Renal Failure and Dialysis Flashcards Preview

Med Surg III exam 3 > Renal Failure and Dialysis > Flashcards

Flashcards in Renal Failure and Dialysis Deck (31):
1

Acute renal failure is (reversible/irreversible)

reversible

2

Acute renal failure

Rapid reduction in urine output

Usually reversible

Tubular cell death and regeneration

3

ARF s/s

Decreased urine output (70%)
Edema
Mental changes
Heart failure
N&V
Pruritus (itching)
Anemia
Tachypenia
Cool, pale, moist skin

4

Pre-renal causes of ARF

Vomiting
Diarrhea
Poor fluid intake
Fever
Diuretic use
Heart Failure
Liver dysfunction
Septic Shock

5

Intrinsic causes of ARF

Interstitial nephritis
Acute glomerulonephritis
Tubular necrosis
Ischemia
Toxins

6

Post-renal causes of ARF

Prostatic hypertrophy
Retroperitoneal disorders
Neurogenic bladder
Bilateral renal calculi

7

Causes of ARF

Pre-renal=55%
Renal parenchymal (intrinsic)= 40%
Post-renal= 5-15%

8

Acute renal failure staging

Onset to time of oliguria

9

Oliguric/Anuric phase of ARF

<400 ml/24 hrs

10

Diuretic phase of ARF

Time from urine output <400 ml/24 hrs until BUN stops rising

11

Late/recovery phase of ARF

Time of stabilization of BUN

12

Convalescent phase of ARF

Urine and BUN WNL

13

Life threatening complication of ARF

Hyperkalemia (can cause cardiac arrest)

14

Hyperkalemia s/s

Weakness
Lethargy
Muscle cramps
Paresthesias
Hypoactive DTR
Dysrhythmias

15

EKG of Hyperkalemia

at K> 5.5-6
Tall, peaked T's
Wide QRS
Prolonged PR
Diminished P
Prolonged QT
QRD-T merge-sine wave

16

ARF management

Identify cause

Hydrate, remove drug thats causing, relieve obstruction.

17

Chronic Renal Failure

Progressive
Not reversible
Nephron loss
75% of function can be lost before its noticeable

18

Causes of CRF

Diabetes
HTN
Glomerulonephritis
HIV
Polycystic kidney disease
Kidney infections and obstructions

19

CRF s/s

Malaise
Weakness
Fatigue
Neuropathy
CHF
Anorexia
N&V
Seizure
Constipation
Peptic Ulcer
Diverticulitis
Anemia
Pruritis
Jaundice
Hemostasis

20

ESRD problems

Metabolic: K/Ca/Na
Volume overload
Anemia, platelet disorder, GI bleed
HTN
Pericarditis
Peripheral neuorpathy
Dialysis Dementia
Immune dysfunction

21

Dialysis

Diffuse harmful waste out of body
Control BP

22

Hemodialysis

3-4x/wk
2-4 hrs
Machine filters blood back to body

23

AV fistula

Surgeon combines artery and vein

3-6 mo to mature

24

AV graft

Tube inserted by surgeon to connect artery and vein

2-6 wks to mature

25

Dialysis PT implications

No BP on fistula arm
Protect arm

Control bleed if it occurs

26

Peritoneal dialysis

Abdominal lining filters blood

27

Continuous Renal Replacement Therapy

Slowly remove fluid, electrolytes, solutes

Used in ICU

28

Continuous AV hemofiltration

uses arterial system to drive blood flow

Connects femoral artery and vein with oncotic pressures driving process

29

Continuous venovenous hemofiltration

Requires mechanical pump

30

Dialysis problems

Lightheadedness-give fluids
Hypotension
Dysrhythmias

Disequilibration syndrome: at end of session (confusion, tremor, seizure) due to cerebral edema

31

Dialysis PT implications

Blood levels optimum after, but fatigue high

Best time to ex varies

May have low BP after dialysis