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BAR Review > Renal Fabs > Flashcards

Renal Fabs Flashcards

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1
Q

normal value: Osmolality

A

280-300 mOsm/kg

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2
Q

normal value: Hematocrit

A

36-54%

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3
Q

normal value: Hematocrit in females

A

36-48%

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4
Q

normal value: Hematocrit in males

A

39-54%

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5
Q

normal value: Hemoglobin

A

12-18g/dL

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6
Q

normal value: Hemoglobin in females

A

12-18d/dL

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7
Q

normal value: Hemoglobin in males

A

13-18g/dL

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8
Q

normal value: Urine specific gravity

A

1.010-1.030

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9
Q

Hormones influencing fluids

A

Aldosterone and ADH

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10
Q

SIADH

A

syndrome of increased ADH

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11
Q

ADH secretion is usually stimulated by one of three mechanisms

A

1) increased serum osmolality
2) decreased plasma volume
3) decreased BP

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12
Q

DI

A

decreased ADH

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13
Q

ADH is released by the

A

pituitary gland

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14
Q

SIADH vs DI

urinary retention

A

SIADH

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15
Q

SIADH vs DI

dilutional hyponatremia

A

SIADH

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16
Q

SIADH vs DI

risk for dehydration

A

DI

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17
Q

SIADH vs DI

hypernatremia (hemoconcentration)

A

DI

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18
Q

fluid gain > electrolyte gain

A

Fluid Volume Excess: hypotonic overhydration

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19
Q

fluid loss < electrolyte loss

A

Fluid Volume Deficit: hypotonic dehydration

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20
Q

fluid loss = electrolyte loss

A

Fluid Volume Deficit: isotonic dehydration

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21
Q

fluid gain = electrolyte gain

A

Fluid Volume Excess: isotonic overhydration

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22
Q

fluid gain < electrolyte gain

A

Fluid Volume Excess: hypertonic overhydration

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23
Q

fluid loss > electrolyte loss

A

Fluid Volume Deficit: hypertonic dehydration

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24
Q

symptoms of FVE

A

weight gain, hypertension, edema, increased urine output, decreased urine specific gravity

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25
Q

symptoms of FVD

A

weight loss, hypotension, dehydration, decreased urine output, increased urine specific gravity

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26
Q

nursing management for FVE

A

decrease oral fluid intake (1,200cc/day), stop IVF and report, administer an osmotic diuretic [Mannitol]

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27
Q

nursing management for FVD

A

increase oral fluid intake, administer IVF, medications depend on etiology

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28
Q

normal range for Sodium

A

135-145

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29
Q

symptoms of Hypernatremia

A

cellular dehydration

"FRIED SALT"
flushed skin
restless, anxious, confused, irritable
increased BP & fluid retention
decreased urine output

skin flushed & dry
agitation
low-grade fever
thirst

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30
Q

symptoms of Hyponatremia

A

cellular overhydration

"SALT LOSS"
stupor/coma
anorexia
lethargy
tachycardia

limp muscles
orthostatic hypotension
seizures/headaches
stomach cramping (hyperactive bowels)

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31
Q

nursing management for Hypernatremia

A

decrease Na in diet, IVF, Furosemide

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32
Q

nursing management for Hyponatremia

A

increase Na in diet, IVF (NaCl), Mannitol

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33
Q

normal range for Potassium

A

3.5-5.5mEq/L

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34
Q

symptoms of Hyperkalemia

A

twitching, spasms, tingling sensation, increased gastric motility (hyperactive BS), diarrhea, decreased HR, hypotension

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35
Q

symptoms of Hypokalemia

A

weakness, diminished DTR, decreased gastric motility (hypoactive BS), constipation, decreased HR, hypotension

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36
Q

nursing management for Hyperkalemia

A

decrease K in diet, avoid salt substitutes, Insulin, prepare for dialysis if sodium is critically high, prepare IV calcium and IV hypertonic glucose, K sparing diuretics [Spironolactone/Aldactone]

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37
Q

nursing management for Hypokalemia

A

increase K in diet, administer KCl via Solu-set maximum dosage of 20mEq/day, K supplements (tablet = N/V; liquid = bitter, take with orang juice)

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38
Q

ECG changes in Hyperkalemia

A

1) tall peaked T waves
2) flat P waves
3) widened QRS complexes
4) prolonged PR intervals

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39
Q

ECG changes in Hyperkalemia

A

1) tall peaked T waves
2) flat P waves
3) widened QRS complexes
4) prolonged PR intervals

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40
Q

ECG changes in Hypokalemia

A

1) ST depression
2) shallow or inverted T wave
3) prominent U wave

41
Q

normal range for Calcium

A

8.6-10mg/dL

42
Q

symptoms of Hypercalcemia

A

weakness/diminished DTR, decreased gastric motility, constipation, excessive urination, increased HR, hypertension

43
Q

symptoms of Hypocalcemia

A

twitching, spasms, tingling sensations, convulsions, (+) Trousseau’s sign, Chvostek’s sign, numbness (fingers, face, limbs), increased gastric motility, diarrhea, decreased HR, hypotension

44
Q

nursing management of Hypercalcemia

A

decrease Ca in diet

administer Phosphorus, Calcitonin, bisphosphates, prostaglandin synthesis inhibitors (NSAIDs)

45
Q

nursing management for Hypocalcemia

A

increase Ca in diet, vitamin D in diet, administer Calcium gluconate via slow push, initiate seizure precautions

46
Q

normal range for Magnesium

A

1.5-2.5mEq/L

47
Q

symptoms of Hypermagnesemia

A

displays symptoms of Hypercalcemia

48
Q

symptoms of Hypomagnesemia

A

displays symptoms of Hypocalcemia

49
Q

nursing management for Hypermagnesemia

A

restrict dietary intake of magnesium-containing foods, avoid the use of laxatives and antacids containing magnesium, administer Loop diuretics [Furosemide], IV CaCl or Calcium gluconate

50
Q

nursing management for Hypomagnesemia

A

increase magnesium-containing foods, Magnesium sulfate (IV or PO), seizure precautions

51
Q

P wave represents

A

atrial depolarization (contraction)

52
Q

QRS complex represents

A

ventricular depolarization (contraction)

53
Q

T wave represents

A

ventricular repolarization (relaxation)

54
Q

atrial repolarization is covered by

A

QRS complex

55
Q

U wave represents

A

repolarization of the Purkinje fibers

56
Q

normal PR interval

A

0.12-0.20 sec

57
Q

normal QRS complex

A

0.06-0.12 sec

58
Q

methods in determining the HR in an ECG reading

A

1) 6-sec method

2) Big box method

59
Q

a PR interval > 0.20sec indicates

A

dysrhythmias; heart blocks

60
Q

a QRS complex > 0.12sec indicate

A

dysrhythmias; PVC

61
Q

normal range for blood pH

A

7.35-7.45

62
Q

normal range for PCO2

A

35-45

63
Q

normal range for HCO3

A

22-26

64
Q

increased PaCO2
increased or normal HCO3
decreased pH

A

respiratory acidosis

65
Q

decreased PaCO2
decreased or normal HCO3
increased pH

A

respiratory alkalosis

66
Q

decreased or normal PaCO2
decreased HCO3
decreased pH

A

metabolic acidosis

67
Q

increased or normal PaCO2
increased HCO3
increased pH

A

metabolic alkalosis

68
Q

compensation in Respiratory Acidosis

A

kidneys eliminate H+ and retain HCO3

69
Q

compensation in Respiratory Alkalosis

A

kidneys conserve H+ and excrete HCO3

70
Q

compensation in Metabolic Acidosis

A

lungs eliminate CO2, conserve HCO3

71
Q

compensation in Metabolic Alkalosis

A

lungs decrease ventilation to increase PCO2, kidneys conserve H+ to excrete HCO3

72
Q

normal range for GFR

A

90-120mL/min

73
Q

normal range for BUN

A

7-20mg/dL

74
Q

normal range for Creatinine

A

0.6-1.2mg/dL

75
Q

a kidney disorder that causes your body to pass too much protein in your urine

A

Nephrotic Syndrome

76
Q

classic symptoms of nephrotic syndrome

A

edema, hyperlipidemia, proteinuria, hypoalbuminemia

77
Q

nursing management for nephrotic syndrome

A

1) Diet: low sodium, cholesterol, and saturated fats; high biologic proteins (dairy products, eggs, meat)
2) Medications: Diuretics, Statins, Prednisone, antineoplastic agent, immunosuppressant
3) report any signs of infections (e.g., respiratory infections)

78
Q

Acute Renal Failure

A

sudden renal damage

79
Q

category of ARF in which there is a decrease in volume/perfusion to the kidneys

A

Prerenal Failure

80
Q

category of ARF in which there is prolonged ischemia

A

Intrarenal Failure

81
Q

category of ARF in which there is an obstruction in the urinary tract

A

Postrenal Failure

82
Q

Onset phase

A

cellular injury

83
Q

Oliguric phase

A

decreased urine output (<400cc/day), decreased GFR (<90), edema, hypertension, hyperkalemia, increased BUN & Creatinine, dialysis may be needed

84
Q

Diuretic phase

A

gradual increase in urinary output (4-5L/day), risk for dehydration, hypotension, hypokalemia, improved GFR & Creatinine

85
Q

Recovery phase

A

may take up to 6-12 months, also called the convalescence stage

87
Q

nursing management for ARF

A

1) Diet: moderate protein
2) Oliguric Phase: decrease fluid intake, antihypertensives, Furosemide
3) Diuretic Phase: increase fluid intake, sodium bicarb for low Na, calcium gluconate for low Ca, magnesium sulfate for low Mg, KCl for low K

88
Q

Hemodialysis

A

outside the body, blood is passed through a dialyzer, fistula or graft is the access site, 3 times a week; 3-5-hour duration, done at the clinic

88
Q

Stage 2 CRF

A

<90cc, mild loss of renal function with proteinuria

89
Q

Peritoneal dialysis

A

inside the body, a hypertonic fluid is administered in the peritoneum (3-5cm below the umbilical area), 4 times a week; 20-30mins duration, can be done at home

90
Q

Chronic Renal Failure

A

progressive and irreversible loss of kidney function

91
Q

Stage 1 CRF

A

> 90cc, normal renal function with proteinuria, asymptomatic

93
Q

Stage 3 CRF

A

A: <60cc, B: <45cc, moderate loss of renal function

93
Q

Stage 4 CRF

A

<30cc, severe loss of renal function

94
Q

Stage 5 CRF

A

<15cc, ESRD

95
Q

symptoms of CRF

A

cardiomyopathy, HF, anemia, stomatitis, uremic gastritis, uremic frost, uremic fetor, coma

96
Q

nursing management for CRF

A

low protein diet, emotional support, skincare (itch precaution), oral care, fistula care, loop diuretics (stage1-2), thiazide diuretics (stage 3-5)

96
Q

eGFR for men

A

90-140mL/min

98
Q

eGFR for women

A

80-125mL/min

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