Renal Failure Flashcards
at what stage do sxs of renal failure begin to occur
stages 3-4
a GFR of what indicates kidney failure and a need for tx
GFR of less than 15
what stage of CRF: diminished renal reserve, no sxs
stages 1 and 2
what stage of CRF: renal insufficiency, polyuria, increases in BUN and creatinine
stages 3 and 4
what stage of CRF: GFR below 15, increased BUN and creatinine, increased sodium, increased potassium, decreased calcium, increased phosphate
stage 5
what labs are elevated in stage 5 CRF
BUN creatinine potassium phosphate sodium
what labs are decreased in stage 5 CRF
GFR
calcium
T or F: in stage 5 CRF you have N/V/D
FALSE, you have n/v and constipation
is UO increased or decreased in stage 5 CRF
decreased
most common perfusion issue in stage 5 CRF
HTN
heart issues that may occur in stage 5 CRF
pericardial effusion
pericardial tamponade
why would pts with stage 5 CRF have hypoglycemia
they are unable to metabolize insulin
common class of med given in stages 1-2 of CRF
ACE inhibitors
why are ACE inhibitors not given frequently past the 2nd stage of CRF
nephrotoxic
T or F: pts with CRF are not usually fluid restricted
FALSE
meds used to treat gout in stage 5 CRF
allopurinol
cholichine
why are meds usually held until after dialysis
meds can be filtered out of the body during tx
phosphate binding agent
renagel
med that may be given to treat anemia in CRF
epogen
teaching with iron supplements
may cause dark/tarry stools
diet teaching with phosphorus in CRF
limit high P foods to 7-8 oz of meat, poultry, or fish and 4 oz of dairy or milk products
this type of food contains a lot of phosphorus
beans
diet teaching with potassium in CRF
limit to 2000 mg/day
diet teaching with sodium in CRF
consume low sodium diet
diet teaching with protein in CRF
consume 7-8 oz/day
diet teaching with fiber in CRF
increase naturally found fibers (veggies)
diet teaching with fluids in CRF
fluid restricted, 1000-2500 cc/day
the goal of this is to remove the end products or protein metabolism such as urea and creatinine, maintain safe concentration of electrolytes and correct acidosis/replensih bicarb levels
dialysis
type of dialysis that a pt must be able to perform on their own
peritoneal dialysis
diet teaching with periotenal dialysis
increase potassium
for what types of pts is peritoneal dialysis contraindicated
COPD
abdominal adhesions/scarring
hernia
potential complications of peritoneal dialysis
peritonitis
local site infection
hernia
T or F: any licensed nurse can perform a dressing change on a hemocath
FALSE, must be the dialysis nurse
used for dialysis: surgery performed that leaves pt with one of their own arteries and veins fused together, takes 2-3 months before use
fistula
used for dialysis: surgery performed that leaves pt with a plastic device connecting an artery and a vein, takes 2 weeks before use
graft
how to tell if a fistula is patent
feel for thrill
listen for bruit
