Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Adults 2 > Exam 2 Renal > Flashcards

Exam 2 Renal Flashcards

(96 cards)

Start Studying
1
Q

anuria

A

no urine output or less than 50mL in 24 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

oliguria

A

less than 400mL in 24 hours or less than 20mL per hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

azotemia

A

accumulation of nitrogenous waste in blood; BUN and creatinine (nitrogen in blood)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

uremia

A

accumulation of nitrogenous waste in urine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

gerontologic changes with kidney and urine

A

aging kidney less able to compensate for fluid changes, solute load, and CO; number of functioning nephrons decrease; decreased renal clearance; creatinine slowly increases; enlarged prostate; incontinence d/t decreased bladder innervation and weakened muscular tone; risk for malnutrition; thirst suppression; confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

normal renal functions

A

maintenance of blood volume or pressure (RAAS); concentrates ions like bicard and hydrogen; maintains long term acid base balance (become acidic without); metabolic gluconeogenesis (liver backup); excrete metabolic waste; produce erythropoietin and renin; convert vitamin D to active form

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Kidney function: Very Clever People Make Exciting Explorers

A

Volume, Concentration, pH balance, make gluconeogenesis or change amino acids, excretion, endocrine creates erythropoietin and renin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

types of AKI

A

prerenal: blood flow to kidney; intrarenal: problem in kidney; postrenal: ureteral blockage; overall 50% mortality with treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

chronic renal insufficiency/Chronic renal failure

A

GFR < 60mL/min; ESRD < 15mL/min; need dialysis or kidney transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Acute kidney injury

A

sudden decrease in renal function resulting from injury or toxins; causes accumulation of nitrogenous waste; if not corrected then can cause irreversible tubular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

risk factors for AKI

A

over age of 65, INFECTION/SEPSIS, cardiac failure, respiratory failure, HX of leukemia or lymphoma, HYPOTENSION, nephrotoxic agents, liver disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

labs associated with AKI

A

increased fluid, increased BUN, increased creatinine, decreased urine output (<400mL/day), acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

stages of AKI

A

initiation -> oliguric (1-7 days) -> diuretic -> recovery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

interventions for AKI

A

dialysis if needed,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

electrolyte changes with AKI

A

hyperphosphatemia, hypernatremia, hypermagnesemia, hyperkalemia (causes peaked T waves)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

assessment for kidney function

A

HPI, questions like what did they come in for?, what are their daily meds?, what is the urine color?, any pain when urinating?, blood present?, recent antibiotics?, recent infections?; physical exam; diagnostic tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

diagnostic testing for AKI

A

CT, MRI, UA, C&S, KUB, ultrasound, cystography; these are looking for structural changes in kidney

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

assessing an AKI

A

urine output volume over 24 hours, GFR, BUN: creatinine ratio (usually 10-20:1)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

BUN normal values

A

10-20mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Creatinine normal values

A

adult men: 0.74-1.35mg/dL
adult women 0.59-1.04mg/dL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

early manifestations of AKI

A

decreased creatinine clearance; increased BUN and Creatinine values; proteinuria (protein passing through glomerulus NOT GOOD)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

later manifestations of AKI

A

fluid retention causing edema and oliguria; anemia due to reduced erythropoietin, acidosis, increased electrolytes and waste products

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

best indicators of kidney function

A

creatinine and urine output

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

prerenal AKI causes

A

decreased perfusion to the kidneys causing decreased perfusion and O2; d/t cardiac damage, vasodilation, hemorrhage, burns, GI losses, stenosis, constriction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
causes of intrarenal AKI
damage in kidneys caused by prolonged ischemia; d/t myoglobinuria, hemoglobinuria, rhabdomyolysis, nephrotoxic drugs (NSAIDs, dye, antibiotics ending in mysin), infections, acute tubular necrosis
26
postrenal AKI
damage after the kidneys; caused by obstruction or blockage of urinary tract causing increased pressure in kidney and decreased filtration; due to renal calculi, blood clots, retriperitoneal issues, BPH, tumors, neuro damage (stroke), spinal cord damage, occluded catheter, urethral strictures
27
treatment of prerenal AKI
IV hydration and PO intake; renal protection before IV contrast; avoid fluid volume deficit; trauma and stenosis need OR; treat infection
28
diagnosis of intrarenal AKI
creatinine > 1.3 (bad kidney)
29
treatment of intrarenal AKI
remove the underlying cause; supportive therapy consisting of IV fluids or dialysis; if caused by med then discontinue med
30
acute tubular necrosis
destroyed tubular segment of nephron causing uremia and renal failure; blood flow to kidney is disrupted; caused by ischemic injury, nephrotoxic injury, blood transfusion reaction, rhabdomyolysis, hypotension, major surgery (kidney transplant), septic shock
31
diagnosing post renal AKI
xray for finding calculi or hydronephrosis, US to look for obstruction, CT without dye for obstruction and viewing of renal perfusion
32
treatment for postrenal AKI
remove underlying cause if possible, IV hydration, supportive measures; urinary catheter, ureteral stent, nephrostomy tube, lithotripsy, cytoplasty, prostate resection
33
AKI nursing management
daily weights at same time and same clothing, monitor IOs, maintain map of 60-70, fluid or sodium restriction, avoid nephrotoxins, nutritional support for electrolytes and protein, skin care, monitor WBCs and temp
34
examples of nephrotoxins
vancomycin, gentamycin, amphotcerin B
35
treating volume overload
diuretics and dialysis
36
treating hyperkalemia
kayexalate to bind and excrete; unstable pt get D50, insulin, calcium
37
treating hyponatremia
give sodium
38
treating hyperphosphatemia
PhosLo binds to excess phosphate; give prior and after meals; calcium should increase as phos goes down
39
treating impaired drug clearance
renal dosed meds d/t decreased excretion
40
treating metabolic acidosis
bicarb admin
41
treating uremia
removal of toxins via dialysis
42
indications for temporary dialysis
volume overload that is unresponsive to diuretics (high dose lasix 40-80), hyperkalemia, metabolic acidosis, progressive azotemia (BUN > 100)
43
options for temporary hemodialysis
intermittent hemodialysis: done via fistula or port, done 3 days a week; continuous renal replacement therapy (CRRT): constant dialysis when in ICU, run through port; peritoneal dialysis: hypertonic saline into peritoneal cavity that sits for a while to remove waste and then is removed
44
preventing AKI
recognize those at risk such as HTN and diabetics, maintain adequate circulating blood volume, limit exposure to toxins, minimize risk of infection
45
CKD
gradual irreversible condition of the kidney that can lead to end stage renal disease (ESRD); kidney damage present for > 3 mo indicated by structural or functional abnormality of kidney with decreased GFR, abnormal components of blood urine or imaging; GFR < 60mL for 3 months with or without kidney damage
46
kidney damage asymptomatic until...
>40% of nephrons lost; dialysis begins when >90% of nephrons lost
47
risk factors for developing CKD
diabetes, HTN, nephrosclerosis (exacerbates renal damage), ACE/ARBs, glomerulonephritis
48
CKD casused by
untreated AKI, metabolic disorders, renal vascular disorders, immunological disorders like lupus, infections like UTI or pyelonephritis, primary tubular disorders, urinary tract obstruction, congenital disorders like polycystic kidney disease; most frequent causes are DM and HTN
49
nephrotic syndrome
leaking of albumin into the urine; kidney is not filtering out albumin back into blood; leads to hypoalbuminemia and edema
50
causes of nephrotic syndrome
bacteria or viral infection, cancer, genetic predispositions, systemic diseases like lupus or diabetes, NSAIDs; lupus causes direct renal damage
51
signs and symptoms of nephrotic syndrome
hypoalbuminemia: causes edema, fatigue, loss of appetite, hyperlipidemia; Proteinuria greater than 3g/day, large amount of protein in urine; may see clots
52
pathology of nephrotic syndrome
inflammatory response in glomerulus causes damage to membrane and causes loss of protein (albumin) that regulates oncotic pressure; leads to hypoalbuminemia
53
signs ans symptoms of CKD
decreased UOP, proteinuria, hematuria, lethargy, altered LOC/confusion, seizures, HTN, hypervolemia, HF, anorexia, N/V, uremic fetor (ammonia breath), metallic taste, impaired immune/inflammatory response, anemia, increased risk of bleeding, amenorrhea, erectile dysfunction, decreased libido, uremic frost, pruritis
54
CKD associated lab values
increase BUN, increased creatinine, increased K, increased magnesium, decreased calcium, increased phosphate
55
different types of UTIs
upper: pyelonephritis (kidney), uretitis (ureter infection); lower: cystitis (bladder), urethritis (urethra), prostatitis (prostate)
56
patho of UTI
can occur in any area of urinary tract; mostly acute (fast and serious), some can have chronic
57
chronic UTI
3+ UTIs in 12 months, bacteria persistent after 2 weeks of treatment
58
more at risk for developing UTI
women 4x more likely d/t short urethra and closer proximity of urethral opening to anus; diabetes increased risk d/t increased sugar and decreased WBC and decreased circulation (bacteria like sugar); pt who rely on catheters to void
59
when male has UTI...
more likely to be structurally related and associated with impaired flow of urine
60
signs and symptoms of UTIs
frequent painful urgent burning urine, urine is red dark milky or cloudy, foul smelling, flank pain if uretitis or pyelonephritis, pressure in pelvic area, fever, fatigue, altered mental status, confusion in older adults
61
gross hematuria
visible blood in urine to the eye
62
diagnosing UTI
UA with culture: will show 2 or more WBCs, 15+ bacteria in high powered field, >10000 colony forming units of one bacteria, + for nitrates, + hematuria, + proteins
63
pharmacological treatment for UTI
simple- trimethoprim/sulfamethazine aka bactrim, nitrofurantoin; complex- ciprofloxacin (can cause tendon rupture); pyridium analgesic for pain (may cause orange urine)
64
glomerulonephritis
bilateral inflammation of the glomeruli following a previous streptococcal infection; can be acute or can be chronic
65
causes of glomerulonephritis
epithelial layer of the glomerular membrane is disturbed
66
signs and symptoms of glomerulonephritis
pitting edema, increased BP, strep infection (common cause), electrolyte imbalance, sore throat, foamy/bubbly pink/red urine
67
complications associated with glomerulonephritis
CKD, ESRD, fluid overload, pulmonary edemat
68
treatment of glomerulonephritis
chronic treated with anitbx, diuretics, vasodilators, corticosteroids; may need plasmapheresis, dialysis, or transplant
69
renal calculi
can occur anywhere in the renal tract such as renal pelvic or calices; risk for development when too much of stone component like Calcium
70
renal calculi predisposing factors
dehydration, infection, obesity, exercise, male
71
types of stones
calcium oxalate and phosphate (associated with high calcium), struvite (associated with UTI), uric acid, cystine (seen in cystinuria)
72
signs and symptoms of renal calculi
N/V, agonizing flank pain that radiates to groin abdomen or testicles, sharp sudden severe pain, hematuria, dysuria, urinary frequency
73
diagnosing renal calculi
ultrasound, IVP (intravenous pyelogram to look at ureter and kidneys), renal stone analysis, KUB xray (kidney ureter bladder scan), serum (calcium oxalate and uric acid)
74
treatment for renal calculi
calculi
75
after renal calculi has passed
want to determine composition of stone and consult dietary for change of diet
76
hemodialysis
removal fluid, electrolytes, toxins from blood across a semipermeable membrane; loosens and separates impurities from blood; most efficient form of dialysis
77
indications for hemodialysis
ESRD, metabolic acidosis, poisonings to clear drug or toxins, AKI, hyperkalemia unresponsive to therapy, FVE in anuric patient
78
End stage renal disease
GFR < 5-10mL/min (GFR<15); BUN > 80-100mg/dL Creatinine >/= 8
79
Vascular access for hemodialysis
central venous line, AV fistula, AV graft
80
central venous line for HD
acute access but temporary, use subclavian or internal jugular or femoral; cons- thrombosis, hematoma, not enough blood flow
81
AV fistula
rapid blood flow that is surgically created; connects artery and vein; takes 2-3 months to mature and lasts 3 years; pros- long lasting, not prone to infection, excellent blood flow, can shower, less likely to form clots; cons- needs to mature before use and requires direct needle into skin
82
AV graft for HD
used when unable to create fistula; inadequate blood vessel, 2-5 weeks to mature, lasts 2 years; pros- excellent blood flow, shower after heals; cons- less time than fistula, more prone to infection, 2 weeks before using, clotting
83
fistula pt education
Do: lanolin for dry skin, check bruit frequently, report bleeding or oozing of patch, wear medic alert bracelet, hold pressure for 20 min following access; DONTs: no blood draw/IV/BP, no tight clothing/jewelry, no lifting heavy items, do not bump, no itching or picking scabs
84
length of dialysis treatment
can be continued for 5-10 years
85
requirements for HD
anticoagulation and BP sufficient enough to remove 1 pint of blood at one time
86
peritoneal dialysis
dialysis takes place across peritoneal membrane; dialysate solution is warmed to body temp and infused into peritoneum; can be intermittent (3-5x a week for 8-12hr), continuous ambulatory (infused, dwells for 4-5 hrs, drains for 4-5 hrs), or cyclic continuous (intermittent night time cycling with day time ambulatory); collection bag must be below
87
complications of PD
peritonitis or infection at site, obstruction of flow, abdominal or discomfort, bleeding, HTN encephalopathy, ESKD, electrolyte disorders, dysrhythmias, resp. distress
88
continuous renal replacement therapy (CRRT)
used for hemodynamically unstable patients like those in ICU setting; slow continuous microfiltration; need A line for accurate pressure readings
89
kidney transplantq
used for those who cannot receive dialysis; human donor to recipient; tissue matching and immunosuppression is essential (type and screen)
90
tissue matching prior to kidney transplant
type and screen, Physical exam (papsmear), tissue typing, antibody screen, CXR, EKG, GI, cardiac workups, hep B, hep C, HIV, CMV
91
post-op care of recipient (kidney transplant)
immunosuppression, monitor for and prevent infection, monitor incision, monitor vitals, assess cardiac and respiratory, monitor urine output and labs, maintain semi-fowlers, pain management, manage urinary catheter; surger is about 3-4 hrs
92
kidney rejection
hyperacute- during surgery, acute- right after surgery, chronic- months to years after surgery; kidney will turn grey; detected via symptoms, rising creatinine, US for kidney size, biopsy
93
ongoing concern with kidney transplant recipients
chronic immunosuppression put patient at high risk for developing infection
94
contraindications to hemodialysis
inability to be anticoagulated, severe cardiac disease, hemodynamic instability
95
peritoneal dialysis drainage should be...
light yellow clear drainage
96
normal BUN, creatinine, GFR
GFR want >90mL/min; BUN normally 10-20 creatinine for men 0.74-1.35 mg/dL creatinine for women 0.59-1.04 mg/dL; BUN to creatinine ratio usually 10-20:1

Adults 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions