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med surg 3 test 3 > renal failure and dialysis > Flashcards

renal failure and dialysis Flashcards

1
Q

True or false

Acute renal failure has a slow reduction in urine output

A

false

rapid

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2
Q

True or False

Acute renal failure is irreversible

A

False

usually reverisble

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3
Q

In acute renal failure, there is tubular cell ____ and _____

A

dseath and regeneration

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4
Q

S/S of ARF?

A

Decrease urine output (70%)

Edema, esp. lower extremity

Mental changes

Heart failure

Nausea, vomiting

Pruritus

Anemia

Tachypenia

Cool, pale, moist skin

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5
Q

in ARF, urine output is decreased by ______%

A

70%

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6
Q

what is pruritus

A

itching of the skin

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7
Q

what are the three ways ARF can occur?

A

pre-renal
intrinsic
post-renal

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8
Q

Pre-renal reasons of ARF include?

A 
Vomiting
Diarrhea
poor fluid intake
Fever
use of diuretics
heart failure 
liver dysfunction
septic shock
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9
Q

Intrinsic reasons for ARF include?

A 
Interstitial nephritis
acute glomerulonephritis
tubular necrosis
Ischemia
toxins
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10
Q

Post-renal reasons for ARF include?

A

prostatic hypertrophy
retroperitoneal disorders
neurogenic bladder
bilateral renal calculi

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11
Q

Pre-renal makes up ____% of ARF

A

55%

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12
Q

Intrinsic or renal parenchymal makes up _____% of ARF

A

40%

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13
Q

Post-renal makes up ____-___% of ARF

A

5-15%

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14
Q

what phase of ARF is when urine output is <400 ml in 24 hours?

A

oliguric/anuric phase

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15
Q

what phase of ARF is when the time of urine output at <400 ml in 24 hours to the time BUN stops rising?

A

Diuretic phase

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16
Q

what is the convalescent phase of the diuretic phase?

A

urine output and BUN are WNL

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17
Q

ARF can lead to hyperkalemia. What are the S/S?

A

Weakness

Lethargy

Muscle cramps

Paresthesias

Hypoactive DTRs

Dysrhythmias

18
Q

describe the EKG of a person with hyperkalemia

A 
K > 5.5 -6
Tall, peaked T’s
Wide QRS
Prolong PR
Diminished P
Prolonged QT
QRS-T merge – sine wave
19
Q

True or False

Hyperkalemia can cause cardiac arrest?

A

True

20
Q

In chronic renal failure, _____% of function can be lost before its noticeable

A

75

21
Q

True or False

Chronic renal failure is non reversible, progressive with nephron loss.

A

True

22
Q

what is the mortality of chronic renal failure?

A

20%

23
Q

Chronic renal failure and ESRD affect more then ___ out of 1,000 people in the US

A

2

24
Q

chronic renal failure causes?

A

Diabetic Nephropathy

Hypertension

Glomerulonephritis

HIV nephropathy

Polycystic kidney disease

Kidney infections & obstructions

25
Q

CRF S/S

A 
Malaise
Weakness
Fatigue
Neuropathy
CHF
Anorexia
Nausea
Vomiting
Seizure
Constipation
Peptic ulceration
Diverticulosis
Anemia
Pruritus
Jaundice
Abnormal hemostasis
26
Q

what are some problems related to ESRD?

A

Metabolic – K/Ca/Na

Volume overload

Anemia, platelet disorder, GI bleed

HTN, pericarditis

Peripheral neuropathy, dialysis dementia

Abnormal immune function

27
Q

what does dialysis do?

A

Diffuse harmful waste out of body

Control BP

Keep safe level of chemicals in body

28
Q

what are the two types of dialysis?

A

hemodialsys

peritoneal dialysis

29
Q

hemodialysis takes around ____ hours and pt must go ____-___ times a week

A

4

2-4

30
Q

in hemodialysis, three types of access include?

A

temporary site
AV fistula
AV graft

31
Q

what is an AV fistula?

A

Surgeon constructs by combining an artery and a vein

3 to 6 months to mature

32
Q

what is an AV graft?

A

Man-made tube inserted by a surgeon to connect artery and vein
2 to 6 weeks to mature

33
Q

PT implications for pts on dialysis include?

A

No BP on same arm as fistula

Protect arm from injury

Control obvious hemorrhage
Bleeding will be arterial
Maintain direct pressure

34
Q

In peritoneal dialysis, an _____ _____ filters the blood

A

abdominal lining

35
Q

what is Continuous Renal Replacement Therapy

A

Slowly remove fluid, electrolytes, solutes; used mainly in ICU

36
Q

what are the two types of Continuous Renal Replacement Therapy ?

A

Continuous arteriovenous hemofiltration

Continuous venovenous hemofiltration

37
Q

what is Continuous arteriovenous hemofiltration

A

Uses arterial system to drive blood flow

Usually connects femoral artery & vein with oncotic pressures driving process

38
Q

what is Continuous venovenous hemofiltration

A

Requires pump because lack arterial system to drive blood flow

39
Q

what are some dialysis related problems?

A

Lightheaded –give fluids

Hypotension

Dysrhythmias

Disequilibration Syndrome

40
Q

what is Disequilibration Syndrome?

A

At end of early sessions
Confusion, tremor, seizure
Due to cerebral edema

41
Q

what are the PT implications for pts on dialysis?

A

Blood levels are optimum after dialysis but fatigue is high

Best time for exercise varies from Pt to Pt

Pt may have low BP after dialysis

med surg 3 test 3 (9 decks)

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