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255 EXAM 3
renal (content)
| Question | Answer |
|---|---|
| Healthy kidneys filter and regulate ____ | fluid, waste, electrolytes |
| If the kidneys are not excreting fluid, worry about fluid volume__ | excesse |
| If the kidneys are not removing waste products, worry about an inc in___ | waste products |
| If there is a build up of waste products, worry about changes in__ | mental status |
| If the kidneys are not filtering electrolytes, worry about imbalance in___ | electrolytes |
| when monitoring Ca worry about___. What is the range ? | Brittle bones, muscles problems, and altered mental status. 8.6-10.2 |
| when monitoring phos worry about ___. what is the range? | Brittle bones.. 3-4.5 |
| when monitoring K worry about___. What is the range? | Arrhythmia/dysrhythmic/Irregular. 3.5-5 |
| when monitoring Na worry about____. what is the range? | Neuro status 135-145 |
| Healthy kidneys make erythropoietin. What is it? what dose it do? | Messenger hormone that sends singles. tells the bone marrow to make new blood cells |
| what happens if the kidneys don't make erythropoietin? | leads to Anemia |
| healthy kidneys activate Vit D. What does Vit do? | vitamin D helps absorb Ca. If not absorbed it causes brittle bones |
| Healthy kidneys balance Ca and Phos as an inverse relationship. Why do they need to be balance? | bone health |
| what are the levels of Ca and Phos if the kidneys are damaged? | Ca levels are low and Phos levels are high |
| What do kidneys have trouble absorbing and excreting? | trouble absorbing Ca and trouble excreting Phos |
| Healthy kidneys balance pH levels. What do they produce and hold on to vs, what do they excrete? | Produce and hold on to bicarb. Excrete acid |
| Healthy kidneys regulate BP by releasing ____ when BP is ____? | releases renin by vasoconstricting when BP is low |
| Renin Angiotensin Aldosterone System | renin converts angiotensinogen to angiotensin 1 then gets converted by and ACE to angiotensin 2 causing vasoconstriction and aldosterone causing retention of Na and H2O then it inc BP with inc pre load and good CO |
| GFR what is it and what is the range? | Glomerular Filtration Rate: >60 is good. anything less is bad |
| BUN what is it and what is the range? | Blood urea nitrogen. 10-20. want the products to be low (burger cost $10-20) |
| Cr what is it and what is the range? | Creatinine. 0.6-1.2 (cheese on burger is 0.60c-1.20c ) |
| Urinalysis looks at? | appearance and components |
| Urine specific gravity what is it and what are the ranges? | measures concentration(stuff) 1.003-1.030. High concentrated, Low diluted |
| Biopsy you look at the__ | tissuie |
| Ultrasound you look at the? | size, shape, and location |
| CT you look for? | abnormalities and surrounding fluid |
| Why are MRIs avoided? | they uses a drug that is toxic for the kidneys |
| What considerations should you take if dye is used/what to do | inc fluid even a fluid flush |
| Why is CKD often symptomatic aft first? | Because it is chronic and happens slowly because the kidneys are trying to compensate. |
| What ABG is in the oliguric phase? | Metabolic acidosis |
| What is the end stage renal failure? | Stage 5 begin dialysis or transplant needed <15 GFR |
| Uremia CKD | high levels of urea (waste) in the blood, happens with multiple body systems are affected and GFR is <15 |
| Uremic Frost CKD | urea leaks out of patients pours, itching skin |
| why are diuretics beneficial to a patient with heart disease? | to dec fluid volume excess |
| What organ can be harmed by the use of diuretics? | kidneys |
| What labs should you monitor for CKD? | GFR, BUN, Cr |
| what nursing intervention can be used to determine fluid volume status? | daily weights |
| What drugs can be nephrotoxic? | ibuprofen, -mycin abx, dye, street drugs |
| What labs should you monitor with vancomycin? | Peak and troph |
| What is dialysis? | machine that acts as a kidney. Filters, regulates, removes fluid electrolytes and waste products |
| what is peritoneal dialysis? | hooked up the inside of the body called the peritoneal space, can be done at home, Automated, continuous ambulatory |
| what is hemodialysis? | Arm or neck 3x a week for 4 hr |
| Quinton catheter | neck, temporary, red pulls blood, blue returnes blood |
| AV fistula | arm, permanent, 3 months, thrill, bruit |
| AV Graft | arm, permanent, 2-4 weeks, Thrill, bruit, PVD patients. Used when there are no good vessels |
| What are the complications of hemodialysis? | hypotension, bleeding, muscle crams from loss of electrolytes |
| What are the complications of peritoneal dialysis? | Hernia back pain and SOB from pressure of the fluid, infections, bleeding, protein loss |
| Why might a provider hold a antihypertensive med when the patient is scheduled for dialysis? | if the patients blood pressure drops they can not receive dialysis because during dialysis they pull the fluid and electrolytes out causing a low BP |
| Live Donor considerations | medical counseling, open or laparoscopic, ICU 24 hr post op, mental and physical health |
| Deceased Donor considerations | Brain dead and previously healthy, vent support for organs, within 72 hr |
| what is cold time for a transplant? | the amount of time the organ is out of body to into the paitent |
| Glomerulonephritis | inflammation of the filtering part of the kidney |
| what findings can the nurse expect when completing a head to toe assessment on a patient with excess fluid volume? | Edema, crackles, SOB |
| Why is it important for a patient with Glomerulonephritis to report daily weights, intake, and output? | Fluid volume overload |
| Anasarca | total body edema |
| Nephrotic syndrome | loosing protein in urine |
| should you inc or dec protein with Nephrotic syndrome? | inc protein |
| is renal cancer responsive to chemo/radiation? | no |
| Cryoblation | fezzeing the tumor |
Created by:
mmarino2