MedSurge-KIDNEY INJURY/DISEASE review
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| Prerenal, acute kidney injury(AKI) characteristics? | ↓ cardiac output, initial cause of most acute renal failure, hypovolemia, renal vascular obstruction, anaphylaxis
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| Intrarenal, acute kidney injury(AKI) characteristics? | tubular obstruction by myoglobin, nephrotic drugs, acute glomerulonephritis
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| Postrenal, acute kidney injury(AKI) characteristics? | mechanical outflow obstruction, prostate cancer, renal stones, bladder cancer
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| Acute tubular necrosis results primarily from? | renal ischemia and nephrotoxic injury & necrosis
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| Renal ischemia leads to acute tubular necrosis by disrupting the? | basement membrane
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| AKI, staging acronym? | RIFLE - Risk / Injury / Failure / Loss / End-Stage Kidney Disease
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| Reversal of oliguria occurs with fluid replacement in pt. with? | prerenal oliguria
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| Urine in prerenal oliguria content? | high specific gravity, low sodium concentration
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| Urine in intrarenal oliguria content? | low specific gravity, low high concentration
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| Urine specific gravity consistently 1.010 and osmolality @ 300 mOsm/kg is about the same as ___ and indicates _____? | plasma; tubules are damaged and unable to concentrate urine
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| Because the kidneys cannot synthesize ammonia needed to excrete H+, ____ ____ occurs. | metabolic acidosis
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| Characteristics of acute renal failure include? | urinary output of 3 - 5 L/day, ↓ Na+ / K+ levels, and fluid weight loss
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| S/S of AKI in the oliguric phase? | muscle weakness and abdominal cramping due to hyperkalemia, urine output @ 300mL/day, peripheral edema
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| Cardiac conduction abnormalities in oliguric phase include | peaked T waves, depressed ST segment, prolonged PR and QRS intervals
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| Most common cause of death in AKI is? | infection
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| During catabolism of body protein serum urea? | increases
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| Calcium-phosphorus imbalances in chronic kidney disease (CKD) results from? | deficiency of active VitD and high phosphorus levels
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| Calcium-phosphorus imbalances can lead to? | bone remodelling and weakened bone matrix
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| Aluminum accumulation is believed to contribute to? | osteomalacia
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| Osteitis fibrosis involves? | replacement of Ca in the bone with fibrous tissue, resulting from increased levels of parathyroid hormone from hypocalcemia
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| An appropriate snack for CKD? | hard candy
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| The syndrome that includes all S/S seen in various body systems in CKD is? | uremia
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| Azotemia is? | an elevation of blood urea nitrogen (BUN) and serum creatinine levels
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| Characteristics of hemodialysis? | requires vascular access, lowers serum triglycerides, intensified anemia, repaid fluid and creatinine loss
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| Characteristics of peritoneal dialysis? | increased hyperlipidemia, portable system, less cardio stress, more protein loss, fewer dietary restrictions
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| The dialysate for peritoneal dialysis contains? | dextrose in a higher concentration than in blood
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| Phases of peritoneal dialysis? | fill(inflow), dwell, drain
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| Temporary catheters vascular access site, characteristics? | usually used for access for continuous renal replacement therapy, most prone to infection
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| Native AV fistula, characteristics? | least likely to thrombose, 4 - 6 weeks healing time
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| Arteriovenous (AV) graft, characteristics? | 2 - 4 weeks healing time, may lead to distal ischemia
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| Evaluation of patency of an AV graft is performed by? | auscultating for the presence of bruits at the site
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| The most common indication for continuous renal replacement therapy is? | fluid overload
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| A major contraindication to kidney transplant is? | extensive vascular disease
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