Renal Flashcards
AKI, CKD, acute glomerulonephritis, hemodialysis, peritoneal dialysis, UTI
Acute glomerulonephritis patho
Occurs after exposure to strep infx
SLE
S+S of acute glomerulonephritis
Oliguria
Dark, rust-colored urine
Hematuria, proteinuria
Edema
HTN
Weight gain
Anorexia, malaise, weakness
UA and lab studies of acute glomerulonephritis
UA: RBCs, protein
Elevated: BUN, creatinine, evidence of recent strep infx
Positive throat culture
Tx of acute glomerulonephritis
Supportive care
Antihypertensive agents, diuretics, temporary dialysis, abx
Sodium-restricted diet
Report HA to HCP
Seizure precautions
CKD causes
DM and HTN
S+S of CKD
Volume overload: edema, pleural effusions, HTN
Accumulation of urea and waste products: pruritis, lethargy, sleep changes, peripheral neuropathy
Low EPO -> anemia
Vitamin D and metabolism -> bone dz
Lab values of CKD
High potassium, phosphorous
Low calcium, GFR
Metabolic acidosis
Pharm of CKD
HTN: ACE inhibitors, ARBs
Anemia: EPO injections, iron
Edema: diuretics
Protect bones: calcium and vitamin D
Hyperkalemia: oral intestinal K binders (sodium zirconium, patiromer)
Hyperphosphatemia: oral phosphate binders (calcium acetate/carbonate)
Metabolic acidosis: sodium bicarbonate
Diet of CKD
Low potassium
Low phosphorous
Sodium and fluid restriction
Modest protein restriction
Hemodialysis dialysis solution
Electrolytes and dextrose can be added
Procedure of hemodialysis
Access pt’s circulation
Administer heparin to pt
Heparinized blood flows through semipermeable membrane in one direction
Dialysis solution flows in opposite direction
Wastes are removed and electrolytes are corrected via diffusion
Ultrafiltration removes excess water from blood
Blood returns to pt via the access line after it has been cleansed
Interventions of hemodialysis
Administer anticoagulants (heparin)
Withhold antihypertensives prior to hemodialysis
Obtain BP on arm opposite of fistula/graft
Provide appropriate nutrition
Weigh before and after
If air embolism occurs during hemodialysis, what tx
Clamp access tubing
Reposition to Trendelenburg on left side
Administer oxygen (high-flow)
Notify HCP
Disequilibrium syndrome def and S+S
Solutes are removed from blood faster than CSF and brain
N+V, restlessness, agitation, confusion -> seizures -> death
Disequilibrium syndrome during hemodialysis tx
Slow/stop dialysis
Notify HCP
Reduce environmental stimuli
Prepare to administer IV hypertonic saline and mannitol
Prepare to dialyze for shorter periods at reduced flow rates to prevent recurrence