Flashcards in Renal Deck (216)
What is the contraindication of haemodialysis?
Severe cardiac failure
Why will patients with a kidney transplant need to take long term immunosuppressants?
To prevent there body rejecting the kidney
What are the 4 possible complications of kidney transplantation?
1) Infections (immunosuppression)
2) Malignancy (immunosuppression)
4) Recurrent kidney disease
What is the contra indication of kidney transplant?
Co-morbidities making the operation too risky
What are the 2 types of donor?
What are the 2 types of deceased donors?
1) Donation after brain stem death
2) Donation after circulatory death
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
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
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
6) Airway adjuncts
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)
What is the response to abnormal B in RRAPID?
1) Sit the patient up
2) Give O2
3) Treat underlying cause
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 (
What would be the response to abnormal C in RRAPID? 3
1) Treat the underlying problem
2) Blood tests / ECG
3) Fluid challenge
What does the D stand for in RRAPID?
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
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
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
What is E in RRAPID and what does it involve?
top to toe examination
adequate exposure - to see rashes or swelling
Prevent cold/preserve dignity
What would be the response to abnormal exposure in RRAPID?
1) Senior medical advices
2) Further management plan
3) Involve critical care outreach team
What is the minimum frequency of NEWS assesment if NEWSing at 0?
What are the parts of the SBARR tool?
Rhabdomyolysis can lead to what kind of AKI?
Snake bites can cause what kind of AKI?
What kind of AKI would MI lead to?
Pre renal AKI (hypotension)
What is rhabdomyolisis?
Breakdown of muscle releasing myoglobin and myoglobin is toxic to the kidney
Why might you measure the serum creatine kinase in AKI?
To test for rhabdomyolysis
What are the 6 complications of AKI?
3) Pulmonary oedema
5) GI symptoms
6) Haematological (anaemia/bleeding)
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
What does hyperkalaemia do to an ECG?
Results in tented T waves