Nur 202 Renal

Front 1

Acute Renal Failure
Stages (Some books say four stages and some say three)

Back 1

Onset, Oliguric, Diuretic, Recovery

Front 2

Onset stage of Acute Renal Failure

Back 2

Onset (1-3 days) Incrase Bun and serum creatinine with normal to decreased urine output

Front 3

Oliguric Statge of Acute Renal Failure

Back 3

Urine output decreased to 400 ml/day or less. Can continue for about 14 days after the onset.

Front 4

Diuretic stage of Acute Renal Failure

Back 4

Urine output exceeds 400 ml/day and can go up to 4 L/day. Near end labs will begin to return to normal

Front 5

Recovery stage stage of Acute Renal Failure

Back 5

Stage can last from 1-12 months. Renal tissue recovers and labs return to normal. Begins when the GFR increases. Usually some permanent loss of renal function, but remaining renal function is sufficient to maintan healthy life.

Front 6

S/S of acute renal failure physical

Back 6

Muscle weakness, n/v, diarrhea. Neuro symptoms - confusion, agitation, disorientation, seizures, and coma

Front 7

Labs of acute renal failure

Back 7

Hyper - kalemia and phosphatemia. Hypocalemia
Metabolic acidosis, azotemia, anemia, elevated BUN and creatinine, proteinuria

Front 8

Priority Nursing Diagnosis for ARF

Back 8

- Excess fluid volume; imbalanced nutrition: less than body requirements; Deficient knowledge; Risk for infection

Front 9

Planning and implementation for ARF

Back 9

Monitor I/O; Diet Mod. Protein, high carbs, restricted K+. Daily weights and observe for edema

Front 10

Medications to avoid with ARF

Back 10

aminoglycoisde antibiotics (Tobramycin, Streptomycin, Gentamicin, Neomycin), NSAID, contrast media, platinoid chemotherapy agents

Front 11

Glomerulonephritis - Definition

Back 11

Group of kidney diseases caused by inflammation of the capillary loops in the flomeruli of the kidney

Front 12

Glomerulonephritis is usually following to what type of infection

Back 12

Group A beta-hemolytic streptococcus.

Front 13

Clinical manifestations of glomerulonephritis

Back 13

pink or cola-colored urine
foamy urine
Hematuria, proteinuria, hypoalbuminemia
Elevated BUN and creatinine
HTN
fluid retention: face or periorbital, hands, feet, abdomen
fatigue, azotemia

Front 14

Tx for glomerulonephritis

Back 14

Diuretics, anithypertensive, antibiotics (if strep), plasmapheresis.

Front 15

Nursing tx for glomerulonephritis -

Back 15

Diet - protein restriction if oliguria, high carb, K+ usually restricted, sodium restricted. Fluid restriction as needed, Monitor I/O, Encourage bedrest for acute stage.

Front 16

Nephrotic syndrome - description of its characteristics

Back 16

Massive edema and albuminuria

Front 17

Cause of albuminuria in nephrontic syndrome

Back 17

Allows plasma protins to escape into the urine - results also in hypoalbuminemia.
Seen with renal conditions that damages golmerular caipllary memrane: such as glomerulonephritis, and systemic lupus erthematosus.

Front 18

S/S of nephrotic syndrome -

Back 18

Severe generalized edema (lecture - periorbital), symptoms of renal failure, loss of appetite and fatigue

Front 19

Lab findings for nephrotic syndrome

Back 19

Proteinuria, hypoalbuminemia, hyperlidemia (lower levels of lipoprotein lipase)

Front 20

Nephrotic syndrome - Important diet to note

Back 20

Provide high-protein diet to restore body proteins and restrict sodium if edema is present.

Front 21

Wilms' Tumor - Risk factors

Back 21

Africian - Americans slightly higher, family hx, aniridia (partial eye iris), undescended testes, hypospadias

Front 22

Wilms' Tumor - definition

Back 22

Intraabdominal tumor of childhood and is associated with congenital anomalies.

Front 23

Tx of Wilms' Tumor

Back 23

Surgery- Nephrectomy of kidney. If both than least affected is left in. Usually a one sided condition.

Front 24

Wilms' Tumor s/s

Back 24

Swelling or mass in the abdomen ( may be palpable), abdominal pain as it enlarges, hematuria, anorexia, weight loss, malaise HTN (63%)

Front 25

Study
Uremia is a manifestation of what renal disease.

Back 25

Renal failure characterized by increased BUN and creatinine

Front 26

Normal serum creatinine helps indicate normal renal function what is the normal level.

Back 26

0.8-1.6 mg/dL per Prentice

Front 27

Some restrictions for end-stage renal disease

Back 27

Potassium, sodium and phosphorus

Front 28

The nurse explains that Pyridium (phenazopyridine) is used in cystitis to:

Back 28

Ease the discomfort of the bladder mucosa.

Front 29

Peritoneal dialysis - Dos and don'ts

Back 29

Do: move person from side to side can help disseminate the fluid throughout the abdomen.
Don't - Raise the HOB (increase intr-abdominal pressure). Refrig. the solution. Increase or decrease the prescribed flow.

Front 30

Indications for dialysis:

Back 30

Volume overload, hyperkalemia, metabolic acidosis, rising BUN and serum creatinine (0.5-1.5 mg/dL normal) and decreased creatinine clearance.

Front 31

What does BUN measure?

Back 31

Serum level of the end products of protein metabolism. Urea is the end product of protein metabolism. In renal failure, the kid. cannot clear all the urea from the blood, The creatinine and BUN will be elevated.

Front 32

Nursing measure for acute renal failure:

Back 32

Observe for secondary infection. Usually a low protein diet. Catherizations are avoided and fluids may be limited.

Front 33

Classic signs of cystitis

Back 33

Frequency, urgency, decreased bladder capacity, nocturia, and dysuria.