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23 Cards in this Set
- Front
- Back
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Oliguria
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under 400cc/24 hours
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Anuria
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Under 100cc/24 hours
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What are the 3 causes of acute renal failure?
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1.) Prerenal = decreased blood flow to the kidneys
2.) Intrarenal = actual damage to the kidney tissue 3.) Postrenal = obstruction that blocks urine flow |
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What is acute tubular necrosis?
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Epithelial cells in the kidney tubules are destroyed due to primarily prolonged ischemia
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Initiation phase
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Starts with event like hemorrhage and ends when tubular injury occurs.
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Maintenance phase
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Edema, hypervolemia, heart failure, plmonary edema, HTN, confusion, agitation, lethargy, seizures, coma, hyperkalemia (muscle weakness, N/D, ekg changes with tall tented T waves), Bowel sounds decreased or absent, uremia
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Recovery phase
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Tubule repair, diuresis
NURSE MUST PROVIDE FLUID REPLACEMENT (500cc + urine output) |
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What are the 4 phases of ARF?
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1. Onset caused by an event
2. Oliguric phase -Urine output below 400cc/24 hours -Excess fluid volume in body causes edema, HTN, CHF -Uremia causes N/V/pruritis -Metabolic acidosis causes Kussmaul's Respirations -Pericarditic causes friction rub, inspiratory pain, and low grade fever -HYPERkalemia 3.) Diuretic phase -Urine output goes up to 4-5L/day -Hypokalemia 4.) Recovery phase can take up to 2 years and urine output becomes normal. |
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Normal BUN
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5-20
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Normal creatinine
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0.6-1.2
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What is the DOC for metabolic acidosis?
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sodium bicarbonate
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A CBC on someone in ARF will reveal what?
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Anemia, decreased epoeitin, decreased RBCs, decreased platelets
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Ultrasound differences between acute and chronic renal failure
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Acute: swelling and inflammation of kidneys
Chronic: shrunken kidneys |
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What drug do people usually try before going on dialysis as a last resort?
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Mannitol; it increases urine flow but must be infused quickly. If flow rate increases to 40mL/hr then the renal failure is reversible!
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What should the client on dialysis' diet include?
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Restricted fluid intake between treatments, low protein, low sodium, low potassium, high carb, high fat diet
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What is a dialysis fistula?
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Anastamosis btw the cephalic vein and the brachial or radial artery. Do not take BP, draw blood, or wear tight clothes on this arm.
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What is a dialysis graft?
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Used when a fistula won't work; it is a bridge between the vein and artery.
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What is a dialysis shunt?
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Used if the graft doesn't work. This allows for access outside of the body.
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What is CRRT?
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Removes toxins and fluid at slow and continuous rate (up to 24 hours) and is for people who cannot tolerate hemodialysis.
-ONLY USE VENOUS ACCESS FOR THIS. NEVER EVER USE THE ARTERY!!!!!! |
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When would you hear a bruit?
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in AV fistulas or AV grafts because they are only heard in arteries.
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After dialysis what happens to the patient's BP normally?
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It decreases bc of large amount of fluid removed. Do not do any invasive procedures for 4-6 hours after dialysis is over.
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What are symptoms of peritonitis?
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Cloudy fluid removed by dialysis, abdominal pain or tenderness, abdominal rigidity
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What should the drainage look like in peritoneal dialysis?
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1st few exchanges will be bloody but then it should turn clear and straw or colorless.
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