Acute Kidney Injury and Chronic Kidney Disease Flashcards

(62 cards)

1
Q

what is AKI? AND what is it characterized as?

A

acute kidney injury is a rapid loss of kidney function

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2
Q

what is BUN? and its range?

A

this is to see how well kidneys and liver are working, it measures amount of nitrogen
 7 to 20 mg/dL (2.5 to 7.1 mmol/L)

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3
Q

what does a high creatinine represent?

A. Telling us that the body needs more protein
B. Too much sodium in the blood
C. Nothing, it is good
D. Warning of a possible malfunction or kidney failure

A

warning us of possible malfunction or failure of kidneys

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4
Q

more protein gives you more?

A

amonia

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5
Q

what is ammonia?

A

is a waste product made by your body during the digestion of protein. Normally, ammonia is processed in the liver, where it is changed into another waste product called urea. Urea is passed through the body in urine.

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6
Q

what is the purpose of the Glomerular filtration rate?

A

Is the rate that is filtering stuff into the bowmens capsule.

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7
Q

GFR end product?

A

if things are low in the GFR than the waste product is higher in the body. Because not alot is being filtered.

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8
Q

Characteristics of ARF

A

functionality:
- decrease GFR
- decrease in urine output
result= increase urea and Cr

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9
Q

what is azotemia?

A

it is the accumulation of waste products (nitrogen and Creatinine)

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10
Q

what is acute kidney injury?

A

loss in kidney function and an has progressive azotemia.

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11
Q

what is ADH (anti-diuretic hormone)?

A

is a vasopressin

its a hormone that helps manage amount of water in your body.

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12
Q

Aldosterone

A

is a steroid hormone

it helps regulate salt and water in the body.

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13
Q

what are the causes of intrarenal?

A
results from
- prolonged ischemia
-nephrotoxins
-hemoglobin released from hemolyzed RBC's
myoglobin released from necrotic muscle.
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14
Q

what is Intra-renal (intrinsic)?

A

the direct cause direct damage to the kidney tissues, result in an impaired nephron function.

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15
Q

what is myoglobin?

A

functions as an oxygen-storage unit, providing oxygen to the working muscles.

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16
Q

what is hemoglobin?

A. protein molecule that measures how much RBC is in a persons blood.
B. Determine its blood percentage of cells
C. Protein molecule in the RBC that carries oxygen from the lungs to body tissue
D. higher than normal hematocrit can indicate: Dehydration.

A

protein molecule in red blood cells that carries oxygen from the lungs to the body’s tissues and returns carbon dioxide from the tissues back to the lungs.

A & D= higher than normal hematocrit can indicate: Dehydration. It is from hematocrit not hemoglobin. Also, measure the red blood cells in a person’s blood. Red blood cells (erythrocytes) are important because they carry oxygen through your body. A low or high red blood cell count can indicate a medical condition or disease.

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17
Q

what is ischemia?

A

blood flow (and thus oxygen) is restricted or reduced in a part of the body.

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18
Q

what are nephrotoxins?

A

is a toxic agent or substance that inhibits, damages or destroys the cells and/or tissues of the kidneys. This is an example of a cytotoxin. The adjective form is nephrotoxic.

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19
Q

what is post renal?

A

obstruction of outflow of urine

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20
Q

what is the most common type of post-renal?

A

benign prostate hyperplasia

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21
Q

what is bilateral ureteral obstruction and what can it lead to?

A

Hydronephrosis, an increase of hydrostatic pressure and tubular blockage.

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22
Q

is post renal of AKI reversible? if so, what is the time frame?

A

the bilateral obstruction must be relieved within 48 hours of onset.

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23
Q

what is the urine output level to be considered Oliguric phase?

A

less than 400 mL/day

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24
Q

what does Oliguric mean?

A

the production of abnormally small amounts of urine.

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25
signs and symptoms of AKI
Signs and symptoms of AKI include: ``` decreased urine output (although occasionally, urine output remains normal) chest pain or pressure jugular vein distention fluid retention, causing edematous legs, ankles, or feet shortness of breath confusion nausea seizures or coma in severe cases ```
26
Oliguric phase
urine output decreases from renal tubule damage (anuria).
27
Diuretic phase
The kidneys try to heal and urine output increases, but tubule scarring and damage occur.
28
recovery phase
Tubular edema resolves and renal function improves
29
what is Hypovolemia?
decrease in the volume of blood in your body, which can be due to blood loss or loss of body fluids
30
The onset of hypovolemia?
the mouth, nose, and other mucous membranes dry out, the skin loses its elasticity, and urine output decreases.
31
what happens when your fluid/blood volume continues to lose the ability to compensate?
Hypovolemic shock occurs. Blood pressure drops. At this point, the heart is unable to pump enough blood to vital organs to meet their needs and tissue damage is likely to occur.
32
signs and symptoms of hypovolemic shock?
Symptoms may include cold, clammy skin, paleness, rapid breathing and heart rate, weakness, decreased or absent urine output, sweating, anxiety, confusion, and unconsciousness.
33
normal urine output
800 to 2000 mL per day
34
what is the daily urine output for the diuretic phase?
1 to 3 but may reach 5 L a day
35
what is high blood pressure and what is its range?
range: > 120 systolic and < 80 diastolic
36
signs and symptoms of HTN
``` headaches shortness of breath nosebleeds flushing dizziness chest pain visual changes blood in the urine ```
37
uncontrolled/complications of HTN
``` MI STROKE aneurysm HF metabolic syndrome memory dementia ```
38
Signs & symptoms of low blood pressure?
``` Dizziness or lightheadedness Fainting Blurred or fading vision Nausea Fatigue Lack of concentration ```
39
Extreme hypotension
Shock Signs and symptoms include: Confusion, especially in older people Cold, clammy, pale skin Rapid, shallow breathing Weak and rapid pulse
40
How much should an adult void in a day?
1-2L /day
41
Creatinine normal values?
0.6-1.20 mg/dL
42
where is Cr solely filtered from?
From the blood via the glomerulus
43
True or False; Cr is absorbed and/or secreted in nephron.
False; it is NOT secreted or reabsorbed in the nephron
44
what is Cr clearance?
is the amount of blood in the kidney that makes per minute that should be free of Cr.
45
what is the purpose of the GFR? a. the amount of blood that is reabsorbed in the nephron b. is the recovery phase c. rate of blood flow through your kidneys d. prevent urine from draining.
C. the rate of blood flow through your kidneys because it is telling us how well the glomerulus is filtering the blood.
46
what is the normal value for GFR? how is it determined?
Determine by, age, race, gender, weight. normal values: 90 mL/min or higher
47
True or False. Rate of GFR at 50 mL/min, is expected to properly filtering the blood.
False. because the normal value of GFR is 90 mL/min. when it is that low, patient urinary output will be low and may experience Oliguria. The urine will be concentrated because the glomerular is not filtering the amount of blood it should, which will increase water in blood.
48
what happens to our body when we have a lot of water in the blood? (select all that apply) a. Hypertention b. Hyperkalemia c. Edema d. Swelling e. anuria
HTN, Edema, and swelling
49
What happens when there is a buildup of waste in our blood? a. hypokalemia b. BUN increases c. Azotemia d. Hyperkalemia
When there is a buildup of waste in the blood, the patient will experience azotemia. The patient will enter metabolic acidosis state because they're not able to excrete hydrogen ions, decrease in bi-carb.
50
Due to the imbalance of electrolytes, which electrolytes will you see in your lab? (select all that apply) a. Hypokalemia b. Hyperkalemia c. hyperphosphatemia d. hypercalemia e. hypocalcemia
the electrolytes you will see are: Hyperkalemia hyperphosphatemia hypocalcemia
51
what are the signs and symptoms of Hyperkalemia? (select all that apply) a. Muscle weakness b. N/V c. SOB d. anuria e. Oliguria
Muscle weakness, N/V, and SOB
52
what are some health problems interfere with how potassium moves out of the body's cells? a. Cushing's syndrome (too much cortisol in your body for too long) b. A tumor in your pituitary gland. c. Bartter syndrome (defect in the thick ascending limb of the loop of Henle) d. Rhabdomyolysis (breakdown of muscle tissue), uncontrolled diabetes, and hemolysis (breakdown of RBC)
d. Rhabdomyolysis (breakdown of muscle tissue), uncontrolled diabetes, and hemolysis (breakdown of RBC) All the other answers are syndromes can be associated with low potassium.
53
In the Olguria phase, will you see a decrease or increase GFR? why?
You will see a decrease in GFR in your lab because the glomerular has decrease its ability to function and filter blood, so you will see urine output of <400 ml/day.
54
The patient is at risk for what type of acute kidney injury, when they have a GI bleed? 1. Prerenal 2. Intrarenal 3. Post renal 4. Recovery phase
1. Prerenal. The patient is losing blood volume, therefore will decrease perfusion to the kidneys. recovery phase, is not apart of the 3 causes of ARF. It is apart of the phases of ARF.
55
what happens when your body has an increase of fluid amount in your body? (select all that apply) a. Urinary Tract obstruction b. Edema c. HTN d. Risk for pulmonary issues e. Swelling
Edema, HTN, Risk for pulmonary issues, and swelling. Urinary tract obstruction is seen in anuria patients. There is no urine output or <100 ml/day.
56
what are the nursing interventions for increase of fluid in the body?
monitor I & O listen for lung sounds monitor their O2 stat levels
57
what is metabolic acidosis? and what are the signs and symptoms of it?
Metabolic acidosis starts in the kidneys instead of the lungs. It occurs when they can’t eliminate enough acid or when they get rid of too much base.
58
what are the signs and symptoms of metabolic acidosis? select all that apply) a. confusion b. sleepiness c. HA d. Fatigue
all of them
59
what are the nursing interventions for oliguria phase? select all that apply. a. safety b. protein diet consumption c. electrolyte imbalances (Na) d. monitor I & O's
- Safety (d/t confusion) - Protein diet consumption (high protein leads to more break down of urea in blood) - monitor I & O for fluid excess in body (d/t not excreting enough urine out the body) Na, will be mild which is expected, BUT you want to watch for hyperkalemia.
60
How do you bring down hyperkalemia?
MD may prescribe Kayexalate
61
what should you expect to see on the ECG for hyperkalemia? a. Peak T waves, inverse QRS complex and Prolonged PR intervals b. Tall T waves, wide QRS complex, short PR intervals C. Prolonged Pr intervals, wide QRS complexes, Peak T waves D. elevated PR intervals and QRS complex, and inverse T waves
Prolonged PR interval, Wide QRS complex and Peaked / Tall T-waves
62
what does Systemic vascular resistance mean? (SVR)
used to create blood pressure, the flow of blood, and is also a component of cardiac function. When blood vessels constrict (vasoconstriction) this leads to an increase in SVR