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31 Cards in this Set
- Front
- Back
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Chronic renal failure is? what happens as the disease progresses?
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- Progressive, irreversible destruction of the nephrons of both kidneys
- As it progresses, most nephrons are destroyed, scar tissue forms and uremia develops |
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Is the course of the disease the same for everyone?
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No, some ppl are unaffected by compensated renal failure whereas others go in ESRD
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When is dialysis or transplatation needed?
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When creatinine clearance falls below 10 mL/min
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What are the leading causes of CKD?
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- Diabetes and hyptertension
- glomerulonephritis and cystic kidney disease |
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Dimnished Renal reserve
GFR? Cr and BUN? symptoms? |
GFR: 40-50% (cut in half)
Cr and BUN: normal Asymptomatic |
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Renal Insufficiency
GFR? CR and BUN? symptoms? |
GFR: 25%
Cr and BUN: increased Mild anemia, fatique, weakness, HAs, nausea, pruritis, nocturia, polyuria |
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ESRD
GFR? Cr and BUN? symptoms? |
GFR: <5-10%
Cr and BUN: increased Increased K and Phosphate, decreased Ca, Na, HCO3, H&H, uremic syndrome present |
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What is uremic syndrome?
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Is eclectic of all the disturbances seen throughout the body in CKD
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Most notable s/s of the GU system is? its a result of?
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- Polyuria
- the kidney's inability to concentrate urine |
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What are the s/s of the GU system?
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- polyuria
- nocturia - SG is fixed at 1.010 - Oliguria and anuria develop as it progresses - Proteinuria |
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What is normal urine specific gravity? what does it measure?
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- 1.005-1.030
- the kidney's ability to concentrate or dilute urine in relation to plasma |
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What are the causes of increased urine specific gravity? decreased?
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- Increased: dehydration, high ADH secretion
- Decreased: diabetes, renal failure |
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BUN and Cr levels _____ as the GFR _____.
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- Rises
- lowers |
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Which is a more definitive indicator of renal function, Cr or BUN?
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Creatinine
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Diabetics that become uremic will require more or less insulin?
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Less
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What are the electrolyte/ acid base imbalances seen in CKD?
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- Increased K, phosphate, Mg, urea
- Decreased Ca, Na - Volume excess - Metabolic acidosis |
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True or False
Dialysis usually improves CNS involvement and stops the progression of neuropathies. |
True
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Pregnancy is less risky for the transplant client or the dialysis client?
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Transplant
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True or False
Demerol is contraindicated in kidney patients. |
True
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If patient is getting digoxin and K is low, what do you need to watch for?
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Toxicity
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When should water soluble vitamins be given?
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After dialysis
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Iron supplements should be given with? not be given with? monitor for?
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- Given with Epogen
- Not given with phosphate binders - Monitor for constipation |
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Phosphate binders should be given with? not be given with? monitor for?
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- Given with meals, Ca supp
- Do not give with iron - Monitor for constipation and increased aluminum levels |
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TUMS should not be given if? what should be given?
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- Phosphate is greater than 6
- Give Renagel or Fosrmal |
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Nutrition support
Fluids: conservative? HD? PD? |
Conservative: UO + 600mL
HD: UO + 100mLs PD: no restictions |
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Nutritional support
Sodium: conservative? HD? PD? |
Conservative: 1-2 grams
HD: 2-3 grams PD: 3-4 grams |
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Nutrtional Support
Potassium:conservatie? HD? PD? |
Conservative: 2-3 grams
HD: 2-3 grams PD: 3-4 grams |
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Nutritional support
Proteins: conservative? HD? PD? |
Conservative: 0.6-0.8 g/kg
HD: 1-1.5 g/kg PD: .5- 2 g/kg |
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Why is protein restricted?
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B/c BUN and Cr is a product of protein metabolism
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What meds should be avoided?
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- Aminoglyasides
- NSAIDS - Demerol - watch Dig if K is low |
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What is the usual maintance dose of Dig?
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0.125 every other day
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