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PJs Cards > Renal > Flashcards

Renal Flashcards

1
Q

How to Control BP & Prevent Kidney Dx

A
  1. Limit sodium
  2. Eat balanced diet: fruits, veggies, grains & low fat
  3. Limit sugar
  4. Limit red meat
  5. Weight management
  6. Stay active
  7. Limit alcohol
  8. Medication, lithium, HCTZ, spirolactone
  9. Licorice
  10. Corticosteroids
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2
Q

Primary Function of beans

A

Acid base balance, secretion, absorption, filtration and excretion

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3
Q

pH of blood

A

7.35 -7.45
Acidosis to alkalosis

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4
Q

What are they 3 regulatory mechanisms

A

Buffers, respiratory, renal

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5
Q

When do buffers start working ?

A

Immediately

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6
Q

Where is the respiratory center located?

A

Medulla

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7
Q

How long does it take respiratory system to work?

A

Mins to hours

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8
Q

How long does it take renal system to work

A

2-3 days

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9
Q

3 (renal) mechanisms for acid elimination

A
  1. Secrete free hydrogen
  2. Combine hydrogen with ammonia
  3. Excretion of weak acid
    *can make bicarb and eliminate hydrogen
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9
Q
A
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10
Q

ABG Values

A

pH 7.35-7.45
PaCO2 35-45
HCo3 22-26

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11
Q

NI for Respiratory Acidosis

A
  1. Watch K+ Levels
  2. May need intubated
  3. Administer O2
  4. Wake pt.
  5. Incentive spirometry
  6. W/hold drugs that suppress breathing
  7. Assess LOC
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12
Q

What is carbonic acid excess caused by

A

Hyperventilating & respiratory failure

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13
Q

S/S for Respiratory Alkalosis

A
  1. Confusion
  2. Fatigue
  3. Tenty
  4. Tachycardia
    Lo Ca+ & K+
  5. Slow deep breaths
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14
Q

What is respiratory alkalosis

A

Carbonic acid deficit caused by hypoxia from acute pulmonary disorders & hyperventilation

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15
Q

Causes of respiratory alkalosis

A
  1. Anxiety
  2. Pain
  3. CNS
  4. Aspirin toxicity
  5. Fever
  6. Head injury
  7. Asthma
  8. Pregnancy
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16
Q

What is metabolic acidosis

A

Excess carbonic acid or base bicarbonate deficit

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17
Q

What causes metabolic Acidosis

A

Ketoacidosis
Lactic acid accumulation (shock)
Severe diarrhea (bicarb in stool)
Kidney Dx (lose ability to reabsorb)

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18
Q

Normal Anion Gap

A

8-12

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19
Q

TX for metabolic Acidosis

A

Strick i&o
Diet
Dialysis
**monitor levels

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20
Q

S/S of metabolic Acidosis

A

Deep rapid breathing
Confusion
Low BP
N/V
Hyper k+
Cardiac changes
**resp alkalosis can happen

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21
Q

What is metabolic alkalosis

A

Base bicarbonate excess caused by prolonged vomiting or gastric suction
**loss of acid

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22
Q

What diuretic do you use for metabolic alkalosis

A

Loop thiazide or Lasix

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23
Q

How much blood do thr kidneys filter

A

1200 MLs per min

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24
Q

Glomerular Function

A

Urine formation & filtration

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25
Q

What is normal GFR

A

125 mL/min

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26
Q

What does urine consist of

A

What the body doesn’t need

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26
Q

How much do normal healthy adults void ?

A

1-2 L/day

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27
Q

ADH

A

Important in water balance & regulated by posterior pituitary gland

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28
Q

Aldosterone

A

Reabsorption of sodium and water & released from adernal cortex

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29
Q

Other functions of the kidney:

A

RBC production & BP regulation

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30
Q

EPO

A

Erthyropoientin ** hormone in response to hypoxemia

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31
Q

How does the kidneys regulate BP

A

Renin is secreted, renin activated angiotensinogen yo angiotensis , angie 1 is converted to angie 2 by ACE , angie 2 stimulates released of aldosterone which reabsorption sodium and water

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32
Q

Ureters

A

Join the renal pelvis @ uretropelvic junction (UPJ) & join bladder @ ureterovesical junction

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33
Q

How much does bladder hold

A

600 - 1000 mL

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34
Q

Bladders primary function

A

Reservoir

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35
Q

What type of muscle Is the destrusor muscle

A

Smooth

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36
Q

How long is urethra

A

Female 1-2
Male 8-10

**controls voiding

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37
Q

What forms the urethrovesical unit

A

Bladder, urethra & pelvic floor muscles

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38
Q

Age related bladder changes

A

Between 30&90 size decreases 20-30% & by 70 loss of 30-50% of glomerular function, loss of elasticity & muscle support & prostate enlargement

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39
Q

How to assess for renal issues

A

I&Os **most important, skin color, look at belly, look at mouth, smell breath, edema, bladder distention, contour of abdomen, Weight gain, muscle wasting, percussion, bowel sounds

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40
Q

Creatinine Level

A

O.6-1.2 mg/dL
**showing pts hydration status

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41
Q
A
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42
Q

Creatinine Clearance

A

Fe: 85-125
Ma: 95-140

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43
Q
A
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44
Q

BUN

A

6-20mg/mL
*shows if pt is dehydrated

45
Q

Azotemia

A

Abnormally high nitrogen waste products

46
Q

Why do you need to strain urine?

A

To get stone analysis

47
Q

Pro Op Cystoscopic Exam

A

NPO, consent, provide examples of risk, preoperative lab work, CBC w/ coag, use caution w/ contrast if pt. Has renal failure

48
Q

Pre-Renal

A

From artery before bean

49
Q

Post Op NIs

A

VS 15×4 30X2 THEN Q1HR
I&O
IV SITE MONITOR
ARTERY PRESSURE BLEEDING
Distal pulses
Inspect posterior of site
May be on bed rest
Watch for retroperineal hematoma

50
Q

Cystoscopic Exam:

A

Out pt or in pt.
Into utertha with numbing solution
Looks for infection in bladder
May take biopsies

51
Q

What may pee look like after cystoscopic exam:

A

Pink tinged urine

51
Q

Is frank res blood ok after cystoscopic exam

A

No!

52
Q

What instructions will the nurse provide to a pt. About a cystometrographt?

A

Water will be instilled into thr bladder through a catheter to assess bladder tone

53
Q

True or false:
Most acute AKI Is reversible?

A

True

54
Q

Causes of pre-renal AKI

A

Severe dehydration, heart failure

55
Q

Is AKI rapid or slow onset

A

Rapid

56
Q

Characteristic of AKI

A

Progression & evaluation in BUN & creatinine

57
Q

Decreases GFR

A

Causes Oliguria

58
Q

PreRenal =

A

Pressure, volume, perfusion problems

59
Q

At risk pts

A

N/V/D
Burn pts

60
Q

Causes for Intrarenal AKI

A

Prolonged ischemia, nephrotoxin,antibiotics, chemo drugs, contrast dyes, NSAIDs, car wreck, injury

61
Q

ATN

A

Acute tubular necrosis

62
Q

What causes ATN

A

Ischemia, nephrotoxins or sepsis
**severe Ischemia causes disruption in basement membrane

63
Q

Is ATN reversible?

A

Yes, if basement membrane isn’t destroyed

64
Q

Risk for intrarenal injury?

A

Major surgery, general anesthesia, shock, sepsis, toxic meds, blood transfusion, HTN

65
Q

AKI Postrenal causes:

A

Mechanical obstruction of outflow:
BPH
Prostate cancer
Renal stones
Trauma
Extra renal tumors
Bilateral ureteral obstruction
Urine refluxes

66
Q

1st Stage of AKI

A

Fluid Overload Stage (oliguric phase)

66
Q

How much urine output with 1st stage oliguric phase

A

Less than 400mL/day

67
Q

How long does it last?

A

10-14 days

68
Q

How much urine output does a normal healthy adult have ?

A

2000mL/day output

69
Q

Causes of metabolic Acidosis

A

Renal failure. Aspirin toxicity, diarrhea. Kidney injury or Dx, DKA

70
Q

Causes of metabolic alkalosis

A

Prolonged Vomiting. Chronic baking soda use, diuretic therphy, massive TRANSFUSIOns, GI suctioning

71
Q

Respiratory Acidosis

A

Respiratory failure, sedative or opioid overdose, atelectasis, brain injury
** decreased rr

72
Q

Respiratory alkalosis

A

Over mechanical ventilation, anxiety, fear, pain, hyperventilating
**increase rr

73
Q

How to treat pulmonary edema

A

Admin 02. Cough and deep breath, semi sitting, hi flowers

74
Q

What is the most important factor of stone formation

A

Urine pH

75
Q

What causes acute poststreptococal glomerular nephritis

A

Antigen antibody complex

76
Q

What would lead to renal calci

A

Urine statist with urinary tract
Obstruction

77
Q

How does hydronephrosis occur?

A

Due to dilation of the renal pelvis and calyces proximal to blockage

78
Q

How to minimize bleeding and discomfort after shock wave lipotrispy

A

Cold compress

79
Q

What is the most common cause of acute glomerular nephritis

A

Presence or systemic infection resulting in thr formation of antigen antibody complexes

80
Q

How to relax the perineal and promote voiding

A

Sitz baths

81
Q

What is most important to monitor after lithotripsy

A

I & O

82
Q

What to do with a pt with priaprism

A

Treat immediately

83
Q

What would the PSA level be if pt has cancer

A

More than 4

84
Q

What would suggest intrarenal failure and acute tubular necrosis

A

Cast and debris in the urinalysis

85
Q

What would suggest renal failure

A

High specific gravity
1.005-1.030

86
Q

Does uti cause flank pain

A

No

87
Q

Most life saving action for pulmonary edema

A

Administering lasix

88
Q

What to report immediately to doctor

A

10ml in 1 hour of urine

89
Q

Priority for pts getting intravesical chemotherapy

A

Have pt empty bladder

90
Q

Effective treating to maintain urinary patent after stone ablation therapy

A

Increase fluids intake to 3000mL/day

91
Q

Only way to analyze stone

A

Straining urine

92
Q

Priority In kidney stones

A

Pain

93
Q

Poststreptococcal glomerular nephritis

A

Immune complex with streptococcus antigen with human antibody

94
Q

Who is at risk for slow healing, increasing infection & urosepsis

A

Elderly, co mobility of diabetes, confusing and poor nutrition

95
Q

When does a complicated UTi exist

A

When other co morbities are present

96
Q

How to prevent UTI

A

Fluid intake about 2000mL without caffeine, alcohol, citrus juice and chocolate drinks

97
Q

APSGN

A

Most recover completely with supportive treatment

98
Q

AV fistula findings:

A

Enlarged for easy access of HD

99
Q

Grafts over fistula

A

Fistula much less likely to clot

100
Q

Indicators of fistula patency

A

Thrill and bruit

101
Q

Whats allowed on dialysis once nitrogen waste are removed

A

More protein

102
Q

How to prevent disequilibruim syndrom

A

Slow infusion rate

103
Q

How to treat abdominal pain abd refried shoulder pain during HD

A

Slow the rate

104
Q

What should be reported immediately in PD

A

Cloudy appearing peritoneal effluent it’s a sign of peritonitis

105
Q

What suggest hypovolumia after kidney transplant

A

Decrease In BP

106
Q

Pt with femoral vein catheter on bed rest

A

Doesn’t need continuous pulse ox

107
Q

What is not a common occurqncr in peritonitis with PD

A

Crystal is the output

108
Q

True or false

A

A pt should full understand lifestyle changes with dialysis before start ?
TRUE

109
Q

Renal failure due to inadequate blood flow

A

Prerenal

110
Q
A

PJs Cards (3 decks)

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