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Flashcards in Renal Deck (216)
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151

What is the contraindication of haemodialysis?

Severe cardiac failure

152

Why will patients with a kidney transplant need to take long term immunosuppressants?

To prevent there body rejecting the kidney

153

What are the 4 possible complications of kidney transplantation?

1) Infections (immunosuppression)
2) Malignancy (immunosuppression)
3) Rejection
4) Recurrent kidney disease

154

What is the contra indication of kidney transplant?

Co-morbidities making the operation too risky

155

What are the 2 types of donor?

Deceased donors
Live donors

156

What are the 2 types of deceased donors?

1) Donation after brain stem death
2) Donation after circulatory death

157

What is haemofiltration and when is it used?

For patients requiring renal replacement therapy on the ICU who are provided with continuous renal support
Works in a similar way to haemodialysis but is much more gentle treatment
Important for patients who are acutely unwell and have cardiac instability who would not tolerate normal haemodialysis

158

What does A stand for in RRAPID and what would you look listen and feel for?

A = airways
Look - chest movements, accessory muscles use, foreign body obstruction, misting of oxygen mask
Listen - abnormal or absent breath soundsa
Feel - airflow on inspiration and expirations

159

If somewhere has abnormal airways what would your response be?

1) Call for help
2) Give them oxygen
3) Jaw thrust, head tilt/chin lift
4) Remove obvious foreign bodies
5) Suction
6) Airway adjuncts

160

What does B stand for in RRAPID and what would you look listen and feel for?

B =. breathing
Look - respiratory rate, depth and symmetry, accessory muscle use, sweating/cyanosis, ability to clear secretions by coughing
Listen - ability to talk in complete sentences, coughing/noisy breathing, percussion, chest auscultation
Feel - tracheal deviation, chest expansion, percussion note, surgical emphysema (rice crispies)

161

What is the response to abnormal B in RRAPID?

1) Sit the patient up
2) Give O2
3) Treat underlying cause

162

What does C stand for in RRAPID and what would you assess to assess the patients status in this? 8

C = circulation
1) Pulse rate and character
2) Cap refill time (

163

What would be the response to abnormal C in RRAPID? 3

1) Treat the underlying problem
2) Blood tests / ECG
3) Fluid challenge

164

What does the D stand for in RRAPID?

Disability

165

What is AVPU and what part of RRAPID is it used to assess?

A - alert
V - responds to a Verbal stimulus
P - responds only to Pain
U - Unresponsive to any stimulus
Use is to assess disability in RRAPID

166

Other than AVPU, what other 2 things would you use to assess disability in RRAPID?

1) Pupils - size/reactive to light
2) Capillary blood glucose level

167

What 3 things may be your response to disability in RRAPID?

1) Protect airway if needed
2) Give glucose is hypoglycaemia
3) Treat seizure activity

168

What is E in RRAPID and what does it involve?

Exposure
Involves:
top to toe examination
adequate exposure - to see rashes or swelling
Prevent cold/preserve dignity
Check temperature

169

What would be the response to abnormal exposure in RRAPID?

1) Senior medical advices
2) Further management plan
3) Involve critical care outreach team

170

What is the minimum frequency of NEWS assesment if NEWSing at 0?

12 hourly

171

What are the parts of the SBARR tool?

Situation
Background
Assessmant
Recommendation
Readback

172

Rhabdomyolysis can lead to what kind of AKI?

Intrinsic

173

Snake bites can cause what kind of AKI?

Intrinsic

174

What kind of AKI would MI lead to?

Pre renal AKI (hypotension)

175

What is rhabdomyolisis?

Breakdown of muscle releasing myoglobin and myoglobin is toxic to the kidney

176

Why might you measure the serum creatine kinase in AKI?

To test for rhabdomyolysis

177

What are the 6 complications of AKI?

1) Uraemia
2) Hyperkalaemia
3) Pulmonary oedema
4) Acidaemia
5) GI symptoms
6) Haematological (anaemia/bleeding)

178

What does the acronym STOP stand for in management of AKI?

Sepsis - treat promptly
Toxins - stop any nephrotoxic drugs
Optimise BP - consider fluids, hold antihypertensive drugs, consider vasopressors
Prevent harm - review medication

179

What does hyperkalaemia do to an ECG?

Results in tented T waves

180

How is pulmonary oedema treated in AKI?

High flow O2
High dose furosemide
Intravenous nitrates