Renal Fabs Flashcards
(98 cards)
1
Q
normal value: Osmolality
A
280-300 mOsm/kg
2
Q
normal value: Hematocrit
A
36-54%
3
Q
normal value: Hematocrit in females
A
36-48%
4
Q
normal value: Hematocrit in males
A
39-54%
5
Q
normal value: Hemoglobin
A
12-18g/dL
6
Q
normal value: Hemoglobin in females
A
12-18d/dL
7
Q
normal value: Hemoglobin in males
A
13-18g/dL
8
Q
normal value: Urine specific gravity
A
1.010-1.030
9
Q
Hormones influencing fluids
A
Aldosterone and ADH
10
Q
SIADH
A
syndrome of increased ADH
11
Q
ADH secretion is usually stimulated by one of three mechanisms
A
1) increased serum osmolality
2) decreased plasma volume
3) decreased BP
12
Q
DI
A
decreased ADH
13
Q
ADH is released by the
A
pituitary gland
14
Q
SIADH vs DI
urinary retention
A
SIADH
15
Q
SIADH vs DI
dilutional hyponatremia
A
SIADH
16
Q
SIADH vs DI
risk for dehydration
A
DI
17
Q
SIADH vs DI
hypernatremia (hemoconcentration)
A
DI
18
Q
fluid gain > electrolyte gain
A
Fluid Volume Excess: hypotonic overhydration
19
Q
fluid loss < electrolyte loss
A
Fluid Volume Deficit: hypotonic dehydration
20
Q
fluid loss = electrolyte loss
A
Fluid Volume Deficit: isotonic dehydration
21
Q
fluid gain = electrolyte gain
A
Fluid Volume Excess: isotonic overhydration
22
Q
fluid gain < electrolyte gain
A
Fluid Volume Excess: hypertonic overhydration
23
Q
fluid loss > electrolyte loss
A
Fluid Volume Deficit: hypertonic dehydration
24
Q
symptoms of FVE
A
weight gain, hypertension, edema, increased urine output, decreased urine specific gravity
25
symptoms of FVD
weight loss, hypotension, dehydration, decreased urine output, increased urine specific gravity
26
nursing management for FVE
decrease oral fluid intake (1,200cc/day), stop IVF and report, administer an osmotic diuretic [Mannitol]
27
nursing management for FVD
increase oral fluid intake, administer IVF, medications depend on etiology
28
normal range for Sodium
135-145
29
symptoms of Hypernatremia
cellular dehydration
```
"FRIED SALT"
flushed skin
restless, anxious, confused, irritable
increased BP & fluid retention
decreased urine output
```
skin flushed & dry
agitation
low-grade fever
thirst
30
symptoms of Hyponatremia
cellular overhydration
```
"SALT LOSS"
stupor/coma
anorexia
lethargy
tachycardia
```
limp muscles
orthostatic hypotension
seizures/headaches
stomach cramping (hyperactive bowels)
31
nursing management for Hypernatremia
decrease Na in diet, IVF, Furosemide
32
nursing management for Hyponatremia
increase Na in diet, IVF (NaCl), Mannitol
33
normal range for Potassium
3.5-5.5mEq/L
34
symptoms of Hyperkalemia
twitching, spasms, tingling sensation, increased gastric motility (hyperactive BS), diarrhea, decreased HR, hypotension
35
symptoms of Hypokalemia
weakness, diminished DTR, decreased gastric motility (hypoactive BS), constipation, decreased HR, hypotension
36
nursing management for Hyperkalemia
decrease K in diet, avoid salt substitutes, Insulin, prepare for dialysis if sodium is critically high, prepare IV calcium and IV hypertonic glucose, K sparing diuretics [Spironolactone/Aldactone]
37
nursing management for Hypokalemia
increase K in diet, administer KCl via Solu-set maximum dosage of 20mEq/day, K supplements (tablet = N/V; liquid = bitter, take with orang juice)
38
ECG changes in Hyperkalemia
1) tall peaked T waves
2) flat P waves
3) widened QRS complexes
4) prolonged PR intervals
39
ECG changes in Hyperkalemia
1) tall peaked T waves
2) flat P waves
3) widened QRS complexes
4) prolonged PR intervals
40
ECG changes in Hypokalemia
1) ST depression
2) shallow or inverted T wave
3) prominent U wave
41
normal range for Calcium
8.6-10mg/dL
42
symptoms of Hypercalcemia
weakness/diminished DTR, decreased gastric motility, constipation, excessive urination, increased HR, hypertension
43
symptoms of Hypocalcemia
twitching, spasms, tingling sensations, convulsions, (+) Trousseau's sign, Chvostek's sign, numbness (fingers, face, limbs), increased gastric motility, diarrhea, decreased HR, hypotension
44
nursing management of Hypercalcemia
decrease Ca in diet
| administer Phosphorus, Calcitonin, bisphosphates, prostaglandin synthesis inhibitors (NSAIDs)
45
nursing management for Hypocalcemia
increase Ca in diet, vitamin D in diet, administer Calcium gluconate via slow push, initiate seizure precautions
46
normal range for Magnesium
1.5-2.5mEq/L
47
symptoms of Hypermagnesemia
displays symptoms of Hypercalcemia
48
symptoms of Hypomagnesemia
displays symptoms of Hypocalcemia
49
nursing management for Hypermagnesemia
restrict dietary intake of magnesium-containing foods, avoid the use of laxatives and antacids containing magnesium, administer Loop diuretics [Furosemide], IV CaCl or Calcium gluconate
50
nursing management for Hypomagnesemia
increase magnesium-containing foods, Magnesium sulfate (IV or PO), seizure precautions
51
P wave represents
atrial depolarization (contraction)
52
QRS complex represents
ventricular depolarization (contraction)
53
T wave represents
ventricular repolarization (relaxation)
54
atrial repolarization is covered by
QRS complex
55
U wave represents
repolarization of the Purkinje fibers
56
normal PR interval
0.12-0.20 sec
57
normal QRS complex
0.06-0.12 sec
58
methods in determining the HR in an ECG reading
1) 6-sec method
| 2) Big box method
59
a PR interval > 0.20sec indicates
dysrhythmias; heart blocks
60
a QRS complex > 0.12sec indicate
dysrhythmias; PVC
61
normal range for blood pH
7.35-7.45
62
normal range for PCO2
35-45
63
normal range for HCO3
22-26
64
increased PaCO2
increased or normal HCO3
decreased pH
respiratory acidosis
65
decreased PaCO2
decreased or normal HCO3
increased pH
respiratory alkalosis
66
decreased or normal PaCO2
decreased HCO3
decreased pH
metabolic acidosis
67
increased or normal PaCO2
increased HCO3
increased pH
metabolic alkalosis
68
compensation in Respiratory Acidosis
kidneys eliminate H+ and retain HCO3
69
compensation in Respiratory Alkalosis
kidneys conserve H+ and excrete HCO3
70
compensation in Metabolic Acidosis
lungs eliminate CO2, conserve HCO3
71
compensation in Metabolic Alkalosis
lungs decrease ventilation to increase PCO2, kidneys conserve H+ to excrete HCO3
72
normal range for GFR
90-120mL/min
73
normal range for BUN
7-20mg/dL
74
normal range for Creatinine
0.6-1.2mg/dL
75
a kidney disorder that causes your body to pass too much protein in your urine
Nephrotic Syndrome
76
classic symptoms of nephrotic syndrome
edema, hyperlipidemia, proteinuria, hypoalbuminemia
77
nursing management for nephrotic syndrome
1) Diet: low sodium, cholesterol, and saturated fats; high biologic proteins (dairy products, eggs, meat)
2) Medications: Diuretics, Statins, Prednisone, antineoplastic agent, immunosuppressant
3) report any signs of infections (e.g., respiratory infections)
78
Acute Renal Failure
sudden renal damage
79
category of ARF in which there is a decrease in volume/perfusion to the kidneys
Prerenal Failure
80
category of ARF in which there is prolonged ischemia
Intrarenal Failure
81
category of ARF in which there is an obstruction in the urinary tract
Postrenal Failure
82
Onset phase
cellular injury
83
Oliguric phase
decreased urine output (<400cc/day), decreased GFR (<90), edema, hypertension, hyperkalemia, increased BUN & Creatinine, dialysis may be needed
84
Diuretic phase
gradual increase in urinary output (4-5L/day), risk for dehydration, hypotension, hypokalemia, improved GFR & Creatinine
85
Recovery phase
may take up to 6-12 months, also called the convalescence stage
87
nursing management for ARF
1) Diet: moderate protein
2) Oliguric Phase: decrease fluid intake, antihypertensives, Furosemide
3) Diuretic Phase: increase fluid intake, sodium bicarb for low Na, calcium gluconate for low Ca, magnesium sulfate for low Mg, KCl for low K
88
Hemodialysis
outside the body, blood is passed through a dialyzer, fistula or graft is the access site, 3 times a week; 3-5-hour duration, done at the clinic
88
Stage 2 CRF
<90cc, mild loss of renal function with proteinuria
89
Peritoneal dialysis
inside the body, a hypertonic fluid is administered in the peritoneum (3-5cm below the umbilical area), 4 times a week; 20-30mins duration, can be done at home
90
Chronic Renal Failure
progressive and irreversible loss of kidney function
91
Stage 1 CRF
>90cc, normal renal function with proteinuria, asymptomatic
93
Stage 3 CRF
A: <60cc, B: <45cc, moderate loss of renal function
93
Stage 4 CRF
<30cc, severe loss of renal function
94
Stage 5 CRF
<15cc, ESRD
95
symptoms of CRF
cardiomyopathy, HF, anemia, stomatitis, uremic gastritis, uremic frost, uremic fetor, coma
96
nursing management for CRF
low protein diet, emotional support, skincare (itch precaution), oral care, fistula care, loop diuretics (stage1-2), thiazide diuretics (stage 3-5)
96
eGFR for men
90-140mL/min
98
eGFR for women
80-125mL/min
