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NUR 326 Exam 2 > AKI and CKD > Flashcards

AKI and CKD Flashcards

1
Q

specifics of kidney injury

A

–kidneys are needy
–injury can be sudden and rapidly progress
–reversible

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2
Q

renal insufficiency numbers

A

25% of normal GFR (>90% = normal)

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3
Q

acute kidney injury

A

–result of ischemic injury r/t loss of volume –> decreased perfusion

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4
Q

what are common consequences of AKIs?

A

toxins or sepsis

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5
Q

prerenal AKI

A

before kidneys; volume loss related

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6
Q

examples of prerenal AKI causes

A

–blood loss
–dehydration

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7
Q

intrarenal AKI causes

A

directly kidneys; acute tubular necrosis

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8
Q

postrenal AKI causes

A

not as common; obstruction causing cell death (blockage, tumor)

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9
Q

symptoms of AKIs

A

–oliguria
–begins 1 day after hypotensive event and lasts 1-3 weeks
–fluid volume excess
–metabolic acidosis
–hyponatremia
–hyperkalemia
–waste product accumulation
–neuro disorders

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10
Q

amounts that specify for oliguria

A

<400mL/day, <30mL/hr

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11
Q

treatment for AKIs

A

–address the cause
–treat manifestations
–monitor labs
–avoid nephrotoxic drugs

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12
Q

manifestations in CKD stages 1 and 2

A

asymptomatic

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13
Q

manifestations in CKD stage 3

A

HTN

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14
Q

stage 4 CKD

A

–symptomatic
–diagnosis

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15
Q

stage 5 CKD

A

–GFR < 15
–uremic

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16
Q

uremic

A

urea in blood; accumulation of waste products in blood

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17
Q

causes of ESRD

A

–diabetes (50%)
–HTN (30%)
–Glomerulonephritis (10%)
–Other (10%)

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18
Q

risk factors for CKD

A

–family history
–increasing age (>60)
–male
–Black/African American
–HTN, DM, smoking
–overweight and obesity

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19
Q

most apparent signs of worsening CKD

A

–proteinuria
–increased angiotensin II

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20
Q

how to monitor for worsening CKD

A

monitor BP and UOP

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21
Q

what is special about the pathogenesis of CKD?

A

cyclical process

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22
Q

psychologic symptoms of CKD

A

–anxiety
–depression

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23
Q

CV symptoms of CKD

A

–HTN
–heart failure
–coronary artery disease
–pericarditis
–peripheral artery disease

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24
Q

GI symptoms of CKD

A

–anorexia
–nausea
–vomiting
–GI bleeds
–gastritis

25
Q

Neuro symptoms of CKD

A

–fatigue
–headache
–sleep disturbances
–encephalopathy

26
Q

pulmonary edema in CKD

A

–bad sign
–dialysis

27
Q

Integumentary symptoms of CKD

A

–pruritis
–ecchymosis
–dry, scaly skin

28
Q

symptoms associated with kidneys no longer maintaining F&E homeostasis

A

–edema
–hyperkalemia
–hyperphosphatemia
–hypermagnesemia
–metabolic acidosis

29
Q

symptoms associated with kidneys no longer ridding body of wastes via urine

A

–anorexia
–malnutrition
–itching (toxin buildup)
–CNS changes (azotemia)

30
Q

symptoms associated with kidneys no longer producing enough erythropoietin

A

anemia

31
Q

symptoms associated with kidneys no longer activating enough vitamin D

A

renal osteodystrophy

32
Q

what can drugs be used to do with CKD?

A

–slow the rate of progression
–treat complications

33
Q

components of slowing the rate of progression of CKD

A

–reduce BP to less than 140/90 (slow titration to normal)
–treat hyperlipidemia (<200)

34
Q

blood pressure control in CKD

A

–ACE or ARB
–other BP meds as needed to maintain SBP (110-130)

35
Q

lipid control in CKD

A

statins as needed; diet control

36
Q

how to treat volume overload in CKD

A

loop diuretic; low-salt diet

37
Q

how to treat hyperkalemia in CKD

A

–diuretics
–kayexalate
–addressed with hemodialysis in ESRD

38
Q

how to treat metabolic acidosis in CKD

A

–sodium bicarb
–alkaline agent

39
Q

how to treat hyperphosphatemia in CKD

A

–calcium carbonate
–phosphate binder

40
Q

how to treat renal osteodystropy in CKD

A

–calcitriol
–activated vitamin D

41
Q

how to treat anemia in CKD

A

–erythropoietin
–black box warning

42
Q

goals of sodium bicarb

A

–slow progression of CKD
–prevent bone loss
–improve nutritional status

43
Q

use of sodium bicarb

A

to treat metabolic acidosis

44
Q

what does an alkalinic agent do?

A

increased pH

45
Q

specifics of sodium bicarb

A

–given PO
–initiate when HCO3 < 15

46
Q

goal of HCO3

A

18-20

47
Q

side effect of sodium bicarb

A

bloating

48
Q

purpose of calcium carbonate

A

treat hyperphosphatemia

49
Q

MOA of calcium carbonate

A

binds to phosphate

50
Q

goals of calcium carbonate

A

–keep normal phosphate levels
–decrease mortality

51
Q

adverse effects of calcium carbonate

A

hypercalcemia –> monitor calcium levels

52
Q

when should calcium carbonate be taken?

A

with meals

53
Q

purpose of calcitriol

A

treat renal osteodystrophy

54
Q

MOA of calcitriol

A

–activated form of vitamin D
–stimulate intestinal absorption of calcium/phosphate and bone mineralization

55
Q

adverse effects of calcitriol

A

–hypercalcemia
–hyperphosphatemia

56
Q

drug therapy in CKD specifics

A

–many kidneys are excreted through the kidneys
–drug doses and frequency may be adjusted (renal dosing)

57
Q

drugs of concern with CKD

A

–digoxin
–diabetic agents (metformin)
–antibiotics (vanc)
–opioids (morphine)

58
Q

concern with opioids in CKD patients

A

greater chance of respiratory distress because the drug doesn’t leave their system as quickly

NUR 326 Exam 2 (7 decks)

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