Flank empaconis

flank bruising (tuner sign)

renal trauma diagnostic test

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

Polycystic kidney disease

hereditary

-multiple cysts in the kidney -progressive, no treatment

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

Nephrotic Syndrome

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

nephrotic causes

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

hyperlipidedema

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

Nephrosclerosis

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

glomerulonephritis

inflammatory disease of the glomerulus.

-proteins, WBC, RBC, leak into urine

Causes acute post-streptococcal infection

key findings

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

actue kidney injury

sudden loss of kidney function

azotemia

waste products accumulate

kidneys cannot excrete nitrogenous waste- BUN and creatine rise

prorenal

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

intrarenal

kidney tissue is damaged (ex: nephrotoxic drugs)

post renal

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

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

diuretic phase

-risk for dehydration, hypokalemia and hypotension

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

T/F

TRUE

Chronic kidney disease problems

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

uremia

the kidneys shut down (urea in the blood)

-affects all body systems

S/S for CKD

decreased calcium increased phosphors

When kidneys are failing, they are not producing erythropoietin

True

Therapeutic interventions for chronic kidney disease

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

why might we start dialysis ?

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

hemodialysis

Artificial kidney removes waste products and excess waste from blood.

(hemodialysis)

ARTERIVENOUS (AV) FISTULA

lowest risk of infection

purposes of hemodialysis

• 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

Hyperkalemia with EKG changes is immediate lethal risk

(t/f)

True

A-E-I-O-U

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

what's true about hypotension?

it is a big issue after dialysis

Permanent vascular access care

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

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

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

Peritoneal Dialysis

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

Peritoneal dialysis

patient can get peritonitis- use sterile technique while performing.

If fluid come back cloudy and abdominal pain is present

Think peritonitis

Kidney translant

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

for kidney transplant, they NEVER remove the old kidney unless

there is a sign of infection or cancer

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

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

diabetes

nephrotic syndrome

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

Glomerulonephritis causes

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

initiating phase of AKI

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

Oliguric phase oF AKI

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

diuretic phase of AKI

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

Recovery phase AKI

in this final phase recovery begins as the GFR rises.