Renal, RAAS

Question 1

RAAS is triggered by what, seen by what electrolyte?

Answer 1

Inadequate renal perfusion - decreased Na+ delivery

Question 2

Decreased Na+ to kidneys sparks an increase in what?

Answer 2

Renin which increases Angiotensin I

Question 3

Angiotensin I converts to ______ by ________

Answer 3

Angiotensin I converts to Angiotensin II by ACE (angiotensin converting enzyme)

Question 4

Angiotensin II produced ________ so the kidneys retain what?

Answer 4

Aldosterone - retain Na+ and H20 (fluids)

Question 5

Angiotensin II causes what three things with the cardiovascular system?

Answer 5

1) myocardial apoptosis (kills cells)
2) cardiovascular remodeling
3) vasoconstriction

Question 6

Angiotensin II causes what physiologic response?

Answer 6

Increased thirst (to increase fluid intake)

Question 7

Overview: RAAS causes what three things to occur?

Answer 7

1) Increase fluid intake
2) Retain fluids we already have
3) Remodel the heart (wut)

Question 8

Oliguria defined as ______ml/kg/hr?

Answer 8

0.2-0.3ml/kg/hr

Question 9

Polyuria defined as____ml/kg/hr?

Answer 9

> 2ml/kg/hr

Question 10

CRRT vs IHD

Answer 10

CRRT is continuous 24/7 procedure.

IHD is intermittent, lasts few hours

Question 11

Two ways for ERRT anticoagulation

Answer 11

heparinize the patient or citrate the lines

Question 12

dialysis: Citrate action and what you need to worry about

Answer 12

citrate into lines as it goes in (blocks calcium), add calcium as lines go back into patient watch lytes

Question 13

How does citrate work as an anticoagulant?

Answer 13

binds to calcium to prevent clot formation

Question 14

Hypotension, arrythmias, bleeding, hypothermia all possible side effects of what?

Answer 14

dialysis

Question 15

dialysis disequilibrium typically occurs when? what is it?

Answer 15

first dialysis

brain edema

Question 16

Strict sterility is of UTMOST importance

Answer 16

BE ASEPTIC

Question 17

CRRT mode: slow con. ultrafiltration

Answer 17

filters only, no replacement of fluids

Question 18

CRRT mode: cont. v/v hemofiltration

Answer 18

filtration with replacement of fluids

Question 19

CRRT mode: cont. v/v hemoDIALYSIS

Answer 19

cleans by diffusion

Question 20

CRRT mode: cont v/v FILTRATION

Answer 20

filters AND diffuses

Question 21

Peritoneal dialysis - non-commercial option

Answer 21

JP drain

Question 22

Peritoneal dialysis homemade solution recipe (3 things)

Answer 22

LRS + dextrose + heparin

Question 23

Dextrose concentration options in peritoneal dialysis (3) and what factor may affect your choice?

Answer 23

1.25%, 2.5%, 4.25% – dehydration. MORE dextrose for OVERhydrated patients (osmotic pressure pulls fluids out with it)

Question 24

Most common risk for peritoneal dialysis?

Answer 24

peritonitis - STRICT ASEPSIS

Question 25

Periotoneal dialysis procedure

Answer 25

1) warmed fluids (body temp)
2) infuse 40ml/kg
3) rest 40 min
4) drain

Question 26

When draining peritoneal dialysis - what amount should you get back?

Answer 26

90-100% – may be more if overhydrated and used 4.25% dextrose