Renal Emergency

Question 1

what are kidneys massively responsible for?

Answer 1

electrolyte balance

Question 2

what is the primary use of K+?

Answer 2

heart

Question 3

what is the primary use for NA+?

Answer 3

neuro (seizures)

Question 4

what is the primary use of Ca++?

Answer 4

strength

Question 5

what is the job of the Adrenal Gland (sits on top of the kidney)

Answer 5

Hormones, but big one is BP. Renin-angiotensin-aldosterone. These innervate the kidney (to say keep or get rid of fluid).

Question 6

Blood test for the Kidneys?

Answer 6

BUN
Creatine
GFR

Question 7

what is end state renal disease?

Answer 7

they require dialysis

Question 8

Disequilibrium syndrome

Answer 8

Occurs after dialysis; Dialysis machine has no way to know how much electrolyte to keep. Electrolyte imbalance. Sometimes when blood returns to body, electrolytes are way out of whack.

Presents with neuro dullness, visual disturbances, seizures, cardiac arrest, altered mental status, etc. Treat the symptoms-12 lead, benzos, etc…

Question 9

what is a big emergency that we will encounter with a pt that has dialysis?

Answer 9

They can be hyper or hypo dialysis.

NEED 12-Lead

Question 10

what is seen with hypokalemia?

Answer 10

widen QRS to a ventricular rhythm.

Question 11

where does aldosterone secrete from?

Answer 11

adrenal gland

Question 12

where does ADH secrete from?

Answer 12

pituitary gland

Question 13

what is Erythropoietin (EPO)? and how is it stimulated?

Answer 13

Stimulated by low O2 levels.

its a hormone that when stimulated calls for the increase production of red blood cells.

Question 14

what is glyconeogenesis?

Answer 14

the creation of new glucose.

Kidneys help do this.

Question 15

how much fluid will get filtered through the kidneys a day?

Answer 15

1000 L in 24hrs.

Question 16

what are nephrons?

Answer 16

functional unit of the kidney, used to filter.

Question 17

what is urinary retention?

Answer 17

the inability to urinate, can not pee due to some type of blockage:

kidney stone
prostate enlargement 
inflammation of urethra.
bladder infection
cancer

Question 18

when someone says that they can not pee, what are two things you need to think to ask?

Answer 18

Difficult to unite and can’t actually pee

aren’t producing urine.

Question 19

what does it mean if a person is not producing urine?

Answer 19

dehydration.

kidney failure.

Question 20

oliguria

Answer 20

small amounts of urine

Question 21

anuria

Answer 21

not make urine

Question 22

dysuria

Answer 22

painful urination

Question 23

what is our concern with an upper UTI?

Answer 23

pyelonephritis

Question 24

what is pyelonephritis?

Answer 24

life threatening infection, and can move up into your kidneys (inflammation of the kidney)

pus and inflammation of nephrons, causes acute renal failure, sepsis, and infrarenal and perinephric abscesses.

Question 25

what do lower UTI involve?

Answer 25

bladder and urethra

very common in young women

Question 26

what is occult bleeding?

Answer 26

its blood traces in the urine, something we wont see, but it needs to have a urine test for.

Question 27

about how much CO will be needed to perfuse the kidneys?

Answer 27

20% or our Cardiac Output is for the kidneys. they metabolize a lot.

if Septic, important to fill the pt to keep them perfused and the kidneys working. Also use of a presser.

Question 28

what should we do with a pt that has a suspected acute or chronic kidney failure.

Answer 28

place them on the 12-lead. we want to look for electrolyte imbalances.