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SET 2 > Renal > Flashcards

Renal Flashcards

1
Q

What is Glomerulonephritis

A

Inflammation in the glomerulus that causes scarring and decreases filtering abilities. Mainly caused by strep A.

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2
Q

What are the s/s of glomerulonephritis?

A 
Flank pain
Costovertebral 
Decreased U/O
Hematuria
Proteinuria
Periorbital edema 
BP increased 
FVE -> Urine Specific Gravity Increased 
Azotemia
Malaise and headache why?
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3
Q

What is the txt for glomerulonephritis

A

Get rid of the strep
I/O and daily weight checks
Diuretics
Monitor BP

Restrict Fluids - fluid replacement 24 loss + 500 ml
Increase the Carbs, decrease the sodium and protein
Dialysis

Activity and Rest

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4
Q

What do you teach with someone with glomerulenephritis?

A

Diuresis begins 1-3 weeks of onset
Blood and urine may continue for months
Teach them signs of renal failure and notify when it happens:

Nausea, vomiting, anorexia, weight gain, malaise, headache, decreased output

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5
Q

What is Nephrotic syndrome?

A

Inflammation in the glomerulus in which big holes allowing proteinuria = hypoalbumin, as a result fluid will go into the tissue the person becomes edematous and blood volume decreases, aldosterone is activated to retain sodium and water but since no protein/ albumin it cant be held in vascular space resulting in tissue and edema. (anasarca)

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6
Q

What are the problems with protein loss (Nephoritic syndrome)?

A

Blood clots , thrombosis

High chloest and trigly, liver will try to compensate making increase release of this.

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7
Q

Causes of Nephritic syndrome

A 
Idiopathic:
Bacteria viral infections
NSAIDS
Cancer and genetics 
Systemic disease such as lupus or diabetes
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8
Q

S/s of nephrotic syndrome

A

Massive proteinuria
Hypoalbuminemia
Edema
Hyperlipidemia

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9
Q

What is the treatment for nephrotic syndrome

A

Diuretics
Ace inhibitors to block aldosterone secretion
Prednisone why?
Cyclophosmide it will decrease body’s immune response, shrink holes, immunosuppressed
Lipid lowering drugs
Anticoagulants for up to 6 months , to prevent thrombosis
Dialysis

Major complication of nephrotic syndrome is infection

Diet
Increase protein moderately 1-2 mg/day
Client is malnourished fast, so sm. frequent meals
Decrease sodium , so they dont retain fluid

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10
Q

What are your nursing considerations for nephrotic syndrome

A

Daily weight
I/o
Measure abdominal girth and extremity size
Good skin care

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11
Q

What is acute kidney injury ?

A

Sudden renal damage

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12
Q

Causes of AKI pre-renal failure

A 
Blood can't get into the kidneys
Hypotension
HR decreased
Hypovolemic
Shock
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13
Q

Causes of AKI, intra-renal

A

Damage inside kidney
Glomerulonephritis and Nephrotic Syndrome
Malignant Hypertension, uncontrolled diabetes
Acute Tubular Necrosis
Hypotension, sepsis, drugs that damage kidneys
Dyes
Drugs - mycin’s
NSAIDS

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14
Q

Causes of AKI, post-renal

A 
Urine cant get out of the kidneys
Enlarged Prostate
Kidney stone
Tumor
Ureteral Obstruction
Edematous stoma (ileal conduit)
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15
Q

What are the four phases of AKI?

A

Initiation phase
oliguric phase (output is <100ml / 24hrs)
Diurectic phase
Recovery phase

** last two**

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16
Q

S/s of AKI?

A 
Creatinine and BUN increased
Specific Gravity increased, BUT may be fixed specific gravity
HTN AND HF
Anorexia, Nausea, Vomitting
Uremic frost
Retain phosphorus*
Anemia*
Hyperkal*
metabolic acidosis
17
Q

What are the nursing meds and treatmens for AKI?

A 
Bedrest * meta and caloric
TCBD
Monitor  i/o *
Daily weights
VS
Meds:
Diuretics*
IV glucose, insulin, calcium gluconate*
Kayexalate to decrease potassium 
Phosphate binding*
Give IV meds in low

Provide client and family support
Oliguric phase ends 10-14 days

18
Q

What is the nutrition for AKI?

A

Increase carbs and fats
low protein diet
avoid foods and fluids high in phosphate
Avoid foods high in potassium

19
Q

How to prevent infection in AKI

A 
Good skincare
Aseptic Technique
Prevent pressure ulcer
mouth care
no catheter
May need replacement therapy
20
Q

Diuretic phase in AKI

A

When Diuretic phase begins watch for:
Output increase
Fluid and Electrolyte

21
Q

Recovery Phase in AKI

A

It is the last phase, protein and calories increased

activity as tolerated

22
Q

What is replacement therapy?

A

Takes over or replace kidney function. It starts when
Bun and creat cannot be decreased
FVE is compromising heart and lungs
Hyperkal and met acidosis cannot be treated

23
Q

What is hemodialysis?

A

Filters glomerulus
3-4 times a week - eat and drink in between treatments must be monitored
Monitor suicidal

24
Q

What meds and nrsg consideration for Hemodialysis?

A

Anticoagulants to prevent clots
Fluid status
Electrolytes and BP

25
Q

Hemodialysis will do what to the blood ? And what does the vascular access do?

A

Remove blood and cleanse it at the rate between 300 to 800 mL , this is a large blood vessel. Two needles inserted into vascular access.

One for blood to send to hemo machine, other to return filtered blood

Arterial end access will remove blood though lower pressure venous. Temp access is in the internal jugular or femoral vein

26
Q

How to care for Hemo access

A

Do not use for IV access, no blood pressure, no needsticks, no constrictions

27
Q

How to assess hemo access?

A

Feel the Thrill hear the bruit

28
Q

What is continuous replacement therapy

A

Done is icu setting never more than 80 ml of blood at a time to not stress cardio system for cardio individuals and kidney injury

29
Q

What is periotoneal dialysis?

A

Periotonial utilized as membrane
Called the exchange takes 20-30 min in which fluid drops by gravity via catheter (2000-2500mls) and then bag is lowered w/ toxin to be drained. Fluid must be warm and drain should be clear. Cloudy indicated infection. If fluid doesnt come out completely turn pts side-to-side. This txt is only for those who cant do hemo or prefers this method

30
Q

Types of peritonial dialysis

A

CAPD - must have energy done 4x a week, no arth or disc disease no colostomy.

APD
Done at night while they sleep but prone to exit site infection and periotonitis.

s/s abd pain and cloudy

31
Q

Dietary needs of dialysis client

A

Increase fiber

Protein

32
Q

S/s of kidney stones

A

Pain/n/v
wbc in urine
hematuria
When syspected get urine specimen and check rbc if confirmed give pain meds

33
Q

Txt for kidney stones

A 
Ondasetro
alph ad blockers why?
nsaids/opiods
increase fluids
surgery
Shock wave
Strain urine

SET 2 (16 decks)

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