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Viewing:

chapter 37- slides 60-119 (final gu exam)

front 1

Flank empaconis

back 1

flank bruising (tuner sign)

front 2

renal trauma diagnostic test

back 2

  • urinalysis, IV pyelogram, ultrasound, CT scan, MRI
  • treat injury- nursing care: monitor vital signs, I&O, iv fluids, pain management

front 3

Polycystic kidney disease

back 3

hereditary

-multiple cysts in the kidney -progressive, no treatment

S/S- full flank pain or back pain, hematuria, hypertension, recurrent UTI

front 4

Nephrotic Syndrome

back 4

excretion of protein lost in urine from increased glomerular membrane permeability.

-liver produces lipoproteins; foamy urine

-decrease In albumin, decrease oncotic pressure fluid shifts from blood vessels into tissues

front 5

nephrotic causes

back 5

periorbital edema, dependent edema, ASCITES-why it matters? fluid overload, skin breakdown, and impaired mobility

front 6

hyperlipidedema

back 6

a common condition characterized by excessively high levels of of lipids- cholesterol triglycerides- In the blood often leading to dangerous plaque build up In the arteries

front 7

Nephrosclerosis

back 7

hypertension damgages kidneys by sclerotic changes. (reduces perfusion& damaging glomeruli)

front 8

glomerulonephritis

back 8

inflammatory disease of the glomerulus.

-proteins, WBC, RBC, leak into urine

front 9

Causes acute post-streptococcal infection

key findings

back 9

cola-colored urine (hematuria), periorbital/ generalized edema hypertension, decreased urine output, most common in children

front 10

actue kidney injury

back 10

sudden loss of kidney function

front 11

azotemia

back 11

waste products accumulate

kidneys cannot excrete nitrogenous waste- BUN and creatine rise

front 12

prorenal

back 12

not enough blood to the kindeys (ex: dehydration or shock)

front 13

intrarenal

back 13

kidney tissue is damaged (ex: nephrotoxic drugs)

front 14

post renal

back 14

urine can't get out due to blockage (ex:BPH)

front 15

What phase is the patient in when they put out massive amounts of urine?

back 15

diuretic phase

-risk for dehydration, hypokalemia and hypotension

front 16

Potassium is the most important in the kidneys, without correcting potassium, can cause cardiac dysthymia's

T/F

back 16

TRUE

front 17

Chronic kidney disease problems

back 17

  • diabetic neuropathy
  • hypertension
  • nephrosclerosis
  • glomerulonephritis (alot about this on exam)
  • autoimmune disease

front 18

uremia

back 18

the kidneys shut down (urea in the blood)

-affects all body systems

front 19

S/S for CKD

back 19

decreased calcium increased phosphors

front 20

When kidneys are failing, they are not producing erythropoietin

back 20

True

front 21

Therapeutic interventions for chronic kidney disease

back 21

  • medications- diuretics, antihypertensives, phosphate binders, vitamin d/calicum supplements and potassium reducers as needed

front 22

why might we start dialysis ?

back 22

when the kidneys can no longer remove fluid, potassium, or toxins

front 23

hemodialysis

back 23

Artificial kidney removes waste products and excess waste from blood.

front 24

(hemodialysis)

ARTERIVENOUS (AV) FISTULA

back 24

lowest risk of infection

front 25

purposes of hemodialysis

back 25

  • removes waste products( urea, creatine)
  • removes excess fluid to prevent edema, hypertension, and heart failure
  • correct electrolyte imbalance, especially hyperkalemia
  • correct acid-base imbalance (metabolic acidosis)
  • support kidney function in AKI or end-stage kidney disease (ESKD)
  • Remove certain drugs and toxins in severe overdose or poisonings

front 26

Hyperkalemia with EKG changes is immediate lethal risk

(t/f)

back 26

True

front 27

A-E-I-O-U

back 27

  • A- acidosis
  • e- electrolyte imbalance (K+ most urgent)
  • I-ingestion of toxins or drugs
  • o-overload (pulmonary edema)
  • u- uremia symptoms

front 28

what's true about hypotension?

back 28

it is a big issue after dialysis

front 29

Permanent vascular access care

back 29

  • post fistula or graft creation
  • neuro checks, pain
  • elevate extremity
  • protect access: no blood pressure, lab draws
  • educate patient

front 30

If a patient comes back from dialysis and he's scheduled for a invasive procedure, what complications can happen?

back 30

can hemorrhage, NEED TO CALL HP to inform them on possible complications!

front 31

Peritoneal Dialysis

back 31

  • Fill time- patient will do it @ bed time
  • Dwell time- how long its staying in cavity
  • Drain time-fluid drained by gravity

front 32

Peritoneal dialysis

back 32

patient can get peritonitis- use sterile technique while performing.

front 33

If fluid come back cloudy and abdominal pain is present

back 33

Think peritonitis

front 34

Kidney translant

back 34

will need to take anti rejection meds for the rest of your life.

front 35

for kidney transplant, they NEVER remove the old kidney unless

back 35

there is a sign of infection or cancer

-as soon as kidney is connected, there should be urine return .

front 36

what is the most common cause of CKD and end stage kidney disease?

back 36

diabetes

front 37

nephrotic syndrome

back 37

the excretion of 3.5 grams or more of protein in the urine per day .

front 38

Glomerulonephritis causes

back 38

can be caused by a variety of factors, including immunological abnormalities, infectious agents, systemic disease, toxins and vascular disorders

front 39

initiating phase of AKI

back 39

begins at the renal injury and lasts until the occurrence of symptoms

front 40

Oliguric phase oF AKI

back 40

less than 400 ml of urine is produced in 24 hours.

front 41

diuretic phase of AKI

back 41

the kidneys begin to excrete waste products again, 1 to 3 L/day of urine is produced.

front 42

Recovery phase AKI

back 42

in this final phase recovery begins as the GFR rises.