Wk 5 Chronic Kidney Disease (CKD) Flashcards
How many stages of CKD is there?
6
What is the GFR for stage 1 CKD?
> 90
What is the GFR for stage 2 CKD?
60-89
What is the GFR for stage 3a CKD?
45-59
What is the GFR for stage 3b CKD?
30-44
What is the GFR for stage 4 CKD?
15-29
What is the GFR for stage 5 CKD?
15 or less
What are the manifestations for stage 1 CKD?
Asymptomatic
What are the manifestations for stage 2 CKD?
Asymptomatic, possibly hypertension
What are the manifestations for stage 3a and 3b CKD?
Hypertension, otherwise asymptomatic
What are the manifestations for stage 5 CKD?
Uremia
What stage of CKD are most people diagnosed at?
Stage 4
What stage of CKD is the patient prepped for renal transplant and on dialysis?
Stage 4
What are the electrolyte imbalances associated with CKD due to edema?
Hyperkalemia
Hyperphosphatemia
Hypermagnesemia
Hyponatremia
Hypocalcemia
Because in CKD, the kidneys can no longer removes wastes from the blood, what results?
Anorexia
Malnutrition
Itching
CNS changes
Why are patients with CKD often anemic?
Decreased production of erythropoietin
What causes renal osteodystrophy?
Decreased synthesis of vitamin D and hypocalcemia
What are the two leading causes of CKD?
Hypertension and diabetes
What are nursing interventions for fluid volume overload?
Monitor for FVO, weigh daily, fluid restrictions
What are nursing interventions for malnutrition?
Monitor for nausea and vomiting
Weight trends
Serum protein levels
H&H
Provide foods that the patient likes
Why is a patient with CKD at risk for injury?
R/t renal osteodystrophy
What are nursing interventions for CKD?
Monitor electrolyte levels
Administer prescribed supplements (calcium, Vit D)
What are nursing interventions for grieving?
Listen to expressions of grief
Identify community support resources
Encourage family involvement
Why is a patient with CKD at risk for infection?
They have a suppressed immune system
What are nursing interventions for risk for infection?
Monitor for signs and symptoms of infection
Screen visitors
Limit number of visitors
Ensure aseptic technique during care
How does CKD cause immune system deficiency?
defective dendritic cells (DCs), premature aging of T cells and impaired cellular and humoral responses
Why do patients with CKD have activity intolerance?
Anemia due to decreased erythropoietin
What are nursing interventions for activity intolerance?
Provide rest periods
Administer anti-anemic medications
Monitor H&H
If a patient has CKD and needs a procedure that uses contrast, what might they have ordered?
Actylcysteine and forced fluids after the procedure
What is important to consider about procedures and a patient with CKD?
Contrast dye is nephrotoxic
What drugs are nephrotoxic?
NSAIDs
Aminoglycosides
etc
What is the antidote for tylenol overdose?
Acetylcysteine
What is the chemical abbreviation of phosphorous?
PO4
CKD causes elevated __ formation so they are often on statin drugs
lipid
What are the end products of protein metabolism?
urea nitrogren and creatinine
What is the typical renal diet?
Low potassium, protein, sodium, and fluid restriction
What are alternative ways to reduce thirst?
Sucking on ice cubes, hard candy, lemon
When should the nurse report to the HCP about weight gain in a CKD patient?
Greater than 4 pounds in 1-2 days
