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NURS 428: Evolution > Renal System > Flashcards

Renal System Flashcards

Exam 3

1
Q

Renal system overview

Kidneys receive what percent of cardiac output?

A

Kidneys receive 21% of cardiac output

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2
Q

Renal system overview

Kidneys process how much blood per minute?

A

The kidneys process 1.2 L of blood per minute

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3
Q

Renal system overview

The entire blood volume is filtered through what? How many times a day?

A

The entire blood volume is filtered through the kidneys 340 times a day

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4
Q

Renal Anatomy

Kidneys are made up of what?

A

Nephron

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5
Q

Renal Anatomy

Nephrons are composed of?

A

Glomerulus
Bowman’s capsule
Tubular system

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6
Q

Renal Anatomy

Glomerular Filtration Rate (GRF): What is it?

A

Rate at which filtrate is formed

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7
Q

Renal Anatomy

Glomerular Filtration Rate (GRF): What does it do?

A

Autoregulation”

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8
Q

Renal Anatomy

Glomerular Filtration Rate (GRF): What do afferent arterioles do?

A

Afferent arterioles adjust diameter in response to the pressure of blood coming to them.

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9
Q

Renal Anatomy

Glomerular Filtration Rate (GRF):

Afferent arterioles adjust diameter in response to the pressure of blood coming to them.

During hypotension:

A

the smooth muscles of the afferent arterioles relax, vasodilation occurs, and perfusion increases, thereby maintaining the GFR at its normal rate.

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10
Q

Renal Anatomy

Glomerular Filtration Rate (GRF):

Afferent arterioles adjust diameter in response to the pressure of blood coming to them.

During hypertension:

A

vasoconstrict to decrease perfusion

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11
Q

Renal Anatomy

Glomerular Filtration Rate (GRF):

In healthy persons, autoregulation maintains homeostasis quite nicely when mean blood pressure falls approximately within a range of what?

A

In healthy persons, autoregulation maintains homeostasis quite nicely when mean blood pressure falls approximately within a range of 80 to 180 mm Hg

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12
Q

Renal Anatomy

Proximal tubules: What do they do?

A

80% filtrate returned to bloodstream by reabsorption in the proximal tubule

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13
Q

Renal Anatomy

Proximal tubules: What do they reabsorb?

A

All the glucose and amino acids

Much of sodium, chloride, hydrogen, and other electrolytes

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14
Q

Renal Anatomy

Proximal tubules: What do they secrete?

A

The proximal tubule cells also secrete substances (e.g., some drugs, organic acids, and organic bases) into the filtrate.

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15
Q

Hormonal Influence includes

A

ADH

Renin

Aldosterone

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16
Q

Hormonal Influence:

ADH: Where are osmoreceptors? What are they sensitive to?

A

Osmoreceptors in hypothalamus sensitive to serum osmolality

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17
Q

Hormonal Influence:

ADH: What would stimulate release of ADH?What does this lead to?

A

During dehydration, when serum osmolality rises, osmoreceptors in the hypothalamus respond by stimulating the hypothalamus to secrete ADH which increases the permeability of collecting tubule cells to water.

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18
Q

Hormonal Influence:

ADH: During dehydration, when serum osmolality rises, osmoreceptors in the hypothalamus respond by stimulating the hypothalamus to secrete ADH

A

which increases the permeability of collecting tubule cells to water.

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19
Q

Hormonal Influence

ADH: What does it do?

A

This permits the reabsorption of water alone (without electrolytes), which in turn decreases the concentration of the ECF.

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20
Q

Hormonal Influence

Renin: What is it secreted by?

A

Secreted by juxtaglomerular cells

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21
Q

Hormonal Influence

Renin: How does it effect GFR?

A

Angiotensin II constricts the smooth muscle surrounding the arterioles. This increases blood pressure, which increases the GFR.

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22
Q

Hormonal Influence

Aldosterone: What triggers the release of this? What is it released from?

A

Triggered by angiotensin II

Adrenal cortex

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23
Q

Hormonal Influence

Aldosterone: What does it do? How?

A

By increasing sodium reabsorption in distal tubule cells, aldosterone causes an increase in renal water reabsorption.

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24
Q

Hormonal Influence

Aldosterone: By increasing sodium reabsorption in distal tubule cells, aldosterone causes an increase in renal water reabsorption. What does this lead to?

A

This increases blood pressure and decreases serum osmolality.

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25
Q

Functions of the Renal System include

A

Renal clearance

Regulation

Fluid balance

Secretion of hormones

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26
Q

Functions of the Renal System:

Renal clearance: What is cleared? How much?

A

Clearance of metabolic end products

About 60 mL of plasma “cleared” of urea/minute

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27
Q

Functions of the Renal System

Regulation:

A

Electrolyte concentrations and pH of the extracellular fliud

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28
Q

Functions of the Renal System

Secretion of hormones: Like what?

A

Calcitrol and erythropoietin

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29
Q

Slide 9/10

A
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30
Q

Assessing for Excessive Volume include:

A

Hypertension, pulmonary edema, crackles

Elevated neck veins, liver congestion and enlargement

Heart failure and shortness of breath

Pitting edema of the feet, ankles, hands, and fingers

Periorbital edema, sacral edema, ascites

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31
Q

Assessment of Urine

What are you assessing for?

A

Assess for color, clarity, and odor

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32
Q

Assessment of Urine

What is normal?

A

Normal: clear and yellow to straw-colored (pale yellow);

smells of ammonia

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33
Q

Assessment of Urine

What is abnormal? What may indicate infection?

A

Being cloudy may indicate infection.

Blood in urine (hematuria) may appear bright red or dark brown

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34
Q

Assessment of Urine

Urine Volume:

What causes acute anuria?

A

Complete bilateral obstruction

Glomerulonephritis

Bilateral vascular occlusion

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35
Q

Laboratory Studies: Urinalysis

What is included?

A

Urine pH

Urine protein

Urine glucose

Urine ketones

Urinary sediment

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36
Q

Laboratory Studies: Urinalysis

Urine pH: What is the normal range?

A

Normal range between 5.0 and 6.5

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37
Q

Laboratory Studies: Urinalysis

Urine pH: pH greater than 7.5 (alkaline urine) suggests what?

A

pH greater than 7.5 (alkaline urine) suggests urinary tract infection.

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38
Q

Laboratory Studies: Urinalysis

Urine pH: pH less than 5.0 may indicate

A

pH less than 5.0 may indicate kidney compensating serum acidosis.

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39
Q

Laboratory Studies: Urinalysis

Urine protein: normal?

A

Normal: 0 to trace

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40
Q

Laboratory Studies: Urinalysis

Urine protein: Proteinuria usually indicates?

A

Proteinuria usually indicates damage to kidneys.

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41
Q

Laboratory Studies: Urinalysis

Urine glucose: What is normal?

A

Normal: negative

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42
Q

Laboratory Studies: Urinalysis

Urine glucose: glucosuria?

A

Glycosuria if serum glucose greater than 200 mg/dL

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43
Q

Laboratory Studies: Urinalysis

Urine ketones: normal?

A

Normal: negative

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44
Q

Laboratory Studies: Urinalysis

Urine ketones: abnormal?

A

Ketonuria indicates DKA.

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45
Q

Laboratory Studies: Urinalysis

Urinary sediment: refers to what?

A

Refers to casts, red cells, white cells, epithelial cells, and crystals

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46
Q

Laboratory Studies: Urinalysis

Urinary sediment: Red blood cells

A

Red blood cells (hematuria)

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47
Q

Laboratory Studies: Urinalysis

Urinary sediment: Red blood cells

What are examples of external sources?

A

External source (kidney stones, trauma, prostatic disease)

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48
Q

Laboratory Studies: Urinalysis

Urinary sediment: Red blood cells

What can cause rbcs in urine?

A

Glomerular diseases

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49
Q

Laboratory Studies: Urinalysis

Urinary sediment: Myoglobin

How can it make the urine appear?

A

Myoglobin in the urine makes the urine appear red; however, when the urine is inspected under the microscope, there is no evidence of RBCs

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50
Q

Laboratory Studies: Urinalysis

Urinary sediment: White blood cells (pyuria)

What does it indicate?

A

Pyuria usually indicate infection.

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51
Q

Laboratory Studies: Urinalysis

Urinary sediment: Myoglobin

What is it caused by?

A

Caused by skeletal muscle breakdown

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52
Q

Diagnostic assessment

Labs include:

A

Urinalysis

pH

Specific Gravity

BUN/Creatine

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53
Q

Diagnostic assessment

Labs include: Abnormal things

A

Protein

Glucose

Sediment

RBC/WBC

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54
Q

Diagnostic assessment

Labs include: BUN/Creatine

A

Creatinine amount of blood cleared of creatinine in 1 minute

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55
Q

Diagnostic assessment

Labs include: BUN/Creatine

What is the normal amount?

A

normal- 0.6-1.2 mg/dL

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56
Q

Diagnostic assessment

Labs include: BUN/Creatine

When would BUN be high?

A

BUN higher if dehydrated, too much protein intake, or from protein breakdown (i.e crush injuries)

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57
Q

Diagnostic assessment

Labs include: BUN/Creatine

What is normal BUN values?

A

Normal 8-20 mg/dL

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58
Q

Increased BUN may have other causes

Such as?

A

Increased protein intake

Increased tissue breakdown

Febrile illnesses

Steroid or tetracycline administration

Reabsorption of blood from the intestine

Dehydration

Shock, heart failure

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59
Q

Increased BUN may have other causes

When are patients symptomatic?

A

Patients are symptomatic when osmolality is greater than 350 mOsm/kg

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60
Q

Diagnostic Studies

Include?

A

Radiologic studies

Renal biopsy

Renal angiography

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61
Q

Diagnostic Studies

Renal biopsy: What are contraindications to this?

A

Contraindications include serious bleeding disorders, severe obesity, and severe hypertension.

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62
Q

Diagnostic Studies

Renal angiography:

A

Assess renal vasculature with ultrasonography

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63
Q

Dialysis:

All forms of dialysis use the principle of what? To do what?

A

All forms of dialysis make use of the principles of osmosis and diffusion to remove waste products and excess fluid from the blood.

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64
Q

Dialysis:

What is present in the dialysis circuit?

A

Semipermeable membrane is in the dialysis circuit between the blood and the dialysate.

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65
Q

Dialysis:

How do dissolved substances move?

A

Dissolved substances, such as urea and creatinine, diffuse across the membrane from an area of greater concentration (blood) to an area of lesser concentration (dialysate).

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66
Q

Dialysis:

Diasylate: has what?

A

Dialysate has varying concentrations of dextrose or sodium to produce an osmotic gradient, pulling excess water from the circulatory system.

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67
Q

Access to Circulation:

What are the three most common methods used to access a patient’s circulation?

A

The three most common methods used to access a patient’s circulation are:

  1. vascular catheter,
  2. arteriovenous fistula, and
  3. synthetic arteriovenous graft.
68
Q

Access to Circulation:

Venous catheters: How are they? How long are they used?

A

(larger than other central lines. used for under 3 weeks of dialysis to prevent infection)

Dual-lumen

69
Q

Access to Circulation:

Venous catheters: Who are they used for?

A

For acutely ill who need hemodialysis, CVVH: continuous venovenous hemofiltration or

CVVHD: continuous venovenous hemodialysis

Patients who suddenly need hemodialysis or CRRT have a venous catheter,

**Dual-lumen catheters inserted into large central veins are used for patients with acute illness who need hemodialysis, continuous venovenous hemofiltration (CVVH), or continuous venovenous hemofiltration with dialysis (CVVH/D).

70
Q

Access to Circulation:

Venous catheters: Why else are they used?

A

Also for temporary use

Dual-lumen venous catheters are also used temporarily for patients on acute dialysis who are critically ill or patients on chronic dialysis who are waiting for a more permanent access (e.g., an arteriovenous fistula or graft) to mature.

71
Q

Access to Circulation:

Arteriovenous fistulas: How is it made?

A

To create the arteriovenous fistula, a surgeon anastomoses an artery and a vein, creating a fistula or artificial opening between them. Arterial blood flowing into the venous system results in a marked dilation of the vein

72
Q

Access to Circulation:

Arteriovenous fistulas: What is the priority of care?

A

Maintaining blood flow through the fistula is the priority of care.

73
Q

Access to Circulation:

Arteriovenous fistulas: Most AV fistulas are developed and ready to use when? When should they be placed?

A

Most arteriovenous fistulas are developed and ready to use 1 to 3 months after surgery and should be placed at least 6 months prior to the anticipated start of hemodialysis.

74
Q

Access to Circulation:

Synthetic grafts: What is it?

A

The graft is anastomosed between an artery and a vein and is used in the same manner as an arteriovenous fistula

75
Q

Access to Circulation:

Synthetic grafts: Why would this be used?

A

For many patients whose own vessels are not adequate for fistula formation, PTFE grafts are extremely valuable.

76
Q

In dialysis, why is anticoagulation used?

A

Blood in the extracorporeal system, such as the dialyzer and blood lines, clots rapidly.

77
Q

Anticoagulation:

What is the most commonly used one? Why?

A

Heparin is most commonly used because it is simple to administer, it increases clotting time rapidly, it is monitored easily, and its effect may be reversed with protamine.

78
Q

Anticoagulation

Specific anticoagulation procedures vary, but the primary goal of all methods is what?

A

Specific anticoagulation procedures vary, but the primary goal of all methods is to prevent clotting in the dialyzer with the least amount of anticoagulation.

79
Q

Anticoagulation

What are the two ways it is done?

A

Systemic anticoagulation

Regional anticoagulation

80
Q

Anticoagulation

What are the two ways it is done?

A

Systemic anticoagulation

Regional anticoagulation

81
Q

Anticoagulation

Systemic anticoagulation

A

Circuit is primed with heparin (most common) followed by continuous rate by infusion pump.

82
Q

Anticoagulation

Regional anticoagulation

A

Infusing the anticoagulant at a constant rate into the dialyzer and simultaneously neutralizing its effects with its antidote before the blood returns to the patient (heparin/protamine sulfate or trisodium citrate/calcium)

83
Q

Renal Replacement Therapy

What is it considered?

A

Lifesaving treatment

84
Q

Renal Replacement Therapy

How is it classified? (What are the different types)

A

Hemodialysis:

Continuous renal replacement therapy (CRRT)

Peritoneal dialysis

85
Q

Renal Replacement Therapy

Classification: HD

What occurs?

A

Diffusion & Ultrafiltration

86
Q

Renal Replacement Therapy

What are indications?

A

Fluid overload

Electrolyte imbalances

Acid-base disturbances

May administer transfusions during dialysis

87
Q

Renal Replacement Therapy

What are indications for hemodialysis?

A

Hemodialysis is indicated in chronic kidney injury and for complications of acute kidney injury.

These include but are not limited to

uremia,

fluid overload,

acidosis,

hyperkalemia,

and drug overdose.

88
Q

Ultrafiltration?

A

This process of fluid moving across a semipermeable membrane in relation to forces created by osmotic and hydrostatic pressures is called ultrafiltration.

89
Q

Hemodialysis

What is it?

A

Quick removal of metabolic wastes and excess fluid

90
Q

Hemodialysis

What is it useful for?

A

Useful for drug overdoses and poisonings

91
Q

Hemodialysis

What does it require?

A

Requires frequent vascular access

92
Q

Hemodialysis

What is the length of treatment? What does it depend on?

A

Length of treatment: 2–4h, three or more times per week,

depending on patient acuity and need

93
Q

Hemodialysis Complications:

A

Dialysis dysequilibrium

Hypovolemia

Hypotension

Hypertension

Muscle cramps

Dysrhythmias and angina

94
Q

Hemodialysis Complications:

What must be done to prevent dialysis disequilibrium? What is dialysis disequilibrium?

A

Uremia must be corrected slowly to prevent dialysis disequilibrium syndrome, which is a set of signs and symptoms ranging from headache, nausea, restlessness, and mild mental impairment to vomiting, confusion, agitation, and seizures.

95
Q

Hemodialysis Complications:

When is dialysis disequilibrium first seen?

A

This complication is seen most commonly when patients begin dialysis treatment for the first time.

96
Q

Hemodialysis Complications:

Why does dialysis disequilibrium occur?

A

The process is thought to occur as the plasma concentration of solutes, such as urea nitrogen, is lowered too rapidly.

97
Q

Continuous Renal Replacement Therapy (CRRT)

What are the types?

A

Continuous venovenous hemofiltration (CVVH)

CVVH with dialysis (CVVH/D)

98
Q

Continuous Renal Replacement Therapy (CRRT)

What are indications?

A

Hemodynamic instability

Large amounts of hourly fluids needed

Need more than 3- to 4-hour treatment to correct acute renal failure

99
Q

Continuous Renal Replacement Therapy (CRRT)

What does it include?

A

Dual-lumen venous catheter

100
Q

Continuous Renal Replacement Therapy (CRRT)

How long is it?

A

Continuous throughout day; may last as many days as needed

101
Q

Continuous Renal Replacement Therapy (CRRT)

Continuous venovenous hemofiltration (CVVH): CVVH is used when patients primarily…

A

CVVH is used when patients primarily need excess fluid removed

102
Q

Continuous Renal Replacement Therapy (CRRT)

CVVH with dialysis (CVVH/D) : CVVH is used when patients primarily need excess fluid removed, whereas CVVH/D is used when…

A

CVVH is used when patients primarily need excess fluid removed, whereas CVVH/D is used when patients also need waste products removed because of uremia.

103
Q

Continuous Renal Replacement Therapy (CRRT):

When is it contraindicated? What should be used instead?

A

CRRT is contraindicated when patients become hemodynamically stable or no longer require continuous therapy; intermittent hemodialysis should be used for these patients.

104
Q

Physiologic Complications in CVVH/D include:

A

Hypotension

Hypothermia

105
Q

Physiologic Complications in CVVH/D include:

Hypotension: What should be done to fix?

A

May need to increase rate of replacement fluids

May need to decrease amount of removal, give NS bolus, vasopressors, 5% albumin

106
Q

Physiologic Complications in CVVH/D include:

Hypothermia: What should be done to fix?

A

Use a blood warmer, warm lines and fluid

107
Q

Peritoneal Dialysis

A

However, in peritoneal dialysis, the peritoneum is the semipermeable membrane, and osmosis, rather than the pressure differentials used in hemodialysis, is used to remove fluid.

108
Q

Peritoneal Dialysis advantages and disadvantages

Advantages:

A

Less complicated

More readily available

Less training required

Less adverse effects

Patients can manage themselves at home

109
Q

Peritoneal Dialysis advantages and disadvantages

Disadvantages:

A

More time is required.

Peritonitis is a potential complications.

Long periods of immobility may result in complications, such as pulmonary congestion and venous stasis.

110
Q

Peritoneal Dialysis (cont’d)

Complications include:

A

Incomplete fluid recovery

Leakage around catheter

Blood tinged peritoneal fluid

Peritonitis

Hypotension

Hypertension and fluid overload

Electrolyte imbalance

Pain, immobility, discomfort

111
Q

Peritoneal Dialysis (cont’d)

Management:

A

Strict aseptic technique monitor I & o,

weight, vs,

monitor for peritonitis,

prevent complications

112
Q

Acute Kidney Injury (AKI)

How many people does it occur in?

A

AKI occurs in up to 10% to 15% of patients who are hospitalized, with a prevalence that can exceed 50% for patients treated in intensive care units (ICUs).

113
Q

Acute Kidney Injury (AKI)

Patients with AKI are at risk for what?

A

Patients with AKI at a high risk of CKD

114
Q

Acute Kidney Injury (AKI)

Hallmarks include:

A

Azotemia

Serum creatinine

115
Q

Acute Kidney Injury (AKI)

Hallmarks include: Azotemia

A

Azotemia: decreased GFR and accumulation of BUN and creatinine

116
Q

Acute Kidney Injury (AKI)

Hallmarks include: Why is serum creatinine a better marker?

A

Serum creatinine better marker because relatively unaffected by metabolic factors

117
Q

Acute Kidney Injury (AKI)

What is used to define AKI/ARF?

A

Rifle classification

118
Q

Acute Kidney Injury (AKI)

Rifle classification

A

Risk-creatinine

Injury-creatinine

Failure-creatinine

L- loss

E- end-stage kidney disease

119
Q

Acute Kidney Injury (AKI)

Rifle classification: Risk-creatinine

A

Risk-creatinine increase of 1.5-2 times baseline

120
Q

Acute Kidney Injury (AKI)

Rifle classification: Injury-creatinine

A

Injury-creatinine increase of 2-3 times baseline

121
Q

Acute Kidney Injury (AKI)

Rifle classification: Failure-creatinine

A

Failure-creatinine increase of 3 or more times baseline

122
Q

Acute Kidney Injury (AKI)

Rifle classification: L- loss.

A

L- loss. Persistent ARF for >4 wk

123
Q

Acute Kidney Injury (AKI)

Rifle classification: E- end-stage kidney disease

A

E- end-stage kidney disease Persistent ARF for >3 mo

124
Q

Acute Kidney Injury (AKI)

A rise of what means AKI?

A

Any rise of greater that 0.3 mg/dL in 48 hours = AKI

125
Q

Urine Output Patterns

A

Oliguria

Nonoliguria

Anuria

126
Q

Urine Output Patterns

Oliguria:

A

Oliguria (less than 0.5 mL/kg/h for 6 hours or less than 500 mL/d)

127
Q

Urine Output Patterns

Nonoliguria:

A

Nonoliguria (greater than 500 mL/d)

128
Q

Urine Output Patterns

Anuria:

A

Anuria (less than 50 mL/d)

129
Q

Causes of AKI

What are the three classifications?

A

Prerenal

Intrarenal

Postrenal

130
Q

Causes of AKI

Prerenal- What is it characterized by?

A

Prerenal- characterized by any event that leads to an acute decrease in effective renal perfusion

131
Q

Causes of AKI

Prerenal- characterized by any event that leads to an acute decrease in effective renal perfusion

Most commonly, precipitating events include?

A

Most commonly, precipitating events include hypovolemia and cardiovascular failure;

132
Q

Causes of AKI

Intrarenal-

A

characterized by actual damage to the renal parenchyma

133
Q

Causes of AKI

Intrarenal- characterized by actual damage to the renal parenchyma

Such as:

A

Glomerular-

Vascular –

Interstitial –

Tubular –

134
Q

Causes of AKI

Intrarenal- characterized by actual damage to the renal parenchyma

Such as: Glomerular-

A

poststreptococcal glomerulonephritis,

diseases causing vasculitis (Wegener granulomatosis)

135
Q

Causes of AKI

Intrarenal- characterized by actual damage to the renal parenchyma

Such as: Vascular-

A

malignant hypertension

136
Q

Causes of AKI

Intrarenal- characterized by actual damage to the renal parenchyma

Such as: Interstitial

A

Interstitial –pyelonephritis

137
Q

Causes of AKI

Intrarenal- characterized by actual damage to the renal parenchyma

Such as: Tubular

A

Tubular – Acute tubular necrosis (ATN)

138
Q

Causes of AKI

Postrenal

A

Postrenal –Obstruction of urine flow from collecting ducts in kidneys to external urethral orifice

139
Q

Causes of AKI

Postrenal –Obstruction of urine flow from collecting ducts in kidneys to external urethral orifice

Such as:

A

Ureteral stones

Blockage- BPH

Tumor

140
Q

ACUTE KIDNEY INJURY:

Clinical manifestations are related to:

A

Clinical manifestations related to decreased GFR,

fluid overload,

and impaired clearance of electrolytes

141
Q

ACUTE KIDNEY INJURY:

Management includes what kind of therapy?

A

Diuretic therapy and nutritional therapy

142
Q

ACUTE KIDNEY INJURY:

Management: What may need to be considered?

A

Dialysis may need to be considered

143
Q

ACUTE KIDNEY INJURY:

Management includes:

A

Eliminate cause, prevent complications, and assist recovery

144
Q

Acute Tubular Necrosis (ATN):

What are the two types:

A

Ischemic ATN

Toxic ATN

145
Q

Acute Tubular Necrosis (ATN):

Ischemic ATN: results from what?

A

Ischemic ATN results from prolonged hypoperfusion.

146
Q

Acute Tubular Necrosis (ATN):

Ischemic ATN: What is it caused by?

A

Caused by hemorrhagic hypotension, volume depletion, poor cardiac output, septic shock, pancreatitis, immunosuppression

147
Q

Acute Tubular Necrosis (ATN):

Toxic ATN: What is it?

A

Is an aminoglycosides antibiotics, contrast-induced nephropathy

148
Q

Acute Tubular Necrosis (ATN):

Toxic ATN: What remains intact?

A

The basement membrane of renal cells usually remains intact.

149
Q

Acute Tubular Necrosis (ATN):

Toxic ATN: The basement membrane of renal cells usually remains intact.- So what does this mean?

A

Thus, non oliguria typically occurs more often and the healing process is often more rapid than ischemic ATN

150
Q

Acute Tubular Necrosis (ATN):

Toxic ATN: What is treatment?

A

Treatment: aggressive volume expansion (0.9NS), alkalinize urine with sodium bicarbonate

151
Q

CHRONIC KIDNEY DISEASE

Epidemiology: What is it considered?

A

Worldwide health problem

152
Q

CHRONIC KIDNEY DISEASE

Epidemiology: Who are rates higher in?

A

Rates higher in African Americans and Native Americans

Higher in men than in women

153
Q

CHRONIC KIDNEY DISEASE

Pathophysiology: What happens to renal function?

A

Slow, progressive, irreversible deterioration of renal function

154
Q

CHRONIC KIDNEY DISEASE

What does it result in?

A

Results in kidney’s inability to eliminate waste products and maintain fluid and electrolyte balances

155
Q

CHRONIC KIDNEY DISEASE

What does it lead to?

A

Leads to end-stage renal disease (ESRD)

156
Q

CHRONIC KIDNEY DISEASE

What are the most common causes?

A

Most common causes are diabetes and hypertension

157
Q

CHRONIC KIDNEY DISEASE (cont’d)

Clinical manifestations

A

Devastating effect on every body system

158
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management:

A

Renal replacement therapies

159
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: What should be managed?

A

Manage fluid balance changes

160
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: Manage fluid balance changes- how?

A

Treat hypovolemia

Prevent hypervolemia

161
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: Manage what kind of alterations?

A

Manage acid-base alterations

Manage cardiovascular alterations

Manage pulmonary alterations

Manage gastrointestinal alterations

162
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: Manage acid-base alterations

A

Metabolic acidosis

163
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: Manage cardiovascular alterations

A

Hypertension

Hyperkalemia

164
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: Manage pulmonary alterations

A

Pulmonary edema

165
Q

CHRONIC KIDNEY DISEASE (cont’d)

Management: What may be necessary?

A

Renal transplantation

NURS 428: Evolution (13 decks)

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