Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
34 Cards in this Set
- Front
- Back
|
What are the main functions of the renal system? |
Filtration, fluid balance, reabsorption, balance potassium |
|
|
How is fluid balance regulated by the renal system? |
Thirst, ADH, elevated k triggers release of aldosterone |
|
|
What is normal urine output, and urea, oliguria, polyuria? |
Normal-1500 mls per day or 0.5 ml per kilogram per hour
Anuria-less than 100 mls per day
Oliguria-100 to 400 ml per day
Polyuria-greater than 2,500 mls per day |
|
|
What electrolytes are affected during an acute kidney injury? |
Potassium, magnesium, phosphate (Remember that K and mag go together) |
|
|
What are the risk factors for developing an acute kidney injury? |
Elderly Females are at greater risk than men Heart failure Elevated BMI COPD Sepsis Rhabdomyolysis Contrast dye Hypotension |
|
|
Is creatinine an early or late symptom of renal failure? |
Creatinine is considered a late indicator do to a 12-hour lag time |
|
|
What labs will be reviewed in a patient with an acute kidney injury? |
BUN (measures waste) Creatinine (tell you what happened 12 hours ago) Glomerular filtration rate Proteinuria Casts (tubular death) Urine electrolytes (sodium) |
|
|
How is the glomerular filtration rate estimated? |
By creatinine clearance Normal clearance 80-120 ml/min |
|
|
What is a postrenal AKI? |
Always think obstruction (urethral obstruction, prostatic disease, infection, neurogenic problems) |
|
|
What can cause a prerenal Aki? |
Always think low blood flow Hypoperfusion, sepsis, heart failure, trauma, severe hypovolemia Urine NA <10 mEq/L |
|
|
What are the three types of renal failure? |
Prerenal, post renal, intrarenal or ATN |
|
|
What is acute tubular necrosis? |
Often called intrarenal, always think damage to renal tubes |
|
|
What is toxic acute tubular necrosis (ATN) |
It is caused by either drugs or bacteria and is considered reversible! remember that you would rather have toxic ATN rather than ischemic |
|
|
What is ischemic acute tubular necrosis? (AtN) |
The regular damage along tubular membranes, tubular cell damage in cast formation, poor kidney perfusion recovery is typically greater than 8 days |
|
|
What are the three phases of acute tubular necrosis (ATN)? |
Oliguric, diuretic, and recovery phase |
|
|
What happens in the first phase of acute tubular necrosis? |
Called the oliguric phase insult to injury occurs within 48 hours, and ability to excrete fluids or metabolic waste. significant increase in BUN and creatinine urine sodium < 10 mEq/L often requires dialysis |
|
|
What is the second phase of acute tubular necrosis? |
Diuretic phase Last 7 to 14 days Will have gradual improvement in renal function Urine output is 2-5 L/day Monitor sodium and potassium very closely during this phase GFR- 80-120 |
|
|
What electrolytes do you want to monitor closely during the diuretic phase of acute tubular necrosis? |
Potassium and sodium |
|
|
What patients are at risk for contrast-induced nephropathy? |
Diabetics, chronic hypertension, pre-existing renal insufficiency, dehydration |
|
|
What is the best prevention and treatment for contrast-induced nephropathy? |
Hydration |
|
|
What are the indications for dialysis? |
Acid base imbalance, electrolyte imbalances (hyperkalemia), intoxication such as overdose, fluid overload, uremic symptoms |
|
|
What are the laboratory findings for the need of dialysis? |
BUN>35 Creatine >4 Potassium>6.5 Uncompensated metabolic acidosis |
|
|
What are the best renal protection against injury? |
Adequate hydration, adequate perfusion, stop nephrotoxic medications (vanc, gentamicin, it large amounts of antibiotics). |
|
|
What lab findings would you expect with chronic kidney disease pts? |
Anemia Increased BUN/creatinine/PO4 Decreased calcium/HCO3/protien |
|
|
What are some of the risk factors for chronic kidney disease? |
Diabetes HTN Autoimmune disease Systemic infection |
|
|
What are possible emergent dialysis options? |
Hemodialysis CRRT Peritoneal dialysis |
|
|
What is dialysate made of |
Bicarbonate and sodium W/ electrolytes |
|
|
Complications of hemodialysis |
Hypertension, and China, dysrhythmia, fever, thrombocytopenia, disequilibrium syndrome |
|
|
What are the signs and symptoms of venous air embolism and hemodialysis? |
Shortness of breath, chest pain, acute right heart failure |
|
|
What is the treatment for an air embolus hemodialysis? |
Lay patient on their left side Trendelenburg position, give 100% of 2 |
|
|
What type of dialysate is used in peritoneal dialysis? |
Is a glucose base dialysate |
|
|
What are the complications to peritoneal dialysis? |
Peritonitis, hyperglycemia, diaphragm pressure, pleural effusion, visceral hernia or perforation |
|
|
What are the contraindications for peritoneal dialysis? |
Recent abdominal surgery, adominal adhesions, need for emergent dialysis |
|
|
What are the normal renal lab values? |
Bun- 5-20 Creatinine- 0.6-1.2 Urine specific gravity- 1.010-10.02 Urine osmolality- 300-1200 Urine sodium-27-287 Urine creatinine-1-2 |
