Renal Test/Misc Drugs

Question 0

Serum Creatinine

Answer 0

0.5-1.5 mg/mL

End product of creatinine metabolism

resides mainly in skeletal muscle

BUN to creatinine ratio 10:1 if numbers are 15:20 serious problem

Question 1

Blood Urea Nitrogen (BUN)

Answer 1

8-25 mg/dL

indicates kidney failure /dehydration

reflects the balance between production and excretion of urea

BUN is not an exclusive rest for renal failure but >100 usually does

Question 2

Creatinine Clearance

Answer 2

85-135 ml/min

creatinine is excreted entirely by the kidneys and is therefore directly proportional to the GFR

Question 3

Serum Osmolality

Answer 3

275-295 mOsm/kg

The concentration of the dissolved substance per unit of solvent **the osmotic concentration in serum

so when Serum Osm is up ADH is released. ADH prevents loss of H2O by the kidneys therefore lowers Serum Osm.

Also the Serum Osm goes up it produces thirst which simulates person to drink fluids therefore lowers Serum Osm.

Question 4

Urine Osmolality

Answer 4

50-1200 mOsm/kg

Osmotic concentration in urine

Question 5

Urine Specific gravity

Answer 5

1.010- 1.022

specific gravity is the mass of a substance compared to the mass of an equal volume of H2O

With CRF reading will stay at a constant 1.010

Question 6

Radiologic tests

Answer 6

Abdominal xray (KUB)
Intravenous Pyelogram (IVP)
Renal scan - po, IV (pretty long test)
Renal Arteriography
Diagnostic Ultrasonography
Percutaneous Renal Biopsy for Renal Cancer : in through skin to do a  punch biopsy

Question 7

Metabolic Acidosis

Answer 7

Most with renal disease

process that causes a decrease in pH of the body as a result of retention of acids or loss of bicarb

will have a loss of ketones

causes: diabetic ketoacidosis/ lactic acidosis/ starvation/ severe diarrhea/

Question 8

ABG’s

Answer 8

pH 		7.35-7.45
pO2 		80-100
pCO2	35-45
HCO3 	22-26
O2 		90-100
Base XS -2 to +3 mEq/L

Question 9

Na: Sodium

Answer 9

135-145

Hypo: (125) restleness, intense thirst, weakness, swollen tongue, seizures, coma
hyper: (>150) restlessness, intense thirst, weakness swollen tongue, seizures, coma

sodium will always have an answer with neuro in it

Question 10

K

Answer 10

potassium: 3.5-5.0

Hypo: depressd T waves and PVC’s. Thirst polyuria, anorexia, weak pulse

Hyper: irritability, cardiac arrhythmias, tall peaked t waves on EKG, V fib.

as potassium lowers sodium rises

any ? about K+ answer will be cardiac

Question 11

Ca

Answer 11

Calicum: 8.5-10 mg/dL

Hypo: Convulsions, arrhythmias, changes in the QT interval on EKG. Positive Chvostek’s and Trousseu’s. Numbmess in the extremities, tingling and muscle twitching

Hyper: muscle weakness, lethargy, apathy, anorexia, HA, N/V

any question with Ca the answer will have muscle in it

Question 12

PH

Answer 12

phosphours: .8-1.4 mmol/L

Excretion is regulated entirely by the kidneys
as PH goes up Ca goes down
Hypo: muscle weakness, tremors, WBC and platelets chnages, mental confusion

Hyper: Watch for all signs of hypocalcemia, seizures

Question 13

Kayexalate

Answer 13

hypokalemic electrolyte modifer

used to treat mild to moderate hyperkalemia

causes the exchange of Na for K ions in the intestine

Onset is 6-24 hours, can be given PO, rectally

use very cautiously in pts. with CHF, HTN, edema, Na resrictions and constipation

S/E= diarrhea and lots of it

Monitor K, I+O, daily wt

this med bins to phosphate and excretes through stool

Question 14

iron supplement

Answer 14

when giving IV or IM you must use a test dose

IM must be given with track

PO should not be crushed, chewed or open the capsules

PO is best absorbed 1 hour ac or 2 hr pc

Question 15

Ca supplements

Answer 15

Os Cal, Mylanta, Tums Etc

always encourage pt to maintain diet adequate in vitamin D

Phosphate binder: Aluminum hydroxide
enhance GI excretion of phosphorus

Question 16

erythropoietin (epogen, Procrit)

Darbenpoetin (Aranesp is long acting)

Answer 16

RBC stimulator

recombinant form of erythropoietin – possesses identical amino acid sequence and biological properties as the natural isolated hormone

alleviates anemia associated with end-stage renal failure

decreases transfusion requirements

improves quality of life

Question 17

Increased Hct leads to:

Answer 17

Increased energy and activity levels
increased exercise capacity
improvements in sense of well-being
improved eating and sleep behavior
improved cognitive function
improved sexual function