Fluids and Electrolytes

Question 1

Renin

Answer 1

Regulates BP by controlling blood volume

Question 2

Erythropoietin

Answer 2

Stimulates RBC production

Question 3

Normal glomerular filtration rate (GFR)

Answer 3

90-120

Question 4

Normal urine output

Answer 4

0.5-1 ml/kg/hr

Question 5

Oliguria

Answer 5

<400 ml/24 hr

Question 6

Anuria

Answer 6

<200 ml - no output/24 hr

Question 7

Polyuria

Answer 7

Excessive output

Question 8

Azotemia/uremia

Answer 8

Accumulation of nitrogenous wastes

Question 9

Causes of AKI (3)

Answer 9

• Reduced perfusion to kidneys
• Damage to kidney tissue
• Obstruction

Question 10

Prerenal failure

Answer 10

Damage before the kidneys

Question 11

Causes of pre-renal failure

Answer 11

Decreased volume/perfusion to the kidneys

Question 12

Intra-renal failure

Answer 12

Damage in the kidneys

Question 13

Causes of intra-renal failure

Answer 13

Prolonged ischemia

Question 14

Post-renal failure

Answer 14

Damage after the kidneys

Question 15

Causes of post-renal failure

Answer 15

Obstruction/blockage in the urinary tract

Question 16

When can a synthetic AV graft start being used after placement?

Answer 16

1-4 weeks

Question 17

When can a central venous catheter be used after placement?

Answer 17

Immediately

Question 18

When can an AV fistula be used after placement?

Answer 18

2-3 months

Question 19

Dialysis disequilibrium syndrome (DDS)

Answer 19

BUN reduced more quickly in body than in the brain causing cerebral edema and electrolyte shifts

Question 20

S/S of DDS (9)

Answer 20

• Headache
• Restlessness
• Nausea with/without vomiting
• Agitation
• Altered LOC
• Confusion
• Seizures
• Cardiac dysrhythmias
• Cardiac arrest

Question 21

3 phases of peritoneal dialysis

Answer 21

• Inflow
• Dwell time
• Drain

Question 22

Inflow phase of PD

Answer 22

Administered over 10 minutes

Question 23

Dwell time phase of PD

Answer 23

30 minutes - 8 hours

Question 24

Drain phase of PD

Answer 24

15-30 minutes

Question 25

Continuous ambulatory peritoneal dialysis (CAPD)

Answer 25

Patient does the exchange usually 4 times/day while awake

Question 26

Continuous cycling peritoneal dialysis (CCPD)

Answer 26

Automated peritoneal dialysis uses a machine to perform exchanges at night while the patient is sleeping

Question 27

Renal function

Answer 27

- Maintain fluids/electrolytes - Secrete renin, aldosterone, angiotensin, erythropoietin - Convert vitamin D to active form (calcitrol) - Excrete metabolic wastes

Question 28

Characteristics of AKI

Answer 28

- Sudden reduction in kidney function - Decreased GFR - Increased BUN, creatinine - Decreased urine output

Question 29

Pre-renal AKI management

Answer 29

- Fluid replacement - Vasopressors - MAP >70

Question 30

Intra-renal AKI management

Answer 30

- Address underlying cause

Question 31

Post-renal AKI management

Answer 31

- Remove blockage

Question 32

S/S of AKI

Answer 32

- Edema - Crackles in lungs - HTN - Azotemia - Low SpO2 - Dyspnea - Confusion - Distended neck veins, bounding pulse - MAP <65 - Tachycardia - Weight gain - Decreased urine output

Question 33

Nephrotoxic NSAIDS

Answer 33

- Meloxicam - Aspirin - Indomethacin - Ketorolac - Ibuprofen - Diclofenac

Question 34

CKD parameters

Answer 34

- Kidney damage with resulting dysfunction - GFR <60 lasting for 3 months or longer - Urine albumin/proteinuria

Question 35

S/S of hyperkalemia

Answer 35

- Tall, peaked T waves - Weakness - Tingling, numbness - Irregular heartbeat - Heart attack - Shortened QT interval - Flattened P waves - Prolonged PR interval - Widened QRS complexes - Fib, asystole

Question 36

S/S of stage 5 CKD

Answer 36

- Anorexia - N/V - Itching - Fatigue, lack of energy - Muscle cramps - Very little urine output - Change in mental status

Question 37

S/S of peritonitis

Answer 37

- Fever - Abdominal pain - Rigid, board-like abdomen - N/V/D - Rebound tenderness - Cloudy effluent - Decreased bowel sounds

Question 38

How long are dialysis sessions and how many times a week are they done?

Answer 38

4 hours 3 times/week

Question 39

What patients are at risk for DDS

Answer 39

Patients with BUN levels >200 during their first few sessions of dialysis

Question 40

S/S of organ rejection

Answer 40

- Fever >100.5 - Weight gain - Decreased urine output - Persistent/unusual weakness or fatigue - SOB - Aches, pains

Question 41

Foods high in potassium

Answer 41

- Oranges - Bananas - Beans - Milk - Carrots - Potatoes - Deep green leafy veggies - Tomatoes - Fish - Nuts

Question 42

Food high in phosphorus

Answer 42

- Meats - Poultry - Fish - Nuts - Beans - Dairy products