Renal

Question 0

Pre-Renal Failure

Answer 0

1. Hypo-perfusion of the kidneys

- Can be caused by MI or cardiac condition leading to hypoperfusion

Question 1

2 Most Common Causes of Chronic Kidney Dz

Answer 1

1. Diabetes

2. HTN

Question 2

Intra-Renal Failure

Answer 2

1. Chemotherapy
2. Infection
3. Drugs

Question 3

Post-Renal Failure

Answer 3

1. Obstruction

Question 4

AKI

Answer 4

1. AKI can lead into chronic kidney dz.

2. Chronic kidney dz can also become acute insult

Question 5

Kidney Function

Answer 5

1. Monitor Fluid levels
2. Regulation of blood pressure
3. HTN is an early sign of kidney dz
4. Erythropoietin (Epogen) Stimulates production of RBC’s

Question 6

S/S of Chronic Kidney dz

Answer 6

1. Poor appetite (anorexia)
2. Failure to thrive
3. Headache (build up of waste products)
4. Pruritus and dry skin and skin color changes
5. Bone pain and osteoporosis (increase phosphorus)
6. Neuro changes (especially w/ acute)
7. Excessive urination

Question 7

AKI results on assessment

Answer 7

1. Fine expiratory crackles

2.

Question 8

KNOW LUNG SOUNDS AND HOW TO DESCRIBE

Answer 8

TEST

Question 9

Urinary Analysis for AKI

Answer 9

1. Protein
2. Casts or blood cells
3. Specific gravity
4. WBC’s & PH

Question 10

Creatinine Clearance

Answer 10

1. Have Pt void before starting test
2. Once test starts, collect the urine and put it on ice
3. Have Patient void at the end of the test
4. Send urine to the lab
   This Measures GFR

Question 11

Normal GFR

Answer 11

125 ml’s/minute

Question 12

Tests for Renal Dz

Answer 12

1. Kidney Biopsy
2. Ultrasound
3. Angiography
   * *KNOW PT EDUCATION

Question 13

Secondary S/S of Chronic Kidney Dz

Answer 13

1. Dry skin
2. Anorexia
3. HTN

Question 14

Kidney Dz Treatment

-To Lower Potassium

Answer 14

1. Lasix (If Kidneys respond)
2. Kayexelate (exchange K+ for H or NA) (FIX)
3. 10 Units Regular Insulin IV Push + D50 Pushed Slow (TEMPorary)

Question 15

Renal

-Diet/Education

Answer 15

1. Complete protein or lower amount of protein

2. Vaccinations

Question 16

Renal

-Phosphorus Binders

Answer 16

1. Calcium Acetate

Question 17

Renal Issues

-Electrolytes

Answer 17

1. Lower NA intake because water follows sodium
2. Potassium increases
3. Phosphorus increases

Question 18

Peritonial Dialysis

-Pt Education

Answer 18

1. Hyperglycemia
   - Dialyzing solution has a lot of glucose in it
2. Peritonitis
3. Reduction of appetite

Question 19

Kidney Transplant

-Pt Ed

Answer 19

1. Immunosuppressant for life

- Stay away from large crowds, sick people

Question 20

Polycystic Kidney Dz **

Answer 20

1. No NSAIDS

Question 21

1. SIM RENAL Pt #1

S/S of Fluid Overload

Answer 21

1. Bounding pulses
2. Possible crackles in the lungs
3. HTN

Question 22

Renal Sim Lab Pt #1

-Order Of Medication Admin

Answer 22

1. Lasix 1st
2. Insulin 10 U + D50
3. Kayexelate 15 grams PO
4. Turn Down or turn off infusing fluids

Question 23

Indications for Dialysis TEST Multiple Select****

Answer 23

1. Refractory Potassium (Won’t come down)
2. Acidosis
3. Elevated BUN and Creatinine 10:1 – BUN 100, Creat 10
4. Mental Status Changes

Question 24

Exchange of Electrolytes W/ Kayexelate

Answer 24

1. Kayexelate will excrete Potassium in exchange for Sodium
2. When K (+) is pushed into the Cell, Hydrogen (+) comes out
3. Hydrogen will put the patient into an acidotic state

Question 25

Disequilibrium Syndrome Post Dialysis

-Patho

Answer 25

1. Blood is cleansed to much and there is an higher solute concentration in the CSF. This pulls fluid into the CSF leading to cerebral edema

Question 26

Disequilibrium Syndrome Post Dialysis

-Priorities

Answer 26

1. Raise HOB for IICP guidelines (30 degrees)
2. Neuro check for CVA q30
3. Seizure precautions
4. Decrease stimuli

Question 27

Disequilibrium Syndrome Post Dialysis

-Treatment

Answer 27

1. IV mannitol
2. 3 % normal Saline
   - Puts concentration back into serum and stops large fluid shift