Rehab Medicine: Renal Rehabilitation Flashcards Preview

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Flashcards in Rehab Medicine: Renal Rehabilitation Deck (38)
1

What does a Physiatrist or Rehab physician 'specialize' in ?

Function (Practical approach to patient care and activities of daily living)

2

Kidney damage with normal or increased GFR

90 mL/min.

3

Kindey damage with a mild decrease in GFR

60-89 mL/min

4

Kidney damage with Moderate decrease in GFG

30-59 mL/min

5

Kidney damage with severe decrease in GFR

15-29 mL/min

6

Kidney failure

Less than 15 mL/min

7

Stage 6 real failure

Dialysis

8

What is the major etiology of Chronic Renal Failure ?

Diabete mellitus (50%)

9

What is the second most prevalent etiology of CRF ?

Hypertension (25%)

10

What is the major manifestation seen in CRF ?

Fatigue

11

What is uremic frost ?

In Chronic renal failure, BUN is so high that urea is crystalizing in the head !

12

What are other manifestation of CRF ?

Fatigue, dyspnea, headache, pruritus, peripheral edema, hyperpigmentation, neuropathy, altered mental status, auscultory rales, “uremic frost”

13

Is the treatment for Stages I-IV CRF medical or Surgical ?

Medical
DM, HTN, Diet Modification (adequate protein intake, restricting fluid/Na and possible K/P)

ACE/ARB

14

What kind of surgical options are available to those with Stage V or higher CRF ?

Dialysis (Hemo or Peritoneal)
Kidney transplant

15

What must be made in the arm of a person who is to undergo heomdialysis ?

AV Fistula
(Use neck while fistula is 'maturing')

16

Why would someone choose peritoneal dialysis over hemodialysis ?

More lifestyle freedom, more pt responsibility,

(Must be done 4x daily)

17

What does peritoneal dialysis increase risk for ?

Peritonitis

18

List the complications associated with renal transplantation

Postop- infection
bleeding
rejection (Signs of Graft Rejection: Anorexia, malaise, fever, HTN, leukocytosis, BUN elevation, kidney enlargement with localized tenderness, graft site tenderness, reduced UO, edema)

19

What is the major "frontline" drug used for immunosupression ?

Prednisone

20

Cylosporine is another drug used as an immunosuprressant after kidney transplant. What mineral deficiency is often seen with long term use of this drug ?

Hypomangnsemia (Must replace Mg+)

21

what other SE are seen in patients on Cyclosporine ?

Heart Attack, Hypertension, Seizures.

22

Besides immunosuppression for transplant patients, what other condition is Azothiopine used for ?

Rheumatoid arthritis.

23

What are the three goal of Rehab

1. Function (FIM)
2. Independence (Owestry Disability Index)
3.QUality of life (SF-36)

24

What professions are part of a Rehabilitation Team ?

Physiatrist
Physical Therapist
Occupational Therapist
Speech Therapist
Neruopsych
Rehab Nursing
Social Worker
Patient Social Reports
OVR

25

What is the role of the physiatrist ?

Provides primary medical care, while coordinating interdisciplinary team and medical specialists

26

What is the role of the Physical Therapist

LE strengthening, transfers, gait, balance, endurance, energy conservation techniques

27

What is the role of the Occupational Therapist

UE strengthening, transfers, fine motor tasks with hands, self care ADLs Home assessments adequate DME/home modifications

28

What is the Role of the Speech Therapist

Speech, language, cognitive assessments, swallow evaluation

29

What is the Role of the Neuropsychologist.

Emotional, behavioral adjustment, higher cognitive and psychological evaluations related to current admission

30

What is the role of the Rehab Nurse

skin care, bowel/bladder management, pain control, preventative / coping education, medication administration

31

What is the Role of Social workers

disposition planning with family and insurance companies

32

Why do 83% of transplant patients not return to work ?

They are afraid their condition will worsen (may not like job,also)

33

What is the main purpose of the Pre-Transplant exercise program ?

To limit the amount of complications that may be seen during or directly after the surgery

Complications include:
Anemia
Electrolyte Imbalance
HTN
Skeletal Muscle Atrophy
CV Deconditioning

34

What do post transplant exercise programs consists of ?

Aerobic and Resistive
Regimens focus of lifestyle: stretching, repetitive low level resistence, aerobic exercise x 30mins daily

35

What SE does the post-transplant workout try to counteract ?

Counteracts SEs of immunosuppressive regimen (muscle wasting, weight gain, fatigue)

36

In terms of cognitive function, what is often seen in post-transplant patients ?

Improved attention, memory, reasoning

37

What does rehabilitation seek to improve in patients who are in ESRD or post-transplant ?

Rehabilitation improves overall physical function, mood, and quality of life.

38

Exercise training in patients with ESRD improved ...

Strength and Endurance