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Medical Nursing > Renal > Flashcards

Renal Flashcards

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1
Q

What diagnostic tests should be used to analyse the kidneys?

A

Haematology
Anaemia, increased urea and creatinine increased phosphorus hypokalaemia
Urinalysis
USG, glucose, crystals, protein, ketones, culture and sensitivity
Imaging
U/s
Biopsy: FNA tru cut

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2
Q

What is pre-renal azoteamia?

A

Not enough blood flow to the kidneys
Hypovolameia
concentrate urine usually reversible

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3
Q

What is post renal azoteamia?

A 
Blockage of urine leaving the system 
Blocked cat 
Uroltihs 
Bladder distension
Increased pressure decreased glomerular filtration can get perms any damage and bladder rupture
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4
Q

What is acute kidney injury?

A

Acute damage to the kidney can be caused by anti freeze ischeamia infections

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5
Q

What are the clinical signs of acute kidney injury?

A 
Lethargy inappetance 
Vomiting D + 
Dehydration 
Ureamic breath 
Oral ulceration 
Decreased urine production
Azoteamia 
Hyperkalaemia 
Hyperphospateamia
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6
Q

What can treat acute kidney injury

A 
Stop nephrotoxic drugs 
Ivft 
Treat pre/post abnormality
Anti-emetics(metrocolpramide, maropitant) 
Ab 
Nutrition
Acid base abnormalities 
Phosphate binders
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7
Q

What is chronic kidney disease?

A

Gradual deterioration of kidney function usually seen in older cats and dogs

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8
Q

What are the clinical signs of chronic kidney disease?

A 
Un concentrated urine 
Azoteamia 
PUPD 
Weight loss 
Halitosis 
Inappetance 
Vomiting 
Non-regenerative anaemia 
Small irregular kidneys 
Dehydration 
Hypertension 
Hypokalemia 
Hyperphophotemia 
Bacterial urinary infection
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9
Q

What can cause chronic kidney disease?

A 
Glomerulonephropathies 
Infectious
Nephrotoxins
Hydronephrosis 
Neoplasia
Inherited or congenital diseases
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10
Q

Investigations of CKD

A

Urinalysis
Haemotlogy and biochem
Severe azoteamia, anaemia hypokalema hyperphospotemia
Blood pressure
Below 120mmhg in a dog below 150mmhg in a cat
Diagnostic imaging

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11
Q

What is kidney staging based on?

A

Creatinine levels
Proteinuria
Blood pressure
Recognise CKD is progressive

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12
Q

What are the main aims of COD treatment?

A

Treat and underlying cause
Correct and maintain fluid balance
Manage clinical signs and complications
Delay progression

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13
Q

What should fluid therapy include for CKD?

A 
2-3xmaintanence 
Electrolyte imbalance 
Hartmann 
Correct dehydration over 24hours 
Reassess urea and creatinine in 24 hours
Home fluid therapy sc blouses 
Encourage fluid intake broths
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14
Q

What dietary management should be tried for CKD

A 
Good quality proteins (restricted)
Wet diet 
Energy dense 
High in potassium vitamins B and E
Decrease sodium 
High fermentable fibre 
Restricted phosphorus 
Phosphorus binders
Careful food aversion
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15
Q

How should vomiting and nausea be treated in CKD?

A

Gastroprotectants Sulcrulfate Zantac

Anti-emetics metoclopromide martipotant

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16
Q

How should inappetance and anorexia be managed in CKD?

A 
Tasty food 
Slow diet change 
Control nausea 
Assisted enteral feeding
Appetite stimulate (mitazipine)
17
Q

How should constipation be treated in CKD?

A

Lactulose enemas
Lactulose orally
Manage dehydration and electrolyte imbalance

18
Q

How should hypokalemia be corrected in CKD?

A

Supplement ivft of oral k gluconate

19
Q

What are the clinical conditions that should be treated to maintain CKD?

A 
Fluid imbalance 
Hypokalemia
Constipation
Inappetance/nausea
Anorexia 
Diet
Hyoerphospahtemia 
Hypertension 
Urinary tract infections 
Anaemia
20
Q

How should hypophosphotaemia Ben corrected in CKD?

A

Phosphate binders in the food
Calcium carbonate
Constipation is a side effect

21
Q

How should hypertension be managed in CKD

A 
Regular check ups 
Amlodopine  cats 
ACE inhibitor dogs (benezipril)
Telmisartan angiotensin 1 receptor blocker
Decrease sodium in the diet
22
Q

How should urinary tract infections be prevented in CKD

A

Encourage urination multiple walks
Multiple litter trays
Antibiotics based on culture and sensitivity

23
Q

How should anaemia be managed in a CKD patient?

A

Blood transfusion
Gastroprotectants (minimise blood loss)
Anaboli steriods (little evidence)
EPO deficiency correct human erythropoietin

24
Q

How should proteinuria be managed in a CKD patient?

A

Benazepril
Omega 3 fatty acids
Telmisartan

25
Q

What is the prognosis for dogs and cats with CKD?

A

Dogs average survival 6-12months
Cats 1-3 years
Best guide is clinical condition rather than lab parameters

26
Q

What conditions can present in lower urinary tract disease?

A 
Cystitis 
Blocked cat 
Uroliths 
Urinary incontinence 
Idiopathic feline lower urinalysis tract disease
27
Q

What are the clinical signs of cystitis and how should it be treated?

A 
Pain urination 
Increased frequency urination 
Blood in urine 
Bacterial infection 
Uroliths 
Incontient dribbling
Treatment 
Antibiotic culture and sensitivity 
Encourage urination and fluid intake
28
Q

What may be the causes of urinary incontinence?

A 
Neurogenic
Spinal cord disease 
Brain disease 
Peripheral nerve damage
Anatomical defects
Sphincter mechanism
29
Q

What Nursing care is required for urinary incontinence

A 
Barrier creams
Keep dry and clean
Frequent trips outside 
Antibiotics 
Hormones 
Bladder expression
30
Q

What are the three types of caliculi and what ph urine do they form in?

A

Calcium oxalate acidic coffin
Struvite alkaline Maltese cross
Urate -acidic thorn aplle

31
Q

Clinical signs of caliculi

A

Hameatouria pollkiuria dysuria

Uti

32
Q

Emergency treatment of a blocked cat

A

Empty the bladder
Cystocentesis
Catheterise and flush bladder with saline until clear
Ivft to treat Hyperkalaemia
Care post obstruction diuresis polyuric and hypokalemic
Monitor urine output and electrolytes
Anti spasmodic treatment

33
Q

Idiopathic lower feline urinary tract disease risk factors and clinical signs

A 
Young over weight restricted exercise indoor cat ablib feeding 
Multicat dry diets
Cystitis stranguria 
Episodic signs self limiting 
Urethral obstruction 
Painful bladder
34
Q

Treatment FLUTD

A

Minimise stress encourage grooming increase water intake antispasmodic reduce stress minimise weight improve toileting
GAGs ABs diet

Medical Nursing (22 decks)

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