Renal System

Question 1

what are 3 things produced by the renal system

Answer 1

bicarbonate
EPO
activates vit D

Question 2

what are common Ca and Phos levels in renal disease

Answer 2

hypocalcemia (can’t activate vit D)
hyperphosphatemia

Question 3

why do people with renal disease have metabolic acidosis

Answer 3

kidneys can’t produce bicarb

Question 4

what 3 things happen when aldosterone is secreted

Answer 4

sodium retention
water retention
potassium excretion

Question 5

what medication can cause dry cough and should tell you the med should be discontinued

Answer 5

ACE inhibitors

Question 6

where do thiazide diuretics act

Answer 6

DCT

Question 7

can collecting a urine sample be delegated to LPN or UAP

Answer 7

yes
but RN has to take from foley

Question 8

UTI assessment findings

Answer 8

dark colored or cloudy urine

pain or burning while urinating

hematuria

strong or foul smelling urine

pain in pelvis

increased urinary urgency/frequency

Question 9

what is the number 1 cause of glomerulonephritis

Answer 9

infection
usually strep

Question 10

diet for glomerulonephritis

Answer 10

decreased protein
decreased sodium to decrease BP and edema
increased carbs to compensate for decreased protein

Question 11

what is nephrotic syndrome

Answer 11

a kidney disorder that causes your body to pass too much protein in your urine
leads to hypoalbuminemia causing third spacing

Question 12

what can cause nephrotic syndrome

Answer 12

infection
NSAIDS
cancer
lupus
diabetes
strep
inflammation

Question 13

what diet do you want in nephrotic syndrome

Answer 13

high protein
low sodium

Question 13

assessment findings for nephrotic syndrome

Answer 13

anascara (widespread edema)

blood clots & high cholesterol because liver senses hypoalbuminemia and starts making more albumin, clotting factors, and cholesterol

Question 14

is hematuria an expected finding in glomerulonephritis

Answer 14

yes

Question 14

what are 4 phases of acute kidney injury

Answer 14

onset phase
oliguric phase
diuretic phase
recovery phase

Question 16

onset phase of AKI

Answer 16

injury occurs
UOP decreases
hours to days

Question 17

oliguric phase AKI

Answer 17

decreased UOP
fluid volume overload
10-14 days

Question 18

diuretic phase AKI

Answer 18

kidneys regain ability excrete waste but can’t concentrate urine

leads to massive amounts of dilute urine causing hypovolemia or hypotension

1-3 weeks

Question 19

2 major causes of CKD

Question 20

what do we want the GFR to be

Answer 20

> 90

Question 21

what electrolyte imbalances will you have in end stage renal failure

Answer 21

sodium and water retention

hyperkalemia

metabolic acidosis

hypocalcemia –> leading to hyperphosphatemia secondary hyperparathyroidism causing osteoporosis

uremia

Question 22

CKD diet

Answer 22

low sodium d/t retaining a lot of fluid
low phos
low potassium
low protein

Question 23

what should peritoneal dialysis drainage look like

Answer 23

clear not cloudy!

Question 24

if all of the dialysate does not come out from peritoneal dialysis, what should the nurse do

Answer 24

turn patient side to side