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z Su15 HEHI 3 > renal failure > Flashcards

renal failure Flashcards

1
Q

oliguria

A

less than 400cc/day

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2
Q

anuria

A

complete cessation of urine excretion

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3
Q

conservative in-patient standard of urine output per hour

A

0.5 - 1cc/kg/hr

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4
Q

glomerulus supplied by ? and drained by ?

A

afferent, efferent

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5
Q

proximal tubule

A 
reabsorb Na
secretory mechanisms (clear drugs, chemicals)
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6
Q

loop of henle

A

concentrate urine

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7
Q

collecting duct

A

reabsorbs water
reabsorbs OR secretes electrolytes
determines final concentration of urine

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8
Q

acute renal failure due to prerenal: basic cause

A

decreased blood flow to kidneys, volume

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9
Q

acute renal failure due to intrarenal: basic cause

A

acute tubular necrosis, nephrotoxins

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10
Q

acute renal failure due to postrenal: basic cause

A

obstruction

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11
Q

especially nephrotoxic antibiotic plus example

A

aminoglycoside, gentamicin

frequent dosing kills kidneys

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12
Q

postischemic prerenal acute renal failure: patho

A

reduced ATP –> free radicals –> cell swell + inflammation –> complement activation –> cytokines –> DAMAGE!

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13
Q

volume of distribution + average for healthy adult

A

dilutional space

amount of drug in body / plasma drug concentration

0.26 L/kg for healthy adult

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14
Q

physiologic effects of acute renal failure (x3)

A

hypertension (unopposed RAAS)

metabolic acidosis (unable to excrete H+)

hyperkalemia (can’t excrete enough K+)

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15
Q

serious clinical symptoms of chronic renal failure visible at ? function

A

70-75%

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16
Q

esrd classification at ? function

A

lt 10% renal function

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17
Q

parts of the nephron (

A 
glomerulus
proximal tubule
loop of henle
distal tubule
collecting duct
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18
Q

ideal creatinine range

A

0.6 - 1.5

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19
Q

ideal BUN range

A

8 - 25

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20
Q

patients able to excrete normal amount of water and electrolytes until ? function

A

lt ~ 10%

21
Q

physiological effects of chronic renal failure x3

A

uremia, anemia, hypertension

22
Q

anemia in chronic renal failure patients results from…?

A

decreased secretion of erythropoetin

rbc has 50% lifespan

23
Q

peritoneal dialysis: frequency, where, nota bene

A

intermittent
can be done at home
less effective

24
Q

hemodialysis: frequency, for what

A

intermittent

for chronic esrd

25
Q

continuous veno-veno hemofiltration dialysis: frequency, for what, where

A

continuous
acute renal failure
in ICU: less hemodynamic stability

26
Q

peritoneal dialysis basic principles x3

physics x2

A

fill
dwell
drain

driven by gravity and diffusion

27
Q

peritoneal dialysis: types x2

A

continuous ambulatory peritoneal dialysis

automated peritoneal dialysis (continuous cycling peritoneal dialysis)

28
Q

s/s peritonitis in pd patient

A

cloudy dialysate, fever, abdominal tenderness, nausea, vomiting

29
Q

a hemodialysis dialyzer is basically…

A

an artificial kidney!

30
Q

hemodialysis physics x2

A

diffusion (dialysis)

convection (ultrafiltration)

31
Q

main components of hemodialysis machine x3

A

dialysate heater
dialysate pump/flow meter
sensors/alarms

32
Q

continuous renal replacement therapy umbrella term for… x3

A

continuous venovenous hemodialysis (cvvhd)
continuous arteriovenous hemodialysis (cavd)
slow continuous ultrafiltration (scuf)

33
Q

continuous venovenous hemodialysis (cvvhd) basic principle

A

CONVECTION (ultrafiltration) not dialysis

34
Q

diffusion (dialysis)

A

solutes move from high concentration to low concentration

35
Q

hemodialysis for which patient population

A

chronic/esrd

36
Q

continuous venovenous hemodialysis / continuous renal replacement therapy for which patient population x2

A

acute renal failure

profound hypervolemia

37
Q

cvvhd vs hd has what benefit

A

less hemodynamic instability

38
Q

indications for emergent dialysis (aeiou)

A 
a cidosis
e lectrolyte imbalance (esp hyperkalemia)
i ngestions (overdose)
o verload
u remia
39
Q

arteriovenous graft: for, where

A

hemodialysis, outpatient

vascular access!

40
Q

arteriovenous graft: for, why

A

hemodialysis, poor vasculature

vascular access!

41
Q

venous catheter: for

A

cvvhd

vascular access!

42
Q

hemodialysis reliable outflow

A

graft designed to bypass central venous stenosis for patients who are failing fistulas or grafts or are catheter-dependent

43
Q

transplant depends on which factors x3

and which is the best match?

A 
blood type
HLA 
antibodies (better match, longevity)
44
Q

tacrolimus (Prograf) nursing considerations x4

A

immunosuppression
daily levels drawn
nephrotoxicity possible
preg category c

kidney transplant drug

45
Q

pregnancy category c

A

risk not ruled out

46
Q

pregnancy category d

A

positive evidence of risk

47
Q

mycophenylate (Cellcept) nursing considerations x2

A

immunosuppression
preg category d

kidney transplant drug

48
Q

prednisone nursing considerations x3

A

immunosuppresant
often leads to weight gain
pregnancy category c

kidney transplant drug

z Su15 HEHI 3 (4 decks)

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