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188 Cards in this Set
- Front
- Back
What acid base imbalance often occurs with renal failure?
|
Metabolic Acidosis
|
|
Use phosphoru binding mecications to treat what?
|
hyperphosphatemia
|
|
Complications of transplantation (2)
|
1. Finding compatible donor
|
|
|
2. Rejection
|
|
Peritoneal Dialysis
|
fill
|
|
|
dwell
|
|
|
drain
|
|
How long does the soln usually dwell in peritoneal dialysis?
|
4 to 6 hours
|
|
How often for hemodialysis?
|
Every three to five days for 3-5 or more hours at a time.
|
|
Initian Phase in ARF
|
1-2 days
|
|
|
reduced urine output and increased BUN
|
|
Oliguric phase (Maintance) in ARF
|
1-2 weeks
|
|
|
hyperkalemia and fluid volume overload
|
|
Polyguric Phase (Diuretic) in ARF
|
progressive increase in urination in pts that were olyguric
|
|
|
May indicate beginning of renal repair
|
|
|
Substantial renal loss of sodium and water
|
|
|
May dehydrate
|
|
Phase of Functional recovery
|
No beginning or end
|
|
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Repair of renal injury
|
|
|
BUN, creatinine, and urine volume gradually return to normal.
|
|
5 stages of chronic renal failure
|
1. slight damage GFR more than 90
|
|
|
2.Mild decrease in function GFR 60-89
|
|
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3. Mod decrease in function GFR 30-59
|
|
|
4. Sever dEcrease in function GFR 15-29
|
|
|
5. kidney failure GFR less than 15
|
|
What is the main protein found in the urine?
|
albumin
|
|
What are the filters of the kidney?
|
glomeruli
|
|
Proteinuria is caused by what?
|
glomerulonephritis
|
|
Glomererular Filtration is best checked by what lab?
|
Blood creatinine
|
|
What lab checks the ability of the kidneys to concentrate urine?
|
Urine Specific Gravity
|
|
What is the diet ordered for patient with renal failure?
|
Low protein
|
|
|
Low sodium
|
|
|
High calorie
|
|
Antidiuretic Hormone effects kidneys by
|
controlling permeability
|
|
Aldosterone effects kidneys by
|
causing the distal tubule and collecting ducts to reabsorb increased levels of sodium.
|
|
Causes of intrarenal ARF
|
*Glomerulonephritis*
|
|
|
Nephrotoxic damage
|
|
|
NSAID's
|
|
|
heavy metals
|
|
Causes of postrenal ARF
|
*calculi (kidney stones)*
|
|
|
obstruction of indwelling cath
|
|
|
tumors
|
|
Causes of prerenal ARF
|
Sepsis
|
|
|
dehydration
|
|
|
hemmorhage
|
|
|
heart/liver failure
|
|
|
burns
|
|
How long does recovery phase last?
|
About 6 months
|
|
Renin-Angiotensin Mechanism
|
one of the most potent vasoconstrictors known.
|
|
|
|
|
|
RAS is a defense mechanism to prevent fall in BP due to loss of blood or fluid.
|
|
|
|
|
|
It can be improperly activated in renal disease causing HTN.
|
|
Alterations in fluid may produce what?
|
Generalized Edema
|
|
Accumulation of wastes (amonia) may cause what?
|
Mucosal Errosion
|
|
Alterations in platelet function may lead to what?
|
Eccymosis
|
|
What is a "silent killer"?
|
Hypertension
|
|
Causes of Acute Renal Failure ARF
|
1. prerenal- low blood flow to kidneys
|
|
|
2.intrarenal-direct damage to kidney parenchyme
|
|
|
3.postrenal-obstruction to flow of urine(may cause hydronephrosis)
|
|
What is ARF
|
Rapid deterioration or cessation in kidney function.
|
|
ARF and childhood!
|
It is uncommon in childhood!!
|
|
Biggest cause of prerenal failure!
|
Hemmorrhage
|
|
Biggest cause of post renal failure.
|
Renal Calculi
|
|
|
(more men than women have renal calculi)
|
|
Biggest cause of intrarenal failure.
|
glomerulonephritis.
|
|
Children with untreated strep may end up with what?
|
pyelonephritis
|
|
Chronic Renal Failure
|
Progressive and Irreversible Destruction of kidneys.
|
|
CRF caused by what?
|
Conditions that cause permanent nephron loss:
|
|
|
diabetes, HTN, glomerulonephritis, polycystic kidney disease
|
|
Each kidney contains how many nephrons?
|
one million
|
|
Diminished Renal Reserve
|
GFR 50% of normal
|
|
|
usually 40-70 mL/min
|
|
Renal Innsuffiency
|
GFR 20-50%
|
|
|
usually 20-40 mL/min
|
|
Renal Failure
|
GFR less than 20%
|
|
|
usually 10-20 mL/min
|
|
End Stage Renal Disease (ESRD)
|
GFR less than 5%
|
|
|
usually less than 10 mL/min
|
|
|
Requires dialysis for survival
|
|
What med is used for hyperkalemia?
|
Kayexalate
|
|
Clinical Manifestations of Chronic Renal Failure
|
Hyperlkalemia
|
|
|
High or low Na
|
|
|
Hyperphosphatemia
|
|
Peritoneal Dialysis
|
Watch for abnormal soln color, should be straw colored.
|
|
Procurement Interview
|
Checks for possible donor.
|
|
Avoid using ________with antacids or mg because of toxicity.
|
Aluminum Hydroxid
|
|
Epogen given for renal failure.
|
To see if it is working, check to see if Hematocrit level is rising.
|
|
Dry scaley skin with ecchymoses, petechiae, and purpura.
|
Because of eurythropeotin
|
|
Facts about acute renal failure
|
-occurs suddenly
|
|
|
-usually reversible
|
|
|
-3 phases
|
|
|
oliguric, diuretic, and
|
|
|
recovery
|
|
What acid base imbalance often occurs with renal failure?
|
Metabolic Acidosis
|
|
Use phosphoru binding mecications to treat what?
|
hyperphosphatemia
|
|
Complications of transplantation (2)
|
1. Finding compatible donor
|
|
|
2. Rejection
|
|
Peritoneal Dialysis
|
fill
|
|
|
dwell
|
|
|
drain
|
|
How long does the soln usually dwell in peritoneal dialysis?
|
4 to 6 hours
|
|
How often for hemodialysis?
|
Every three to five days for 3-5 or more hours at a time.
|
|
Initian Phase in ARF
|
1-2 days
|
|
|
reduced urine output and increased BUN
|
|
Oliguric phase (Maintance) in ARF
|
1-2 weeks
|
|
|
hyperkalemia and fluid volume overload
|
|
Polyguric Phase (Diuretic) in ARF
|
progressive increase in urination in pts that were olyguric
|
|
|
May indicate beginning of renal repair
|
|
|
Substantial renal loss of sodium and water
|
|
|
May dehydrate
|
|
Phase of Functional recovery
|
No beginning or end
|
|
|
Repair of renal injury
|
|
|
BUN, creatinine, and urine volume gradually return to normal.
|
|
5 stages of chronic renal failure
|
1. slight damage GFR more than 90
|
|
|
2.Mild decrease in function GFR 60-89
|
|
|
3. Mod decrease in function GFR 30-59
|
|
|
4. Sever dEcrease in function GFR 15-29
|
|
|
5. kidney failure GFR less than 15
|
|
What is the main protein found in the urine?
|
albumin
|
|
What are the filters of the kidney?
|
glomeruli
|
|
Proteinuria is caused by what?
|
glomerulonephritis
|
|
Glomererular Filtration is best checked by what lab?
|
Blood creatinine
|
|
What lab checks the ability of the kidneys to concentrate urine?
|
Urine Specific Gravity
|
|
What is the diet ordered for patient with renal failure?
|
Low protein
|
|
|
Low sodium
|
|
|
High calorie
|
|
Antidiuretic Hormone effects kidneys by
|
controlling permeability
|
|
Aldosterone effects kidneys by
|
causing the distal tubule and collecting ducts to reabsorb increased levels of sodium.
|
|
Causes of intrarenal ARF
|
*Glomerulonephritis*
|
|
|
Nephrotoxic damage
|
|
|
NSAID's
|
|
|
heavy metals
|
|
Causes of postrenal ARF
|
*calculi (kidney stones)*
|
|
|
obstruction of indwelling cath
|
|
|
tumors
|
|
Causes of prerenal ARF
|
Sepsis
|
|
|
dehydration
|
|
|
hemmorhage
|
|
|
heart/liver failure
|
|
|
burns
|
|
How long does recovery phase last?
|
About 6 months
|
|
Renin-Angiotensin Mechanism
|
one of the most potent vasoconstrictors known.
|
|
|
|
|
|
RAS is a defense mechanism to prevent fall in BP due to loss of blood or fluid.
|
|
|
|
|
|
It can be improperly activated in renal disease causing HTN.
|
|
Alterations in fluid may produce what?
|
Generalized Edema
|
|
Accumulation of wastes (amonia) may cause what?
|
Mucosal Errosion
|
|
Alterations in platelet function may lead to what?
|
Eccymosis
|
|
What is a "silent killer"?
|
Hypertension
|
|
Causes of Acute Renal Failure ARF
|
1. prerenal- low blood flow to kidneys
|
|
|
2.intrarenal-direct damage to kidney parenchyme
|
|
|
3.postrenal-obstruction to flow of urine(may cause hydronephrosis)
|
|
What is ARF
|
Rapid deterioration or cessation in kidney function.
|
|
ARF and childhood!
|
It is uncommon in childhood!!
|
|
Biggest cause of prerenal failure!
|
Hemmorrhage
|
|
Biggest cause of post renal failure.
|
Renal Calculi
|
|
|
(more men than women have renal calculi)
|
|
Biggest cause of intrarenal failure.
|
glomerulonephritis.
|
|
Children with untreated strep may end up with what?
|
pyelonephritis
|
|
Chronic Renal Failure
|
Progressive and Irreversible Destruction of kidneys.
|
|
CRF caused by what?
|
Conditions that cause permanent nephron loss:
|
|
|
diabetes, HTN, glomerulonephritis, polycystic kidney disease
|
|
Each kidney contains how many nephrons?
|
one million
|
|
Diminished Renal Reserve
|
GFR 50% of normal
|
|
|
usually 40-70 mL/min
|
|
Renal Innsuffiency
|
GFR 20-50%
|
|
|
usually 20-40 mL/min
|
|
Renal Failure
|
GFR less than 20%
|
|
|
usually 10-20 mL/min
|
|
End Stage Renal Disease (ESRD)
|
GFR less than 5%
|
|
|
usually less than 10 mL/min
|
|
|
Requires dialysis for survival
|
|
What med is used for hyperkalemia?
|
Kayexalate
|
|
Clinical Manifestations of Chronic Renal Failure
|
Hyperlkalemia
|
|
|
High or low Na
|
|
|
Hyperphosphatemia
|
|
Peritoneal Dialysis
|
Watch for abnormal soln color, should be straw colored.
|
|
Procurement Interview
|
Checks for possible donor.
|
|
Avoid using ________with antacids or mg because of toxicity.
|
Aluminum Hydroxid
|
|
Epogen given for renal failure.
|
To see if it is working, check to see if Hematocrit level is rising.
|
|
Dry scaley skin with ecchymoses, petechiae, and purpura.
|
Because of eurythropeotin
|
|
Facts about acute renal failure
|
-occurs suddenly
|
|
|
-usually reversible
|
|
|
-3 phases
|
|
|
oliguric, diuretic, and
|
|
|
recovery
|