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15 Cards in this Set
- Front
- Back
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progressive, irreversible destruction of nephrons in both kidneys
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chronic kidney disease
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Staging of kidney disease
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stage 1-kidney damage w/normal or incr GFR
2-damage w mild decr GFR 3-moderate decr GFR 4 severe decr GFR 5-kidney failure/transplant |
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s/s kidney disease
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uremia - syndrome of all s/s that varies according to pt, cause of disease, comorbid, age
polyuria-1st symptom oliguria anuria |
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metabolic disturbances of kidney disease
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hyperinsulinemia stimulates hepatic production of triglycerides- risk factor of accelerated atheroscleerosis, does not decr w/dialysis due to glucose in dialysate fluid
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electrolyte imbalances of kidney disease
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hyperkalemia-due to decr excretion
sodium-restrict to 2g/24 hr hypermagnesia-do not give MOM metabolic acidosis-can't excrete ammonia |
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hematologic problems of kidney disease
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anemia due to decr RBC production, iron deficiency
bleeding tendencies due to defect in platelet function infection-altered immune response, malnutrition, trauma |
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CV and GI problems of kidney disease
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CHF
stomatitis due to urinous breath |
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s/s chronic renal failure
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yellow, discolored skin-retention of urinary pigments
pale, dry, scaly skin pruitis-bleeding/infection uremic frost-urea crystals on skin dry brittle hair thin, brittle nails petechiae & ecchymosis |
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goals for pt with kidney disease
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preserve renal function
treat symptoms prevent complications promote comfort, self worth treat depression |
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drug therapy for hyperkalemia in kidney disease
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restrict high K foods
IV glucose, insulin needs glucose to prevent hypoglycemia Kaexolate-cation-exchange resin-can cause diarrhea |
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drug therapy for HTN in chronic renal failure
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restrict sodium & water
give ACE inhibitors calcium channel blockers 3 position BP |
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drug therapy for renal osteodystrophy in chronic renal failure
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less than 1000 mg/day phosphate intake
avoid preparations with aluminum or magnesium to avoid dementia |
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drug therapy for anemia in chronic renal failure
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procrit or epogen
FeSO4 avoid transfusion unless blood loss or symptomatic anemia |
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complications of drug therapy in chronic renal failure
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drug toxicity
watch digitalis preparatins antibiotics pain meds normeperidine NSAIDs |
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nutrition for chronic renal failure
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protein restriction 40g/day
fat-determined by caloric rqmt carbs limited iron-variable sodium 2-3g/day calcium-1000-1500/day folic acid water restriction - urine output +600 cc |
