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78 Cards in this Set
- Front
- Back
continuous venous hemofiltration with dialysis in which fluid and solute clearnace takes place
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CVVH-D
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arterial blood being stolen from distal extremity
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steal syndrome
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dextrose or sodium solution pulling excess water from the circulatory system by osmosis
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dialysate
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fluid removal for volume overload only
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SCUF
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inflow, dwell, drain
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dialysis cycle
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continuous treatment where blood is remvoed from the body and circulated for an extended period of time
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CRRT
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continuous venous hemofiltration with fluid and solute clearance
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CVVH
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the peritoneum acts as a semipermeable membrane to clear waste products by osmosis and filtration
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peritoneal dialysis
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movement of fluid and molecules across a semipermeable membrane from one compartment to another
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renal replacement therapy
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instillation of peritoneal dialysate, equilibration for 4-6 hours and drainage
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exchange
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blood circulates from the ____ to the renal artery into the kidneys
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aorta
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each renal artery branches into one million _______ that perfuse one million ______ which filter the blood into an ultrafiltrate that passes into Bowman's Capsule. remaining blood passes out via the _____
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afferent arterioles, glomeruli, efferent arteriole
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blood circulates thru the ____ around the tubules where reabsorption and excretion take place as the kidney balances electrolyte levels, acid base levels, hormone regulation, hydration status and finally excretes urine into the collecting ducts.
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peritubular capillary
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the collecting ducts send urine to ____ via _____ to be stored in ______ until urination occurs
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renal pelvis, ureters, bladder
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From Bowman's Capsule the ultrafiltration enters the _____ where the majority of solutes and water are reabsorbed.
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proximal convuluted tubule
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____ and ____ are almost completely reabsorbed in the proximal convoluted tubule.
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glucose and amino acids
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the ultrafiltrate travels to the _____
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loop of henle
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the distal portion of the loop of henle is permeable to ______ only
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water
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the ascending portion of the loop of henle is permeable to _____ only
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solute
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from the loop of henle the ultrafiltrate moves to the _______ where final correction of ________ takes place
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distal convoluted tubule, acid base balance
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_____ secretion takes place in response to low peripheral blood pressure
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renin
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water reabsorption takes place in the presence of _____
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ADH
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aldosterone is released in responce to ____ levels
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sodium
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electrolytes such as ___, ___, ___, and ____ are corrected
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K, Na, Ca and PO4
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the remaining ultrafiltrate passes from the distal convoluted tobule to the _____ for final correction of fluid-water balance which is controlled by ___ on the walls.
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collecting ducts, ADH
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absence of ADH can result in
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excessive urination, hypovolemic shock and death
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when smooth muscle afferent arterioles constrict
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SBP and GFR increases
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when smooth muscle afferent arterioles relax
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SBP and GFR decreases
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during low fluid intake periods the kidneys will concentrate urine by using
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juxtamedullary nephrons
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series of specialized cells within the afferent and effernet arterioles and distal convoluted tubules that secret renin
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juxtqamedullary apparatus
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MAP in the glomerulus maintins a blood flow of
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125ml/min
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when renin is secreted by the kidneys it travels to the ____ to convert angiotnsin to angiotensin 1.
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liver
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angiotensin 1 then travels to the ___ to convert angiotension 1 to angiotension 2 which causes _____ of the peripheral blood vessels and secretion of _____ from the adrenal cortex
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lungs, vasoconstriction, aldosterone
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in the presence of a UTI the urine pH will become
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alkalotic
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in the presnece of a metabolic acidosis the urine pH will become
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more acidic
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any process that decreases the oxygen content in the blood initiates the release of
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erythropoietin
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the kidneys convert vitamin D to its ctive form so ____ can be absorbed in the body
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calcium
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BNP is sereted by the muscle cells of the ____ when the extracellular volume expands and stretches them
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ventricle
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the degree of stretch by the volume of blood determines regulation of BNP secretion to the kidneys which then ____ GFR, _____ Na excretion in the tubules, _____ RAAS and ____ aldosterone secretion
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increase, increase, inhibit, inhibit
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ANP is secreted by the cells of the ____ when the extracellular volume expands and stretches them
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atria
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normal urine specific gravity
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1.010 to 1.030
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what does a cloudy urine specimen mean
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pus, infection
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what does blood in the urine mean
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RBCs, trauma, hemolysis, RF
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what does a fixed specific gravity of <1.005 mean
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renal failure
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what does protein in the urine mean
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renal failure
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what is normal urine pH
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50 to 6.5
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when does glucose become detectable in the urine
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when serum glucose >200
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normal Na
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135-145
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normal potassium
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3.5-5.0
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normal Cl
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98-112
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normal Ca
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8.5-10.3
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normal PO4
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2.5-4.5
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normal Mg
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1.6-2.5
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normal albumin
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>3.5
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normal H/H
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12-17/37-42
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normal BUN
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8-20
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normal creatinine
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0.6-1.2
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normal arterial pH
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7.35-7.45
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normal PaCO2
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35-45
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normal PaO2
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60-80/80-100
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normal HCO3
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22-26
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normal O2 sats
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95-100%
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normal serum osmolality
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280-290
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major cause of mortality in renal failure pt
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infection
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increase systemic BP
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renin
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precipitate in brain eyes, gums, heart valves
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PO4 crystals
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dysrhythmia of hyperkalemia
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V Tach
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dryness of skin
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xerosis
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calories for renal diet obtained from
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cholesterol and lipids
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irreversible deterioration in RF pt
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chronic RF
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secreted in response to low O2 states
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erythropoietin
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give sparingly to RF patients
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protein
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treatment of a patient with nephrotoxic ATN as a result of exposure to radiopaque dye would include
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* aggressive fluid administration
* dialysis * diuretics * dopamine * skin care * teaching |
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diuretic phase of ATN involves
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* maintaining hydration
* preventing hypokalemia * supporting renal function |
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foods for a CRF pt would include
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* steamed vegetables
* yogurt * baked potatoe |
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priorities when caring for a renal failure pt would include
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* daily weights
* fluid restrition, low protein, high calorie diet * diuretics and antihypertensives * discharge teaching * IV fluids before, during, and after cardiac cath * monitor serum creatinine, BUN and leukocyte esterase * monitor K, PO4, Na, Mg, Ca, H/H, and platelets |
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patient risk factors for developing renal failure include
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* DM
* radiopaque dye * vanco * HTN |
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to decrease bleeding tendenies in a RF pt you would
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* monitor RBCs, platelets, bleeding times and coag studies
* avoid NSAIDS * protect the pt from injury * assess for HIT * assess for GI bleed |