Adult Renal/Electrolytes Flashcards
(53 cards)
1
Q
Urolithiasis
A
presence of calculi (stones) in the urinary tract
2
Q
Nephrolithiasis
A
- kidney stones
- CVA tenderness and flank pain
3
Q
Ureterolithiasis
A
stones in the ureter
4
Q
Symptoms of renal calculi
A
- hematuria
- renal colic (unilateral pain spasms in flank)
- severe radiating pain
- nausea/vomiting/sweating
- hypertension
5
Q
Renal failure causes _____volemia
A
- hypervolemia
- If the kidneys are failing, they are not effectively making urine
6
Q
Respiratory acidosis
A
- inability to expel carbon dioxide
- airway obstruction
- decreased ventilation
7
Q
SIADH
A
- can lead to hyponatremia
- hemodilution
- increased urine gravity
- too much ADH
- ADH causes water retention, too much water is retained
- no peripheral edema
- bc fluid retained across all areas
- blood pressure is mostly normal
8
Q
SIADH care
A
- monitor for changes in mental status and level of consciousness
9
Q
Rhabdomyolysis
A
- breakdown of muscle
- releases contents into bloodstream
- diagnose through serum creatine kinase levels
- give IV fluids to prevent kidney damage
- give statins
10
Q
Pyelonephritis
A
- similar to cystitis and fever
- tachycardia
- flank pain
- Treatment is antibiotics and hydration
11
Q
Acute kidney injury (AKI) causes
A
- prerenal (not kidney related) causes
- hypovolemia/dehydration! (most common)
- sepsis
- shock
- burns
Intrarenal/intrinsic (inside kidney) causes - allergy
- embolism/thrombosis
- nephrotoxic agents
- postrenal causes
- urine flow obstruction
- stones, strictures (abnormal narrowing)
- tumor
- hypotension = decreased blood flow to kidneys
12
Q
Acute kidney injury (AKI) findings
A
- risk for hyperkalemia
- metabolic acidosis
- reduce sodium and potassium
- oliguria
- treatment is IV fluid challenges
- daily weights
- treatment is IV fluid challenges
- MONITOR CREATINE TO SEE EVIDENCE OF KIDNEY INJURY
13
Q
Chronic kidney disease
A
- causes hyperphosphatemia
- give Sevelamer
- decreases testosterone (hypogonadism)
- lowers hormones
- fatigue and decreased sex drive
14
Q
Bacterial cystitis
A
- bladder infection
- E coli
- Treatment is antibiotics
- hydration
- avoiding caffeine and alcohol
15
Q
Polycystic Kidney Disease
A
- fluid-filled cysts on the kidneys
- abdominal or flank pain
- hypertension
- early
- lose lots of salt so may need to increase salt intake
- advanced
- low sodium diet
- constipation = increase fiber for relief
- hematuria
- berry aneurysm
- can cause hemorrhagic stroke
- only cure is kidney transplant
- dry heat for pain relief
- avoid NSAIDS
16
Q
Dialysis disequilibrium syndrome (DDS)
A
- caused by rapid removal of urea
- headache and nausea is a concern!
17
Q
End-stage renal disease (ESRD)
A
- Low hemoglobin levels
- diet low in everything + fluid restrictions
- applesauce is low in potassium
- causes azotemia (nitrogen/creatine/waste buildup in blood)
- causes asterixis (hand flopping)
- testicles atrophy
- ANURIA is EXPECTED
18
Q
Hypoparathyroidism
A
- mirror hypocalcemia
- numbness/tingling
- tetany
- carpopedal spasms (Trousseau’s sign)
- Chvostek’s sign
- muscle/abdominal cramps
- prolonged QT intervals
19
Q
Prostatic hyperplasia
A
- weak urinary stream
- nocturia
- dribbling in underwear
- difficulty starting stream
- progressively worse over 4 years
- leads to kidney damage
- give Finasteride
- avoid caffeine
20
Q
TURP
A
- procedure for prostatic hypertrophy or prostate cancer
- may cause sexual dysfunction
- retrograde ejaculation
- large lumen urinary catheter is placed
- significant complication is HEMORRHAGE
- MONITOR FOR SHOCK
- tachycardia
- restlessness
21
Q
Causes of hypomagnesemia
A
- alcoholism
- diarrhea
- diuretics
- annorexia
22
Q
Causes of hypermagnesemia
A
- renal failure
- antacids
- lithium therapy
- adrenal insufficiency
- hypothyroidism
23
Q
Hyperemesis gravidarum
A
- pregnancy complication
- nausea, vomiting, weight loss
- vomiting puts risk for hypokalemia
- hypokalemia associated with metabolic alkalosis due to vomiting
24
Q
renal failure will be at risk for _____kalemia
A
hyperkalemia
25
renal failure hemodialysis dietary modifications
- low sodium, phosphorus, calcium, and potassium
- blueberries, cream of wheat, coffee is good
26
uremia
- buildup of waste products as a result of untreated kidney failure
- waste products from protein breakdown
- protein restriction helps
27
Ulcerative colitis flare-ups
- ten or more episodes of diarrhea per day
- loses a large volume of fluid, resulting in deficient fluid volume
28
Cranberry juice
used for UTI prevention, not UTI treatment
29
Acute glomerulonephritis s/s
- proteinuria
- hematuria
- periorbital edema
- oliguria --> hypervolemia --> weight gain
- cola/tea-colored urine
- adverse effect
- severe hypertension
- cause’s encephalopathy
- severe headache = monitor BP
- decreased glomerular filtration rate (GFR)
30
Acute glomerulonephritis (AGN) diagnosis
- Renal insufficiency is the hallmark of AGN
- ↑ BUN and ↑ creatinine.
31
Hepatic encephalopathy
- monitor mental status/fall risk
- increased serum ammonia level
- give lactulose (depletes ammonia)
- give Rifaximin (decrease production of ammonia)
- DO NOT give benzodiazepines
- avoid hypokalemia as is contributes to ammonia production
32
Dumping syndrome
- complication after gastric bypass surgery
- rapid emptying of food into the small bowel
- resulting in hypotension
- abdominal pain, diarrhea, nausea
- tachycardia
- risk of hypoglycemia.
33
Dumping Syndrome care
- avoid simple carbohydrates (refined sugars)
- foods include candy, cookies, pastries, cola
- increase protein and complex carbohydrates
- rice cereal, chicken breast, scrambled eggs, potatoes, whole grain, pasta
- gives body time to absorb before dumping
- lay down after meals
- avoid fluids with meals
34
High BUN indicates
- dehydration
- kidney damage
35
Kidney biopsy
- diagnosis idiopathic nephrotic syndrome
- lay supine following procedure
- may give back roll for support
36
Urine amount
0.5 mL/kg/hr
37
Diabetes type 1 vs 2
DOES NOT FEATURE HYPERTENSION
- type 1
- DKA
- ketones in urine
- type 2
- caused by overweight
- hyperglycemic-hyperosmolar state (HHS)
- THINK SEVERE DEHYDRATION
- FLUID REHYDRATION!!
38
Albumin
- protein
- low in inadequate nutrition
- made in liver
39
Trousseau's sign
- severely low calcium/magnesium
- palmar flexion
- hand flexes up when inflating BP cuff
40
Chvostek Sign
- severely low calcium/magnesium
- tapping check to trigger facial twitching
41
Calcium
- role in blood clotting
- formation of teeth and bones
- nerve impulse
- muscle contractions
42
Sodium
- manages blood volume
- nerve impulses
43
Chloride
- acid-base regualtion (and bicarb)
- extracellular fluid balance
44
Fluids for hypernatremia
- hypotonic fluids
- Dextrose 5% (D5W)
- lowers sodium
- monitor for hyponatremia
- NOT LR
45
Hypokalemia
- hypoactive bowel sounds
- muscle cramping
- weakness
- flattened T-waves
- DO NOT give IV potassium if oliguric
46
Pyelogram
- IV urography
- urinary tract imaging
- must clense bowl the night before
- empty bladder
- no catheter used
47
Prostatic hyperplasia risk factors
- 40+ years old
- obesity
- diabetes type 2
48
Wernicke Encephalopathy
- thiamine (B1) deficiency
- changes in mental status
- confusion
- oculomotor dysfunctions
- opthalmoplegia (eye paralysis)
- nystagmus
- unstable gait = ataxia
- nutritional deficiency
49
Wernicke encephalopathy causes
- chronic alcoholism
- hyperemesis in pregnancy
- bariatric surgery
- anorexia
50
Wernicke encephalopathy treatment
-IMMEDIATE
- glucose with thiamine (B1)
- helps prevent Korsakoff syndrome (chronic B1 deficiency)
- if given without thiamine is can worsen the condition
51
FAST algorithm
- face, arm, speech, time
- identifies stroke
52
Foods for dehydration
- promotes hydration
- fruits and vegetables
- melon/honeydew
- cucumber
- strawberries
- tomatoes
- AVOID SUGAR
- cola
- ice cream
- avoid caffeine, sodium
53
Hyperglycemic-hyperosmolar state (HHS)
- diabetes type 2
- THINK SEVERE DEHYDRATION
- FLUID REHYDRATION!!
- 1000 mL per hour
- don’t correct to quick, especially if client has history of heart failure
- check glucose every 2 hours
