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NCLEX > Renal > Flashcards

Renal Flashcards

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1
Q

inflammatory reaction in the glomerulus

A

glomerulonephritis

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2
Q

main cause of glomerulonephritis

A

strep infection

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3
Q

sx of glomerulonephritis

A 
sore throat
malaise/HA
BUN/CR
sediment/protein/blood in urine
flank pain
increased BP
facial edema
decreased UO
increased urine specific gravity
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4
Q

with glomerulonephritis the patient is going into fluid volume _____

A

excess

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5
Q

treatment for glomerulonephritis

A

get rid of the strep
monitor BP
fluid replacement

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6
Q

how is fluid replacement managed for glomerulonephritis

A

24 hr fluid loss + 500 ml

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7
Q

protein in the urine only happens when _____ is damaged

A

kidney

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8
Q

dietary needs for glomerulonephritis

A

low protein
low Na+

increased carbs!

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9
Q

____ and _____ may stay in the urine for months after glomerulonephritis

A

blood and protein

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10
Q

teach the glomerulonephritis patient sx of renal failure….which are?

A 
malaise
HA
anorexia
N/V
decreased output
weight gain
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11
Q

think what about nephrotic syndrome

A

loosing lots of proteins

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12
Q

an inflammatory response in the gloemerulus which makes big holes in the glomerulus so protein starts leaking out in the urine (proteinuria)

A

nephrotic syndrome

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13
Q

total body edema associated with nephrotic syndrome

A

anasarca

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14
Q

problems associated with protein loss

A

blood clots

increased triglycerides and cholestrol

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15
Q

causes of nephrotic syndrome

A

idiopathic

bacterial or viral infections
NSAIDs
cancer and genetic predisposition
systemic diseases such as lupus or diabetes
strep
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16
Q

sx of nephrotic syndrome

A

proteinuria
hypoalbuminemia
edema
hyperlipidemia

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17
Q

treatment for nephrotic syndrome

A 
diuretics
ACE inhibitors
prednisone
lipid lowering drugs
dialysis
anticoagulation
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18
Q

diet for nephrotic syndrome

A

decreased Na+

increased protein

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19
Q

the rule is to limit protein with kidney problems except with ____ _____

A

nephrotic syndrome

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20
Q

renal failure requires _____ failure

A

bilateral

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21
Q

in pre-renal failure _____ can’t get to the kidneys

A

blood

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22
Q

causes of pre-renal failure

A

hypotension
decreased HR
hypovolemic
any form of shock

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23
Q

intra-renal failure is when damage has occurred _____ the kidney

A

inside

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24
Q

causes of intra-renal

A 
glomerulonephritis
nephrotic syndrome
dyes
drugs
malignant HTN
DM
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25
Q

in post-renal failure is when ____ can’t get out of the kidneys

A

urine

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26
Q

causes of post-renal failure

A 
enlarged prostate
kidney stone
tumors
ureteral obstruction
edematous stoma
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27
Q

sx of renal failure

A 
elevated BUN/CR
increased specific gravity
anemia
HTN
HF
anorexia, N/V
uremic frost
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28
Q

_____ could cause lethal arrhythmias with renal failure

A

hyperkalemia

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29
Q

which acid base imbalance is renal failure in?

A

metabolic acidosis

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30
Q

in renal failure they retain ____ and serum ____ goes down

A

phosphorus

calcium

31
Q

two phases of acute renal failure

A

oliguric phase

diuretic phase

32
Q

during the oliguric phase what happened to UO?

A

decreased

33
Q

the UO in the oliguric phase is usually what in 24 hrs

A

100-400 ml/24 hrs

34
Q

in the oliguric phase the client is in fluid volume ____

A

excess

35
Q

what happens to the K+ in oliguric phase

A

increased

36
Q

UO with diuretic phase of acute renal failure

A

increased (10L/day)

37
Q

the client in the diuretic phase is in fluid volume ____

A

deficit

38
Q

what will happen with the K+ in the diuretic phase of acute renal failure

A

decrease

39
Q

the dialysis machine is like the ______ (filters)

A

glomerulus

40
Q

hemodialysis is done __-__ times a week

A

3-4

41
Q

to prevent the blood clots from forming in hemodialysis, the client is giving an _____ during dialysis

A

anticoagulant

42
Q

what 2 things are watched constantly with hemodialysis

A

electrolytes and BP

43
Q

which meds should you hold for a client going to hemodialysis

A

lisinopril
nitro
water soluble vitamins
ampicillin

(they can get famotidine bc its not filtered by the kidneys)

44
Q

with hemodialysis, blood is being removed, cleansed, and then returned at a rate of ___-___ ml/min

A

300-800

45
Q

the site where they have access to a large blood vessel because very rapid blood flow is essential for hemodialysis

A

valvular access

46
Q

anastomosis between an artery and a vein

A

arteriovenous fistula (AVF)

47
Q

a synthetic graft to join the vessels

A

arteriovenous graft (AVG)

48
Q

when a client has an alternate vascular access, what is the associated nursing care for that extremity?

A

No BP
No needle sticks
No constriction

49
Q

cat purring sensation that you can palpate over the area

A

thrill

50
Q

turbulent blood flow you can auscultate over the area

A

bruit

51
Q

in peritoneal dialysis they use the peritoneal membrane as a ____

A

filter

52
Q

_____ is warmed and infused into the peritoneal cavity by gravity via Tenckhoff catheter

A

dialysate

53
Q

how long does it take to infuse dialysate into the peritoneal cavity

A

10 minutes

54
Q

the time the dialysate stays into the peritoneal cavity

A

dwell time

55
Q

why do we warm the dialystate?

A

promotes vasodilation

56
Q

what should the drainage look like from the peritoneum

A

clear, straw-colored

57
Q

if the peritonal fluid is cloudy

A

infection

58
Q

what if all the fluid doesn’t come out with peritoneal dialysis?

A

reposition client

59
Q

two types of peritoneal dialysis

A

CAPD (continuous ambulatory peritoneal dialysis)

CCPD (continuous cycle peritoneal dialysis)

60
Q

continuous ambulatory peritoneal dialysis must be done how often?

A

4 times a day, 7 times a week

61
Q

who can’t do CAPD (continuous ambulatory peritoneal dialysis)

A

disc disease
arthritis
colostomy

62
Q

peritoneal dialysis catheter to a cycler at night and their exchange is done automatically while they sleep.

A

CCPD (continuous cycle peritoneal dialysis)

63
Q

major complications of peritoneal dialysis

A

constant sweet taste
hernias
anorexia
low back pain

64
Q

most serious complication with peritoneal dialysis

A

peritonitis

65
Q

1st sign of peritonitis

A

cloudy effluent 1st sign

66
Q

increase what in the diet with peritoneal dialysis?

A

fiber and protein

67
Q

continuous renal replacement therapy (CRRT) is typically done in the ____ setting and is continuous so that the client doesn’t have drastic fluid shifts

A

ICU

68
Q

with CRRT there is never more than ____ mL of blood out of the body at one time being filtered and therefore does not stress the cardiovascular system as much

A

80 mls

69
Q

CRRT is performed on a client with :

A

fragile cardiovascular status

acute renal failure

70
Q

other names for kidney stones

A

urolithiasis

renal calculi

71
Q

sx of kidney stones

A

pain
N/V
WBCs in urine
hematuria

72
Q

anytime you suspect a kidney stone, get a urine specimen ASAP and have it checked for ____

A

RBCs

73
Q

if a kidney stone is present, the client will get ____ ____ immediatley

A

pain medication

74
Q

treatment for kidney stones

A 
ondanestron 
NSAIDs
opioids
increase fluids
maybe surgery
strain urine

NCLEX (10 decks)

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