acute and chronic kidney

Question 1

acute renal failure

Answer 1

the kidneys fail to remove metabolites from the blood

Question 2

chronic kidney disease

Answer 2

gradual destruction of nephrons

Question 3

prerenal definition and causes

Answer 3

• before renal failure
• outside source
• hypoperfusion
• increased creatinine

Question 4

intrarenal definition and causes

Answer 4

• internal
• damage to renal parenchyma and nephrons

Question 5

postrenal definition and causes

Answer 5

• after renal failure
• result of obstruction
• commonly associated with BPH and renal calculi

Question 6

AKI has a _____ progression

Answer 6

rapid

Question 7

CKD has a _____ progression

Answer 7

slow

Question 8

what type of disorders increase the risk for CKD

Answer 8

vascular disorders

Question 9

risk factors for AKI

Answer 9

• trauma
• surgery
• infection
• urinary tract obstruction
• nephrotoxic drugs
• use of contrast media

Question 10

phases of AKI

Answer 10

• initiation
• maintenance
• recovery

Question 11

initiation phase of AKI

Answer 11

• start of event to onset of tubular necrosis
• lasts from hours to days
• pt is asymptomatic

Question 12

maintenance phase of AKI

Answer 12

• decrease in glomerular filtration rate and worsening of tubular necrosis
• pt experiences symptoms

Question 13

recovery phase of AKI

Answer 13

• tubule cell regeneration
• diuresis
• lasts 5 days to 1 year

Question 14

clinical manifestations for AKI

Answer 14

• oliguria
• metabolic acidosis (confusion, agitation, seizures)
• hyperkalemia (muscle weakness, ECG changes)
• hyponatremia (decreased LOC, seizures)
• hypocalcemia (muscle spasms/twitching, Chvostek sign)

Question 15

electrolyte disturbances with AKI

Answer 15

• hyperkalemia
• hyponatremia
• hypocalcemia

Question 16

fluid management for a pt with AKI

Answer 16

• fluid restriction (insensible water loss (500mL) + urine output)
• accurate I+O

Question 17

diet for AKI pt and why

Answer 17

low-protein diet d/t how hard protein is on the kidneys

Question 17

what does a dialysate mimic?

Answer 17

extracellular fluid

Question 18

what happens during hemodialysis

Answer 18

removal of electrolytes, waste and excess water

Question 19

5 causes for CKD

Answer 19

• damage to nephrons
• subsequent hypertrophy of remaining nephrons
• increase nephrotic pressure
• Glomerular sclerosis
• nephron destruction

Question 20

risk factors for CKD

Answer 20

• diabetes
• HTN

Question 21

electrolyte disturbances with CKD

Answer 21

• hypocalcemia
• hyper/hypomagnesemia
• hyperkalemia

Question 22

ESRD

Answer 22

end-stage renal disease

Question 23

ESRD manifestations

Answer 23

• Kussmaul respirations
• HTN
• edema
• anemia
• decreased platelet function
• decreased immunity
• delayed inflammatory response
• uremic fetor
• seizures
• osteoporosis
• increased BUN, crt, uric acid
• uremic frost

Question 24

stage 1 of CKD

Answer 24

• kidney damage with normal or increased GFR
• asymptomatic; normal BUN and creatinine

Question 25

stage 2 of CKD

Answer 25

• mildly decreased GFR
• asymptomatic; possible HTN; blood work generally within normal limits

Question 26

stage 3 of CKD

Answer 26

• moderate GFR decrease
• HTN; possible anemia and fatigue, anorexia, possible malnutrition, bone pain, slight elevation of BUN and serum creatinine

Question 27

stage 4 of CKD

Answer 27

• severely decreased GFR
• HTN, anemia, malnutrition, altered bone metabolism; edema, metabolic acidosis, hypercalcemia, possible uremia, azotemia, increasing BUN and creatinine levels