Renal failure

Question 1

Oliguria

Answer 1

<400ml/24 hours

Question 2

Anuria

Answer 2

<100ml/24 hours

Question 3

Acute Renal Failure: Prerenal (9)

Answer 3

loss of circulating blood, hemorrhage, GI loss, burns, sepsis, diuretics, low CO (CHF, MI), AApressure, renal obstruction.

Question 4

Acute Renal Failure: Intrarenal “cortical” the meat of the kidney (6)

Answer 4

Renal capillary are swelling. malignant HTN (not coming down), Infection (strep), Immunological.(lupus, pastor)

Question 5

ARF: Postrenal

Answer 5

Obstruction to outflow (urethera, bladder uti, prostatic hypertropy, calculi)

Question 6

ARF: Intrarenal “Medullary”

Answer 6

Ischemic <60mm hg of blood in 40 mins. (hemorrhage, shock) Neprhotoxic (NSAID, ABs, Contrast dyes)

Question 7

ARF management:

Answer 7

Remove the cause (ischemic block, or nephrotoxins), Manage fluids and e-, (lower K, Insulin, NaHCO or use kayexalate)

Question 8

ARF management: cont..

Answer 8

I/O, Edema, weight, BP, ECG, LOC, e-, BUN, Creatinine.

• renal Diet
• Infection precautions.

Question 9

CRF Management

Answer 9

Preserve renal function, delay dialysis, monitor lab values, diabetes regulation, HTN regulations (to lessen damage)

Question 10

CRF Medications

Answer 10

Erythropoietin, Iron supplements (between meals) & folic acid, Ca and POS tabs (with meals), Ani-HTN, Meds to lower K+

Question 11

CRF Teaching

Answer 11

Dietary and fluid restrictions, hyperkalemia, reduce thirst (ice cube, lemon, hard candy), Counseling.

Question 12

Hyperkalemia s/s

Answer 12

Irritability, arrythmias, tall t waves, v fib.

Question 13

CRF what do patients report?

Answer 13

Gain of weight, high BP, dyspenia, edema, fatigue, confusion, weakness.

Question 14

CRF Diet

Answer 14

Restrictions: fluids, proteins, NA, K, Phosphorus.

will need Ca supplements.

Question 15

Hemodialysis care on fistula or graft

Answer 15

Aseptic technique with access, bruit/thrill, assess infection clotting.

Question 16

Complications of Hemodialysis?

Answer 16

HTN, Muscle cramps, blood loss, hepatitis, sepsis, disequilibrium disorder.

Question 17

Peritoneal Dialysis complications?

Answer 17

exit site infection, peritonitis, abdominal pain, outflow problems hernia, lower back problems, bleeding, pulmonary complication, protein loss, “Sclerosing filtration” loss of ultrafiltration.

Question 18

s/s of peritonitis?

Answer 18

fever, abdominal pain, rigid stomach, n/v

Question 19

Risks of infection at peritoneal site?

Answer 19

observe for infection, aseptic technique, observe effluent for cloudiness.

Question 20

Hemodialysis monitoring. pretreatment

Answer 20

UA, phosphate, calcium, Wt, BP, access condition

Question 21

Hemodialysis monitoring during treatment

Answer 21

bp, hr, loc, access site,

Question 22

hemodialysis monitoring after treatment

Answer 22

bp, loc, weight, access site (bleeding out)