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Nsg 210 Ch. 44
Renal Disorders
| Question | Answer |
|---|---|
| 500ml of gained wt equals how many pounds? | 1 lb or 1kg = 1,000ml 10lb = 5L = 2500ml |
| s/s of: FVD FVE | FVD: wt loss < or equal of 5%, decr skin turgor, dry mucous memb, oliguria/anuria, incr hematocrit, BUN incr out of propor to creatinine FVE: crackles, distended neck vv, wt. gain, edema, decr BUN, hematocrit |
| s/s of hypo/hypernatremia 135-145 | hypona: nausea, malaise, lethargy, HA, abd cramps, apprehension, seizures hyperna: dry sticky mucous mem, thirst, rough dry tongue, fever, restlessness, weakness, disorientation |
| s/s of hypo/hyperkalemia | <3.5 hypo: anorexia, abd distention, paralytic ileus, muscle weak, ECG changes, dysrhythmias >5.0 hyper: diarrhea, colic, N, irritable, muscle weak, ECG change |
| s/s of hypo/hypercalcemia | <8 hypo: abd/muscle cramps, stridor, hyper reflexes, tetany, +Chvostek/Trousseau, tingle finger/mouth >10 hyper: bone/flank pain, muscle weak, depressed reflexes, constipation, N/V, confusion, stones |
| s/s Mg hypo/hypermagnemesia | hypo: like hypocalcemia tx: diet, mg hyper: like hypercalcemia, flushing, resp dep, cardiac arrest tx: Ca gluconate, vent, dialysis |
| s/s hypo/hyperphosphetemia | hypo: like hypercalcemia tx: diet, phosphorus oral hyper: like hypocalcemia tx: diet restrict, phosphate binders(Os-Cal, PhosLo), NS, IV dextrose, insulin |
| Tx for hypo/hyper fluid volume | FVD tx: fluids FVE tx: fluid/Na restrict, diurectics, dialysis |
| Tx for hypo/hypernatremia | hypo tx: diet, NS, hypertonic saline hyper tx: fluids, diurectics, diet restrict |
| tx for hypo/hyperkalemia | hypo tx: diet, PO K, hyper tx: diet restrict, diurectics, IV glucose, insulin and Na bicarb, Ca gluconate, dialysis |
| tx for hypo/hypercalcemia | hypo tx: diet, Ca salt PO hyper tx: fluids, etidronate, pamidronate, mithramycin, calcitonin, glucocorticoids, phosphate salts |
| mild/mod/severe renal disease | mild: GFR 60-90 mod: GFR 30-59 severe: GFR 1-29 ESRD: <15 |
| hardening of the renal aa is termed? | nephrosclerosis r/t htn and diabetes and major cause of ESRD and CKD |
| malignant nephrosclerosis is assoc with? benign? tx: | malignant HTN >130 diastole assoc with atherosclerosis/HTN TX: Ace inhibitors & ARBs and treat DM |
| An inflammation of the glomerular capillaries is termed? cause? tx? nsg mgmt? | glomerulonephritis r/t strep or infection. See protein/blood in urine tx: plasmophoresis, antibiotics, antiHTN, corticosteroids Nsg: carb diet to clear proteins, I/O |
| what is azotemia? | abnormal concentration of nitrogenous waste in blood |
| These s/s are seen in renal failure or chronic glomerulonephritis | hyperkalemia- not pass K metabolic acidosis: not pass acid and not regenerate bicarb anemia- decr erythropoiesis hypoalbuminemia- protein loss incr phosphate - not lose phosphate decr Ca- Ca binds phosphate mental changes impaired nerve cond - urem |
| Other s/s or renal failure | enlarged heart, pulmonary edema, L vent hypertrophy, tented T waves from hyperK, shrinking kidney cortex |
| What happens with Goodpasture syndrome? tx? | antibodies attack lung and renal tiss tx: immunosuppression wtih Cytoxin and steroids, plasmaphoresis/dialysis |
| One type of renal failure from incr glomerular permeability with massive proteinuria, edema, high cholesterol tx? | nephrotic syndrome tx: protein diet(meat), diruetics, ACE inhibitors to reduce proteinuria, chol. meds |
| what is preferred tx for renal Ca? | radical nephrectomy- remove kidney, adrenal gland, fat & lymph nodes Torisel is IV infusion to tx adv renal cell carcinoma |
| 50% incr in creatinine above baseline indicates? | ARF- acute renal failure |
| The three categories of ARF are | prerenal: happens b4 reaches kidney(hypofusion) intrarenal: damage to glomeruli/tubules from inf, toxins, tumors, incr K/ph postrenal: after kidney(obstruction in tract: stones, prostate |
| What are the 4 phases of ARF | intiation: initial insult, ends when oliguria starts oliguria: incr BUN, creatinine, K, Na diuresis: incr output recovery: takes 3-12mos |
| What is one of the earliest signs of tubular damage in the kidney? | low sp. gravity, inability to concentrate urine |
| Decr GFR, oliguria, anuria make pt high risk for? tx? | hyperkalemia Kayexalate, low dose dopamine, IV glucose & insulin or Ca Gluconate(drives K back into cell TEMPORARILY until removed dialysis Na Bicarb diet restrictions |
| Complications of ESRD and tx | hyperkalemia pericarditis r/t uremic waste htn r/t na & h2o retention anemia bone disease r/t retention of phosphorus and low Ca and decr of Vit D |
| Med mgmt of ESRD | antacids, antihtn(lisinopril), antiseizure(dilantin, Valium), EPO, restrict fluid, dialysis, transplant |
| Wastes and fluid are removed in dialysis by | diffusion:high concentrationin blood to lower in dialysate osmosis:from low concentration(blood) to high concentration(dialysate bath) |
| what is preferred method of permanent access? | arteriovenous fistula(AVF) by joining art to vein. Needs 2-3mos to mature b4 use |
| what is common complication of dialysis? diet? | hypotension(N/V, diaphoresis, tachycardia, dizzy) SOB, muscle cramps, dysrhythmias diet: low protein, high calorie |
| What is main adv in peritoneal dialysis vs hemodialysis? | PD for those who can't do hemo, more gradual, those susceptible to rapid fluid/electrolye/metabolic changes like diabetes, cardio pts and htn,HF, pul edema. PD takes 36-48h and hemo 6-8h |
| With dialysis, how should nurse adm htn meds? | htn is common and htn meds must be withheld to avoid hypotension |
| what is main complication of kidney surgery? | hemorrhage and shock |
| An important nsg fx for kidney transplant pts is | assess psychological stress and coping |
Created by:
palmerag
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