Renal Flashcards by Hannah James

Prerenal

prior to kidney 55-60%

most common

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Intrinsic

in the kidney

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postrenal

after kidney

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BUN Normal

8-20

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GFR Normal

> 90

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GFR adequate with no other issues

60-90

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creatinine normal

men: 0.7-1.3
women: 0.6-1.1

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AKI:
Urine output

may or may not be accompanied by a decline in urine output

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AKI:
BUN

rapid increase

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AKI:
GFR

decrease

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AKI:
Creatinine

increase

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AKI definition

a rise from baseline of at least 0.3 mg/dL within 48 hours or at least 50% higher than baseline within 1 week

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Causes of prerenal

NSAIDS
hypovolemia
HF
shock

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causes of intrinsic

sepsis/infection
tubulars
acute tubular necrosis
kidney stone

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acute tubular necrosis leads to what

tubular obstruction, edema, cell injury

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why does acute tubular necrosis cause intratubular obstruction

epithelial cells break off and cause obstruction

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cause of postrenal

BPH
UTI

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is pre-renal reversible

YES

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what serves as a measure for nephron injury and repair

proteinuria

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what medication causes green pee

propofol

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oliguria

decreased urine output

<400 mL/24 hour

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examples of crystalloids

isotonic
hypotonic
hypertonic

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examples of colloids

albumin
PRBC

pull fluid into intravascular

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how to treat hyperkalemia

-calcium
-glucose
-insulin
-kayexalate

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diet for patients with renal issues

high carb diet

diet restrictions for patients with renal issues

potassium phosphate protein sodium fluids

what are two foods that are high in potassium

potatoes and chocolate

what are some complications for acute renal failure

hyperkalemia metabolic acidosis anemia and prolonged bleeding infections cardiac malnutrition

who is at risk for Chronic kidney disease

small gestational birth childhood obesity hypertension diabetes mellitus African & Native Americans

contrast can cause what?

kidney failure 1% will require dialysis

if a patient with renal failure needs a CT, what do we give them prior?

fluid bolus

assessments

-I&O -daily wights -grey turners sign

grey turners sign

bruising on the flanks near 11th and 12th rib *1 or both sides*

normal BUN to Creatinine ratio

10:1

does high BUN alone indicate renal failure

what is significant about men and their muscle mass

men have more muscles, which can break down and affect the kidney

what BUN to Creatinine ratio represents a prerenal condition

15:1

what two electrolyte abnormalities are common with AKI

-hyperkalemia -hypocalcemia

what does <60 GFR indicate

lost half of the kidney function

anuric

no urine output

hematuria

blood in urine

what color of urine indicates good hydration

clear to pale yellow

what color of urine may indicate an AKI

coca cola-dark brown

acute tubular necrosis: ischemic

trauma burns sepsis

acute tubular necrosis: intratubular obstruction

transfusion reaction massive tumor

Urden: 4 phases os Acute tubular necrosis

1. onset phase 2. oliguric/anuric phase (decrease of urine) 3. diuretic phase (increase of urine) 4. recovery phase

Stages of kidney disease: >90

stage 1 AKI

stages of kidney disease: 60-89

stage 2 AKI

stages of kidney disease: 30-59

stage 3 AKI

stages of kidney disease: 15-29

stage 4 CKD

stages of kidney disease: <15 or dialysis

stage 5 CKD

as the GFR decreases... the stage...

increases

what lifestyles also impact renal disease

cigarette smoking lipid oxidation (obese)

hemodialysis: how many days a week?

hemodialysis: what happens to BP and electrolytes?

decrease in both

hemodialysis: do they give BP meds before sending patient?

NO *dialysis can decrease with BP, so giving any BP meds can cause a dangerously low BP*

what is the gold standard for chronic hemodialysis

AV fistula

AV Fistula vs AV Graft

fistula: vein connected to artery graft: fake graft connecting artery and vein

CRRT

*continuous renal replacement therapy* 24 hour dialysis

what does CRRT need

quinton catheter

CRRT: how do we stop giving a patient this?

we need to wean them off of it

CRRT: complication

filter clotting -heparin (bleeding & clots) -citrate and calcium

why do we leave the access site visible

so we can see if it is returning to the patient. Machine will not alert you if it is not going back into the patient.

what do we need to wear during peritoneal dialysis? why?

mask sterile!!

what temp of fluids do we give for peritoneal dialysis?

warm fluids

skin issues with end stage kidney

pruritus dry pale

what is the most severe elctrolyte

potassium

signs of hyperkalemia

peaked T waves widened QRS VF, VT

as renal failure processes and GFR progresses below 50 mL which change occurs?

metabolic acidosis

Renal Flashcards

(69 cards)