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Chronic Renal Failur

Renal 2 Exam

Chronic renal failure is aka ESRD
Person can survive without dialysis until almost ____% of nephrons are lost 90
Creatinine clearance of <____% means dialysis or transplant is needed for survival 15
GFR is calculated by creatine, albumin, age, race, gender, BUN
Urinary sym of CRF Polyuria d/t loss of ability to concentrate urine, eventually oliguria or anuria. Fixed sp grav 1.010, positive protein, WBC casts (pyuria), hematuria depending on cause
What happens to BUN and Creat? Increase
Increased BUN results in what? N/V, lethargy, HA, impaired thought processes, uremic frost
Urea and uric acid salts on skin Uremic Frost
Electrolyte imbalance includes Increase K, NA, Phos, Decreased Ca, bicarb
What are other s/s of CRF Diarrhea, constipation, peripheral neuropathy, yellow-gray discoloration of skin, pruritis, leg pain, dyspnea
Diet for CRF Restrict K, Na, Protein, Fluid, phos. Provide multi vitamin
What is protein and fluid restriction for CRF 40g/day protein, 600 mL + previous day output fluids
Low K foods include Green or wax beans, apples, grapes, bell peppers
Avoid K foods such as Spinach, lima beans, potatoes, tomatoes, and peas
What meds to control Hyperk? Kayexalate, insulin (ER situation not qd), sodium bicarb
What meds to control HTN? ACEI, CCB, BB, Vasodilators, diuretics
Decreases effect of K on cells but does not decrease K Ca Gluconate
With what is anemia treated? Epogen IV or SQ 3x/week
What Phos binding meds given? Os-Cal, Phos lo with meals, Renegal
Why would antiseizure meds be given? Uremia and HyperNa
What nursing measures? Daily weight, Strict I/O, check skin (increased r/o infection), anticipate grieving, dialysis, life-threatening overload (Increased Na, BUN)
When conservative tx no longer effective, _____ and/or ________ are the only options dialysis, kidney transplant
What are the indicators for dialysis? K>6, BUN >120, fluid overload w/ compromised cardiac or pulmonary status, sig mental status changes, pericarditis, pericardial effusion, cardiac tamponade
What output is considered anuria? <40-50 mL/day
Created by: mreedy