case 8 medical conditions Flashcards
(23 cards)
what does crepitations in the lungs mean
fluid in lungs leading to crackling noises
signs of fluid overload
raised bp, SOB, swelling
what is congestive cardiac failure due to left ventricular systolic dysfunction
weaker left ventricle leading to decreased ability of the heart to pump blood around the body (congestive heart failure)
what are the 3 main types of diuretic
loop, thiazides, potassium sparing (incl mineralcortocoid receptor antagonist)
why should we avoid prescribing diuretics to be taken at night
increases need to urinate so taking in the night would disturb sleep pattern
total fluid intake per day
2L
tachycardia def
raised HR
What monitoring needs to take place for someone with CCF and fluid retention who has been started on an IV diuretic whilst in hopsital
U&Es - kidney function
crcl - monitor perfusion
weight - is fluid decreasing
what drugs should be prescribed in someone with CCF
beta blocker
acei
what is impornat to counsel patinet on who have started a diuretic
fluid balance. essential for diuretics to work and to prevent fluid overload (too much) or dehyration and AKI (to little)
don’t take at night - need to urinate
control salt intake
What is AKI, and what can cause it
Acute kidney injury
can be caused by nephrotoxic drugs, dehydration or damage to kidney tissue
categorised as pre-renal, renal and post-renal
AKI means there is reduced perfusion meaning there can be a build up of toxins in the blood that need clearing.
how is AKI staged
using blood results and crcl
what is the issue around efferevecent preparation
they contain sodium so may not be suitable for all patients particularly where dehydration is an issue or high sodium levels
what transformations does vit D go under
undergoes 2 transformations: colecalciferol alfalcacidol (kidney) and then aldacalcidol active form (liver).
what types of drugs should be prescribed post transplant
immunosurpressive to prevent risk of rejection
symptoms of c.diff infection
- Foul smelling stools over past 2 days
- Frequent need to go poo
- Recently completed a course of broad spec abx - can increase risk
why do drugs treating c.diff need to be prescribed via the oral route, not IV
c.diff infecton resides in the GI tract
IV route bypasses the stomach and GI system which is where the c.diff infection resides. This means we would not be treating the infection
6 key functions of the kidney
removes toxins and waste products from the body
controls blood pressure by regulatinf RAAS system - Renin-Angiotensin-Aldosterone System. Role in removing fluid to control this
fluid balance - also by RAAS system
signals for erythropoietin when levels get to low
electrolyte balance - role in balancing calcium, vit D and phosphate
Acid base balance
how can mineral bone disease occur and what role does the kidney play in this
Kidneys play a role in balancing calcium, vitamin D and phosphate. Vitamin D is needed to absorb calcium. Bone releases calcium if not enough in bthe lood = mineral bone disease. Kidney activates Vitamin D into calcitriol (active form). Phosphate is balanced by the kidneys, passing it in urine. Kidney impairment = low vit d = low calcium, high phosphate
what is the consequence of hyperkalemia
Disruption of the heart’s electrical system, leading to irregular heartbeats (arrhythmias)
Muscle weakness
Cardiac arrest (in severe cases)
Impaired muscle function
Impaired nerve function
Kidney damage
Increased mortality risk
what is trasnferrin
Transferrin attaches to iron and transports and releases it into the bloodstream - low levels mean that iron is not being transported around the body appropriately. Indicator of iron deficiency and chronic illness TIBC, UIBC & Transferrin
what is renal bone disease aka renal osteodystrohy
complication of CKD. bones weaken due to changes in mineral hormone levels in blood due to kidney damage
how is CKD severity assessed
egfr
