more htn = eventually causes glomerulosclerosis and loss of nephrons

35
Q

major causes or CKD

A

htn and uncontrolled diabetes

36
Q

diabetic nephropathy

A

chronic high blood sugars = production of pro inflammatory cytokines causes changes to kidneys -> thickening of tubular basement membrane, thickening of renal arterial wall, sclerosis of nephrons; major intra renal cause of CKD

37
Q

CKD is staged based off of the __________

A

GFR; as it decreases condition worsens

38
Q

in CKD stages 2 and 3 we want to

A

protect kidneys, try to reverse damage

39
Q

Stages 4 and 5 of CKD will require

A

dialysis

40
Q

S&S early stages of CKD

A

GFR goes up, diuresis

41
Q

S&S late stage CKD

A

htn, edema, hyperkalemia (muscle cramps, ECG changes, fibrillations), metabolic acidosis, osteodystrophy (not enough calcium = secondary hyperparathyroidism = causes osteoporosis), uremia, neuro changes, anorexia, vomiting, skin changes (uremic frost)

42
Q

Labs in CKD will look like

A

Increased BUN and Cr, high potassium and phosphorus, low calcium, metabolic acidosis

43
Q

renal diet

A

low sodium, low phosphorus, low protein, low potassium

44
Q

CKD treatment

A

restrict fluid intake, no K+ sparing diuretics or ACE inhibitors, regular lab work, dialysis

45
Q

hemodialysis

A

3-4 times/week, blood goes out IV in artery and gets filtered then goes back to body through IV in vein (has fistula), will cause rapid fluid shift, monitor bp and electrolytes

46
Q

fistula nursing considerations

A

no BPs or IVs in arm of fistula, palpate for a thrill, and musculature a bruit

47
Q

Peritoneal dialysis

A

not all can handle hemodialysis, peritoneal membrane is used to filter instead of machine; dialysate is infused into peritoneal cavity and dwells for 6hrs, fluid is drained taking
toxins with it; drainage should be clear (cloudy indicates infection), need to drain all dialysate (everything that goes in needs to come out) might need to turn pt side to side

NCLEX (23 decks)

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