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Dialysis M3
Exam 6
| Question | Answer |
|---|---|
| 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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