Renal Failure

Front 1

What acid base imbalance often occurs with renal failure?

Back 1

Metabolic Acidosis

Front 2

Use phosphoru binding mecications to treat what?

Back 2

hyperphosphatemia

Front 3

Complications of transplantation (2)

Back 3

1. Finding compatible donor
2. Rejection

Front 4

Peritoneal Dialysis

Back 4

fill
dwell
drain

Front 5

How long does the soln usually dwell in peritoneal dialysis?

Back 5

4 to 6 hours

Front 6

How often for hemodialysis?

Back 6

Every three to five days for 3-5 or more hours at a time.

Front 7

Initian Phase in ARF

Back 7

1-2 days
reduced urine output and increased BUN

Front 8

Oliguric phase (Maintance) in ARF

Back 8

1-2 weeks
hyperkalemia and fluid volume overload

Front 9

Polyguric Phase (Diuretic) in ARF

Back 9

progressive increase in urination in pts that were olyguric
May indicate beginning of renal repair
Substantial renal loss of sodium and water
May dehydrate

Front 10

Phase of Functional recovery

Back 10

No beginning or end
Repair of renal injury
BUN, creatinine, and urine volume gradually return to normal.

Front 11

5 stages of chronic renal failure

Back 11

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

Front 12

What is the main protein found in the urine?

Back 12

albumin

Front 13

What are the filters of the kidney?

Back 13

glomeruli

Front 14

Proteinuria is caused by what?

Back 14

glomerulonephritis

Front 15

Glomererular Filtration is best checked by what lab?

Back 15

Blood creatinine

Front 16

What lab checks the ability of the kidneys to concentrate urine?

Back 16

Urine Specific Gravity

Front 17

What is the diet ordered for patient with renal failure?

Back 17

Low protein
Low sodium
High calorie

Front 18

Antidiuretic Hormone effects kidneys by

Back 18

controlling permeability

Front 19

Aldosterone effects kidneys by

Back 19

causing the distal tubule and collecting ducts to reabsorb increased levels of sodium.

Front 20

Causes of intrarenal ARF

Back 20

*Glomerulonephritis*
Nephrotoxic damage
NSAID's
heavy metals

Front 21

Causes of postrenal ARF

Back 21

*calculi (kidney stones)*
obstruction of indwelling cath
tumors

Front 22

Causes of prerenal ARF

Back 22

Sepsis
dehydration
hemmorhage
heart/liver failure
burns

Front 23

How long does recovery phase last?

Back 23

About 6 months

Front 24

Renin-Angiotensin Mechanism

Back 24

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.

Front 25

Alterations in fluid may produce what?

Back 25

Generalized Edema

Front 26

Accumulation of wastes (amonia) may cause what?

Back 26

Mucosal Errosion

Front 27

Alterations in platelet function may lead to what?

Back 27

Eccymosis

Front 28

What is a "silent killer"?

Back 28

Hypertension

Front 29

Causes of Acute Renal Failure ARF

Back 29

1. prerenal- low blood flow to kidneys
2.intrarenal-direct damage to kidney parenchyme
3.postrenal-obstruction to flow of urine(may cause hydronephrosis)

Front 30

What is ARF

Back 30

Rapid deterioration or cessation in kidney function.

Front 31

ARF and childhood!

Back 31

It is uncommon in childhood!!

Front 32

Biggest cause of prerenal failure!

Back 32

Hemmorrhage

Front 33

Biggest cause of post renal failure.

Back 33

Renal Calculi
(more men than women have renal calculi)

Front 34

Biggest cause of intrarenal failure.

Back 34

glomerulonephritis.

Front 35

Children with untreated strep may end up with what?

Back 35

pyelonephritis

Front 36

Chronic Renal Failure

Back 36

Progressive and Irreversible Destruction of kidneys.

Front 37

CRF caused by what?

Back 37

Conditions that cause permanent nephron loss:
diabetes, HTN, glomerulonephritis, polycystic kidney disease

Front 38

Each kidney contains how many nephrons?

Back 38

one million

Front 39

Diminished Renal Reserve

Back 39

GFR 50% of normal
usually 40-70 mL/min

Front 40

Renal Innsuffiency

Back 40

GFR 20-50%
usually 20-40 mL/min

Front 41

Renal Failure

Back 41

GFR less than 20%
usually 10-20 mL/min

Front 42

End Stage Renal Disease (ESRD)

Back 42

GFR less than 5%
usually less than 10 mL/min
Requires dialysis for survival

Front 43

What med is used for hyperkalemia?

Back 43

Kayexalate

Front 44

Clinical Manifestations of Chronic Renal Failure

Back 44

Hyperlkalemia
High or low Na
Hyperphosphatemia

Front 45

Peritoneal Dialysis

Back 45

Watch for abnormal soln color, should be straw colored.

Front 46

Procurement Interview

Back 46

Checks for possible donor.

Front 47

Avoid using ________with antacids or mg because of toxicity.

Back 47

Aluminum Hydroxid

Front 48

Epogen given for renal failure.

Back 48

To see if it is working, check to see if Hematocrit level is rising.

Front 49

Dry scaley skin with ecchymoses, petechiae, and purpura.

Back 49

Because of eurythropeotin

Front 50

Facts about acute renal failure

Back 50

-occurs suddenly
-usually reversible
-3 phases
oliguric, diuretic, and
recovery

Front 51

Emergency tx of hyperkalemia.

Back 51

dialysis and 50% hypertonic glucose IV, calcium gluconate IV, regular insulin, sodium bicarb IV, Kayexelate

Front 52

Lab results with ARF

Back 52

-urine output below 400 mL in 24 hours
-increased blood urea nitrogen level
-increased serum creatine
-