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ADULT HEALTH 3 > RENAL FAILURE > Flashcards

RENAL FAILURE Flashcards

1
Q

What are the 7 Renal functions??

A
  1. Blood pressure control
  2. Fluid and electrolyte balance
  3. Filtration of waste products
  4. ## ACID/BASE Balance
  5. Erythropoietin production (stimulates RBC production).
  6. Activation of VITAMIN D!!
  7. Urine production 1ml/kg/hr!!!!!
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2
Q

What is BUN?

A
  1. Product of protein metabolism!!
  2. Affected by: protein intake, liver function, *Fluid volume (bun increases if fluid is low)
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3
Q

What is Creatinine?

A
  1. Waste product of muscle activity!!
  2. Vary based on age, race, gender
    • Filtered by Glomerulus
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4
Q

What would happen to BUN if there’s GI bleeding?

A

Increases!

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5
Q

Does BUN rise or decrease when there’s low volume or low CO??

A

BUN Rise when there’s low volume!!

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6
Q

What is GFR??

A
  1. The # of functioning Nephrons!!
  2. Based on Creatinine levels, race, gender, age
    — HIGHER IN THOSE OF AFRICAN ANCESSTRY
  3. Normal: >60ml/min
  4. Chronic Kidney Disease: 15-60 ml/min
  5. ESRD: <15 ml/min
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7
Q

What are LAB ALTERATIONS WITH RENAL DYSFUNCTION??? (10)

A
  1. Sodium (low)
  2. Potassium (high)
  3. Magnesium (high)
  4. Phosphorus (high)
  5. Vitamin D (low)
  6. Calcium (low)
  7. *Parathyroid Hormone (PTH) (High)
  8. Albumin:
    - Serum (decrease w/ urinary loss, malnutrition)
  9. **Hgb and Hct (Low – Anemia)
  10. **Iron and Ferritin (low)
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8
Q

What are other DIAGNOSTIC TESTS TO use for renal dysfunctions???

A
  1. MRI and CT scans
  2. Renal angiography
  3. (IVP) Intravenous Pyelogram –> NEEDS BOWEL PREP (image kidneys, ureter, bladder)
  4. CONTRAST USED:
    1) Renal fx
    2) Hydration!
    3.) Allergies (does NOT matter if they have iodine or shellfish allergies. can still be given)
    4.) Hold METFORMIN 48 hours before and after
    5) NSAIDS: AVOID!!!!!!!!! (also w/ ANY other kidney disease!!)
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9
Q

What are the nursing duties during Pre and Post RENAL BIOPSY???!!!!!

A

PRE-BIOPSY:
1. **NPO 4-6 hours!!!!!
2. **Coagulation studies (bc risk of bleeding)

POST-BIOPSY:
1. **Bed-rest and SUPINE
2. Local pain is normal
3. Monitor for bleeding
4. Monitor for infection
5. **HEMATURIA FOR 48-72 HOURS!!!! (expect this)
6. Hydration durrrr!!!

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10
Q

Which disease is bc of GENETIC disorder???

A

POLYCYSTIC KIDNEY DISEASE!!!!

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11
Q

What are the S/S of POLYCYSTIC KIDNEY DISEASE?????

A
  1. HYPERTENSION
  2. Abdominal, flank, and lower back pain
  3. CVA Tenderness and PALPABLE, Enlarged kidney
    4.HEADACHE –> cerebral aneurysm
    ———–
  4. Increased ABDominal girth!!
  5. CONSTIPATION
  6. HEMATURIA
  7. ** UTI’S AND KIDNEY INFECTIONS!!!!!!!!***
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12
Q

WHAT IS THE NUMBER ON S/S OF POLYCYSTIC KIDNEY DISEASE?????!!!!!!

A

HYPERTENSIONN

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13
Q

What are THE COMPLICATIONS OF POLYCYSTIC KIDNEY DISEASE??? (2)

A
  1. CYSTS May grow in the Liver, Pancreas, blood vessels.
  2. Heart valve issues, KIDNEY STONES, and Cerebral Aneurysm!!!
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14
Q

What are the PATIENT CARE for POLYCYSTIC KIDNEY DISEASE???

A
  1. Family History
  2. ***ANTIBIOTICS as needed
  3. Pain COntrol: NO NSAIDS, Acetaminophen okay
  4. Prevent constipation
  5. ## Diet: Limit salt, Cautious w/ protein – choose PLANT-BASED protein, NO Saturated fats, LOW POTASSIUM AND PHOSPHORUS
  6. Fluid considerations: pt specific
  7. Control BP: ACE or ARBs
  8. Monitor renal function
  9. ** POTENTIAL FOR RTT or Transplant!!
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15
Q

What are the 5 CAUSES/Etiologies of Acute Glomerulonephritis????

A
  1. **Infections: Strep (or also Impetigo)
  2. ** Autoimmune Diseases: Goodpasture’s and Lupus
  1. Vasculitis*
  2. HTN*
  3. DIABETES*
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16
Q

wHAT ARE s/s OF Acute Glomerulonephritis????

A
  1. Fluid Overload S/S: Edema (general, periocubital, dependent, and ascites) AND increased BP & HR.
  2. ## Oliguria, Hematuria, “FOAMY” URINE!!!!!!!***
  3. *Fatigue and Muscle Cramp!!
  4. **Abdominal and Flank pain, N/V!!!
17
Q

What are the DIAGNOSTIC Findings of Acute Glomerulonephritis????

A
  1. UA: Blood, protein, WBC, Casts (indicator of post-strep)
  2. ## CBC: Increase WBC
  3. Decreased ALBUMIN, AND INCREASED COMPLEMENT
  4. Increased BUN, CREATININE, AND eGFR!!
18
Q

What are the Patient care for Acute Glomerulonephritis????

A
  1. TX based on cause and symptoms
  2. Abx, Diuretics, Antihypertensives: ACE and ARBs
  3. ## CORTICOSTEROIDS
  4. Daily Weight (1kg = 1L of fluid retained!!!!)
  5. ## Strict I&O
  6. Fluid and Na Restrictions (OUTPUT + Insensibe loss (600 ml) = next day’s fluid allowance)
  7. Low-moderate PROTEIN
  8. ## Manage HYPERKALEMIA
  9. Potential for SHORT TERM DIALYSIS
19
Q
A

ADULT HEALTH 3 (1 decks)

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