RENAL Flashcards
What is glomerulonephritis
It is an inflammatory reaction in the glomerulus
When antibodies lodge in the glomerulus; you get scarring and decrease filtering.
What is the main cause of glomerulonephritiis
Streptococcus Bacteria
What are the main S/S to watch out for Renal Failure
(WANDMH) Weight loss anorexia nausea/vomitting decreased urine output malaiase headache
What is the patho of nephrotic syndrome
- inflamatory response in glomeruli where big holes started to leak out protein
- Decreased protein in blood–> hypoalbuminia
- Increased fluid in tissue spaces–> edema
- Body tries to compensate via RAS
- Increased fluid but no albumin to hold it in.
- Patient experiences Anascara
What are the problems associated with protein loss
- risk for Blood clots (thrombosis) (no protein that would normally prevent blood from clotting)
- Increased cholesterol and triglycerides (d/t liver trying to compensate by making more albumin=increased cholesterol and triglycerides)
What are the causes of nephrotic syndrome
Idiopathic bacterial/viral infection NSAIDS cancer and genetic predisposition systemic disease like lupus or diabetes strep
Which disease do you NOT limit protein in the kidneys with?
Nephrotic Syndrome
When you have -decreased perfusion to kidneys, -hypotension -arryhthmias -hypovolemia -any form of shock What kind of renal failure is this?
Pre-renal failure
When you have: -Glomerulanephritis -nephrotic syndrome -over use of dyes -drugs (aminoglycosides) -malignant HTN -DM causing vascular damage What kind of renal failure is this?
Intra-renal (inside kidney)
When you have: -enlarged prostate -kidney stones -tumors -uretral obstruction -edematous stoma (ileal conduit) What kind of renal failure is this?
Post-Renal Failure
What are the 2 phases of Renal Failure
Oliguric and Diuretic
Which phase of renal failure do you get:
- decreased urine output
- client is in fve
- hyperkalemia
Oliguric phase
Which phase of renal failure do you get if:
- It is a sudden onset
- U/O is increaed
- Client is in FVD–> Shock
- Hypokalemia
Diuretic phase
What should you be monitoring when someone is going through hemodialysis
- eat and drink
- to be on an anticoagulant therapy (bleeding precautions)
- depression
- electrolytes and blood pressure
What are some of the types of access used for hemodialysis
AVF (Arteriovenous fitsula)
AVG (Arteriovenous graft)
How many needles are inserted in the vascular space and what are they used for.
- 1) allow blood to be pulled from circulation and sent to the hemodialysis machine
2) return filtered blood back to client for circulation
What veins can be used that wont require surgery for hemodialysis
Internal jugular
Femoral vein
What should you make sure you don’t do when caring for someone going through a hemodialysis
- don’t have BP on that extremity
- No needle sticks
- No constrictions
What assessments should you make with access for hemodialysis
-Patency
-Palpate –> Thrill-cat purring sensation
-Auscultate–>Bruit-turbulent blood flow
FEEL A THRILL HEAR A BRUIT
Should a dialysate be warmed before infusion for peritoneal dialysis and if so why
Yes, because it promotes vasodilation
What happends in the dwell time of peritoneal dialysis
-fluid (2000-2500cc) fills peritoneal cavity about 10mins
and remains in the peritoneal cavity
What happens in the exchange phase of peritoneal dialysis
-When the bag is lowered and fluids along with toxins are drained
What color should the drainage look like
Clear, Straw-liked
What can you do to a patient if all fluid is not able to come out
Gently move client from side to side
What are the two types of Peritoneal dialysis
CAPD (continuous ambulatory peritoneal dialysis)
CCPD (Continious cycle peritoneal dialysis)
If someone has a colostomy or arhtritis can they undergo CAPD
No
What are some complications of peritoneal dialysis
1) Peritonitis
2) Constant sweet taste
3) Hernia
4) Altered body image/sexuality
5) Anorexia
6) Low back pain
What should a person undergoing peritoneal dialysis have more in their diet
Fiber and protein
What kind of setting and patient is Continous renal replacement therapy (CRRT) done
ICU and a cardiovascular and acute renal failure patient