Flashcard decks

Renal Failure

22 flashcardsby Brooke
Study these flashcardsFree · spaced repetition · iPhone, Android, Mac & web

All cards

1
Acute Phases (4) OODR
  • 1. Onset of injury (initiation)
  • 2. Oliguric Phase ( LOW urine output 400mL/ 24 hrs or <30m/ hr ) High SG
  • 3. Diuresis Phase (HIGH urine output; 3-6 L/day to flush out the problem ) Low SG
  • 4. Recovery Phase ( takes about a year )
2
Oliguric phase key findings PIP
  • Anorexia
  • N & V
  • Dreceased urinary output
3
Treatments for ARF
Fluid bolus or Diuretic; PUSHES from Oliguric phase to diuresis phase
4
Acute Kidney Injury Patho (3) PIP
  • Prerenal → Prefusion decreased; low oxygen.
  • Intrarenal → Inside the renal
  • Postrenal → Blockage past the renal
5
Prerenal is caused by?
  • Obstruction such as embolism, tumor, blood clot
  • Low BP
  • Low cardiac output w/ ECG dysrhythmia or HF
6
Intrarenal is caused by?
  • Infection
  • CT contrast
  • Antibiotics
  • Long term use of NSAIDS
7
Postrenal is caused by?
  • Kidney Stones
  • Tumor
  • Benign prostatic hyperplasia (Big swollen prostate)
8
Kidney waste
  • Hydrogen ions (pH under 7.35 = Metabolic Acidosis)
  • Urea (BUN over 20 = Bad kidney) leads to uremic frost, crystallized urea deposits on skin, which causes prutitis
  • Creatinine (over 1.3 = Bad kidney)
  • Urine output (<30mL/hr = kidneys in distress)
9
What is GFR
  • Glomerular Filtration Rate
  • How much blood the kidneys can filter per min
  • NORMAL over 90mL/min
10
5 Stages of CKF
  • 1 ~ 90+ GFR
  • 2 ~ 89-60 GFR
  • 3 ~ 59-60 GFR
  • 4 ~ 29-15 GFR
  • 5 ~ 15 or less GFR (end stage renal disease)
11
Causes of CKF?
  • Old age
  • Chronic damage; uncontrolled diabetes, HTN, & autoimmune diseases
  • Infection that causes glomerulonephritis
  • Polycystic kidney disease (cysts in kidneys)
12
Diagnostic to determine how well kidneys are functioning
Creatinine Clearance Test - how well GFR is working
13
Signs & Symptoms CHRONIC
  • Oliguria
  • Fatigue & Weakness
  • Fluid Retention (edema)
  • HTN → strokes, HA, kidney damage
  • Anemia
  • Azotemia/ Uremia
  • Uremic pruritus
14
Hypertensive Crisis Key Signs
  • Headaches
  • Nausea & Vomiting
  • Changes in mental status
15
Fluid Volume Overload Key Signs
  • Crackles in lungs / Dyspnea
  • JVD
  • Bounding Pulses
  • Tachycardia
  • Pitting edema (pale, cool skin)
16
Electrolytes
  • HIGH Sodium
  • HIGH Phospherous = LOW calcium → osteoporosis and risk for fractures
  • HIGH Potassium HIGHEST PRIORITY
17
HIGH K+ causes?
  • Peaked Twaves
  • ST elevation
  • Wide QRS complex
18
Sign of high k+
weak, lethargic, bradycardia
19
Treatment for high k+
  • 1. IV Calcium Gluconate = Dysrhythmias
  • 2. IV 50% Dextrose + R Insulin
  • 3. Kayexalate (exchanges Na for K in the intestines)
  • 4. Dialysis
20
Nursing Interventions
  • Daily Weights (1kg = 1L of fluid)
  • AVOID Drugs bad for the kidney; NSAIDS, Milk of magnesia, Antibiotics, CT contrast dyes
21
Diet
  • RESTRICT Na+ & K+ (NO canned foods, processed meats. package foods) (NO salt substitutes, leafy veggies, avacados, carrots, tomatoes, strawberries, oranges, or bananas)
  • DECREASE P & Protein (NO dairy) (LOW protein = less stress on kidney)
22
Dullness to percussion of the bladder following voiding indicates?
incomplete bladder emptying
Study all 22 cards for free