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MM Flash Cards
Co-Existing Diseases: Renal
| Question | Answer |
|---|---|
| What is the initial treatment of acute renal failure? If this initial treatment fails, what drug therapies are indicated? | Initial tx of oliguria associated w actute |
| Why should LR be avoided in the pt w chronic renal failure? | LR contains K+ @ 4 mEq/L. The CRF pt is unable to excrete K+. LR could aggravate hyperkalemia. |
| Which muscle relaxants are best used for the pt with chronic renal failure? Why? | Atracurium, vecuronium, cisatracurium, and mivacurium are best for the chronic renal failure pt bc they do not depend on renal excretion for clearance. |
| Which muscle relaxant is contraindicated for the crhonic renal failure pt w hyperkalemia? | Succinylcholine. Release of K+ after its administration could result in life threatening hyperkalemia. |
| Proteinuria & hypoalbuminemia are hallmarks of pt's w what kidney disorder? | Nephrotic syndrome |
| What are six pathophysiological manifestations of the nephrotic syndrome? | 1)Sustained & heavy proteinuria 2)Hypoalbuminemia 3)Edema & ascites 4)Hypovolemia 5)Hyperlipidemia (Hypercholesterolemia) 6)Hypoercoagubility (leading to increased incidence of thromboemboli) |
| what laboratory value reflects the nephrotic syndrome? | Proteinuria & hypoalbuminemia are hallmarks of the nephrotic syndrome. Thus, serum albumin concentration (normal range 3.5-5.0 mg/d) is expected to be less than 3.5mg/dl in the pt w nephrotic syndrome. |
| What are five signs of acute glomerulonephritis? What will urinalysis & a blood workup show in the pt w acute glomerulonephritis? | Manifestations of acute glomerulonephritis include:1)hematuria 2)protenuria 3)hypotension 4)edema 5)increased plasma creatinine concentration.Urinalysis will reveal hematuria & proteinuria, blood chemistry will reveal increased creatinine concentrations. |
| What blood laboratory value is likely to change in acute tubular necrosis? | With acute tubular necrosis, serum creatinine concentration increases well above its normal value of about 1 mg/dl. |
| What laboratory test is the best measure of end stage hepatorenal failure? | Urine sodium concentration (UNA). UNA < 10 mEq/L is indicative of end stage hepatorenal failure. |
| Your pt's creatinine clearance of 10 ml/min is indicative of chronic renal failure. WHich of the following drugs should you be most concerned about in this pt? Digoxin, quinidine, vecuronium, or atracurium? | Digoxin most depends on renal excretion & would be the agent of most concern if the pt severe renal failure. |
| Elimination of digoxin is primarily by? | The kidney's with approximately 35% of the drug excreted daily. |
| Elimination of atracurium? | Atricurium undergoes hoffman elimination its administration to the pt w renal failure is of no real concern. |
| Is quinidine of a real concern when being administered to a pt w severe renal failure? | ALthough 20% of administered quinidine is eliminated unchanged in the urine, most of it is hydroxylated in the liver to inactive metabolites, which are excreted in the urine. |
| The elimination of vecuronium is primarily? | Hepatic, but up to 20% of the drug is eliminated in the urine. The effects of larger doses of greater than 0.1 mg/kg are only modestly prolonged in pt's w renal insufficiency. |
Created by:
ngawlik
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