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Dialysis M3

Exam 6

Average human life span? 80-100 years
By year 2050 35% of the population will be will be more than 55 years old
diabetics have 2 1/2 times more MI's and are 75% more likely to die of CV disease
CV disease is the _____ common cause of hospitalization and death in elderly most
_________ is the most common CV condition coronary atherosclerosis
________ years old are the fastest growing segment of new ESRD 65-74
Factors about ESRD population Decrease in number of neurons, brain size and weight
Elderly ESRD patients have reduced ability to regulate______________. salt and water balance
Dehydration may occur in elderly patient because of _____________. decreased thirst perception
Hyperkalemia is more likely in ____________. Elderly using K+ supplements or K+ sparing diuretics or bata blockers
Decrease in ability to activate Vitamin D caused decrease calcium reabsorption by intestines__________. Causes decrease in serum calcium
Decrease arterial elasticity, increased peripheral resistance, myocardial valvular rigidity _________. result in poor compensation to stress
Renal function Physiologic loss of nephrons leads to the slower rate of clearance by kidney.
There are ________ glomeruli from birth to age 40 one million
Glomeruli decrease to __________ by age 70 1/2 to 3/4 the amount of nephrons
Indications for acute dialysis in the pediatric patient include: Hyperkalemia, CHF, HTN, acidosis and symptoms of uremia
Indications for chronic dialysis: When creatinine clearance is < 10 ml/min
T/F Pediatric dialysis requires one on one T
Extracorporeal circuit must not hold more than ____ of blood volume 10%
Infants must be placed on ______ during TX Scale
With infants _____ rate is important to determine UF rate blood flow
Special machine are required for children ___ < 20 kgs
One of the complications of Diabetes, ______. Retinopathy
Diabetic induced renal disorders, ______. Infections
Toxic to kidnes, ______. Contrast medium
Once proteinuria occurs dialysis will be required in______? 8-10 years
Early functional changes____________________? Decreased afferent arteriole resistance
Name 3 diabetic nephropathy preventive strategies _____,____,____? Glycemic control, control BP, ACE inhibitors
Cardiovascular disease leading cause of death in diabetic patients on dialysis
Kt/v K times T decided by V
K= Dialyzer's urea clearance
T= time of dialysis
V= Volume of distribution of urea
What is NKF-DOQI?
What is the recommended delivered dose of dialysis Kt/v should be? 1.2 for both adult and ped but desired at 1.3
Does not allow for____? quantitative assesment
A PRU during a single dialysis session has been proposed as a means of calculating ___? Kt/v
Kt/v is calculated by collecting a _____ sample of peritoneal fluid 24 hour
PRU ia a ______? Linear
80% CO to liver, heart, brain
30% CO to TBW
20% CO to muscle bone and skin
_____ liter per day for ESRD patients one
Water/fluids comprise of_______? 60% of body weight
Fruits and vegetables are_______? 90% water
Metabolic water results from oxidation of foods; yield is 200-300 ml/day
early skin sign of renal failure dry scaly skin
extravascular volume overload periorbital
avoid diuretics when GFR is less than _______? 5-10% of normal
terminal stage of of renal failure Uremic frost skins
sign and symptoms of Hyperkalemia EKG changes with tented T waves, ST depression
etiology of Hyperkalemia decrease GFR and K+ excretion, acidosis, bleeding
management of Hyperkalemia avoid salt substitute with potassium, correct catabolism, sodium bicarbonate, calcium, hypertonic glucose, kayexalate… DIALYSIS
signs and symptoms of metabolic acidosis low plasma bicarbonate, low PH, kussmaul respiration
pericarditis triad chest pain, fever and pericardial friction rub
pericardial effusion disappearance of friction rub and paradoxical pulse (> 10mmHg difference between systolic and diastolic BP during inspiration)
pericardial tamponade sac becomes filled with fluid restricting contraction of the heart low bp with narrowing pulse pressure
volume overload can result from _______________? inadeguate removal of fluid during dialysis
alterations in red blood cells (anemia) Sins and symptoms fatigue, SOB, Hct 20-25%, Hgb 6-8 grams, chest pain
treatment of alterations in red blood cells (anemia) iorn supplements, folic acid, blood transfusions, EPOGEN, aranesp
what facilitates calcium absorption in the GI tract? Activated form of Vitamin D that is normally produced in the kidneys
% of calcium found in bones? 98-99
when ionized plasma calcium levels drop the parathyroid hormone PTH is produced
PTH increases the activity of osteoclasts in the bone
Phosphate is essential to life, a component of _____ ATP
Normal phosphate level 2.5-4.5 mg/100ml
If calcium level decreases the phosphate level______? increases
If calcium levels increase the phosphate level______? decreases
Created by: SGT WEAVER
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