Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

INP3 - SALLY > Week 8 - Renal > Flashcards

Week 8 - Renal Flashcards

1
Q

the renal system consists of ? (4)

A
  • kidneys
  • ureter
  • bladder
  • urethra
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

the kidney functions?

A

primary function is to maintain a stable environment for optimal cell and tissue metabolism

  • excrete metabolic wastes
  • regulate blood Ph
  • secretes hormones to regulate BP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Acute Kidney injury (Define)

A

sudden, severe impairment of renal function causing an acute build up of toxins in the blood

  • results in fluid and electrolyte imbalances
  • can develop over hours or days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

AKI - Causes

- (3 main types)

A

Prerenal: (outside the kidneys)
*due to factors external to the kidneys that reduce renal blood flow
- hypovolaemia (dehydration, Hemorrhage, Diarrhoea and vomiting)
- decreased cardiac output
(shock, AMI, hypotension)

Intrarenal; (injury directly to the kidneys)
- Acute Tubular Necrosis
(can be caused by side effects of medications or triggered by acute events such as hypotension. results in death of the tissue within the tubule > causing blocking of the tubules and decrease in function over time)

Post Renal: (damage further down in the renal tract)
*involves mechanical obstruction of urinary outflow >
as flow of urine is obstructed urine refluxes into the renal pelvis which impairs renal function
- enlarged prostate
- renal cancer
- bladder cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

AKI - Risk Factors

A
  • pre existing renal impairment (diabities0
  • hypotension
  • dehydration
  • age > 70
  • admission to icu, AKI occurs in 20 - 50% of pts admitted to icu

specific conditions:

  • burns
  • cardiac disease
  • sepsis/ MODS
  • abdominal surgery
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

AKI - signs and symptoms (11)

A
  • decreased urine output
  • proteinuria
  • volume overload
  • hypotension (early)
  • hypertension (late)
  • arrhythmias
  • PO
  • pleural effusions
  • nausea and vomiting
  • anorexia
  • seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

AKI - pt assessment

- what to ask about when taking history?

A
  • dysuria
  • incontinence
  • nocturia
  • haematuria
  • diabities
  • hypertension
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

AKI - aim of treatment

A

maintain effective circulating volume

- treat cause!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

AKI - pt assessment

- DRSABCD

A

Airway:

  • patent?
  • 80% of pts with AKI will require mechanical ventilation

Breathing:

  • RR, WOB
  • High flow 02
  • observe for kussmauls respirations (Breathing rapidly and deeply) bodys attempt to get rid of C02
  • auscultate lungs (crackles or diminished breath sounds)

Circulation

  • HR
  • BP (GFR cannot be maintined with systolic BP <9 intubate (indicate uremia very bad and requires urgent dialysis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

AKI - interventions & investigations

A
  • IV access
  • FBC
  • IDC
  • CVC
  • (+/-) inotropes to maintain perfusion to the kidneys
  • ECG (look for signs of hyperkalaemia)
  • CXR
  • abdominal xray
  • CT
  • pathology
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

hyperkalaemia on ECG

A
  • prolonged PR interval
  • wide QRS
  • tall peaked T waves
  • untreated can lead to VF and VT
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

how to treat hyperkalaemia?

A

insulin and glucose (10 - 20 units actrapid) > takes potassium with glucose into the cells > = decreased potassium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Dialysis - define

A

is the diffusion of solute molecules across a semi permable membrane from an area of higher concentration to lower concenctration

  • used to remove excess fluid and metabolic waste products in the pt with renal failure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

dialysis - 2 types

A
  • haemodyalysis

- peritional dialysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Haemodialysis

A

a procedure by which blood passes by an artificial semi permable membrane outside the body

  • needs a permanent vascular access site > internal arteriovenous fistula
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Peritoneal Dialysis

A
  • uses the peritoneum surrounding the abdominal cavity as the dialyzing membrane
  • 2 - 3L of dialysate fluid infused
  • fluid must be changed 4-5 times per day
17
Q

Peritoneal Dialysis

- advantages

A
  • pt can be ambulant

- can be managed at home

18
Q

Peritoneal Dialysis

- disadvantages

A
  • risk of bowel perforation

- risk of infection at catheter site

19
Q

Chronic Renal Failure

A
  • defined by either the prescence of kidney damage or a GFR of <600ml/min for over 3 months
  • progressive and irreversible destruction of renal function over time
  • renal system experiences ischaemia, inflammation, fibrosis and scaring
  • nephrons are permanently destroyed distrupting fluid & electroylete balance as well as waste removal
  • CRF is progressive and often goes unnoticed. pt can lose up to 90% of renal function asymptomatically
20
Q

CRF - 3 stages

A

1) diminished renal reserve
2) renal insufficiency
3) renal failure and uremia

21
Q

brief patho of CRF

A 
as renal failure is occurring subtances that are usually excreted accumulate in the body including nitrogenous waste, electrolytes and uremic toxins
^
eventually all organs affected
^
in the end = systemic disease
22
Q

CRF - causes

A
  • chronic infection
  • vascular disease
  • obstructive processes (prostate, ascities)
  • endocrine disease
  • congenital abnormalities
  • diabities
23
Q

CRF - signs and symptoms

A

Airway/ Breathing:

  • SOB
  • kassmauls RR’s
  • PO
  • pleural effusion

Circulation:

  • polyuria
  • oliguria > anuria as CRF worsens
  • hypertension
  • electrolyte and acid base imbalance
  • cardiac arrhythmias

Disability:

  • decreased mental activity
  • weight loss
  • coma (late sign)
24
Q

CRF - what conditions can it result in/ lead to?

A
  • HF
  • anaemia
  • bleeding tendicies (especially GIT bleeding)
25
Q

CRF - Management

A

early management focuses on:

  • eliminating factors that may further decrease renal function
  • measures to slow progressive of disease to ESRD

Airway/ breathing;
- 02

Circulation:

  • control BP
  • balance fluid intake and output
  • dialysis
  • monitor electrolytes

Disability:

  • identify and treat complications
  • maintain nutrition
  • energy conservation with ADL’s
26
Q

CRF - medications

A
  • alkalinizing agents for acidosis
  • insulin and glucose to decrease potassium
  • antihypertensives
  • antibiotics for infection
27
Q

End Stage Renal disease (ESRD)

- what is it?

A

is reached when damage to the kidney function is irreparable and irreversible

28
Q

End Stage Renal disease (ESRD)

- how is it diagnosed?

A

by a GFR of < 15 l/min

29
Q

End Stage Renal disease (ESRD)

- treatment options

A
  • haemodyalis
  • peritioneal dialysis
  • renal transplantation
  • palliative care
30
Q

kidney transplant

A
  • only definite treatment for pts with ESRD
  • immunosuppression required to avoid rejection
    eg; prednisolone
  • don’t take out old kidney put new one in flank can feel it sitting there

INP3 - SALLY (9 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions