Week 3 - Study Guide Flashcards
(40 cards)
1
Q
what is CKD
A
- the progressive, irreversible loss of kidney function
- GFR < 60 for 3 months or longer
2
Q
what stage of CKD is considered end-stage renal disease? what do most patients in this stage require?
A
- stage 5
- require either dialysis or transplant
3
Q
define uremia; at what point does it usually occur?
A
- constellation of signs & symptoms resulting from buildup of waste products & excess fluid associated w kidney failure
- often occurs when GFR is 10 or less
4
Q
what 3 main functions are lost during CKD? what does this cause
A
- excretory
- regulatory
- endocrine
= causes symptoms in every body system
5
Q
define oliguria
A
- diminished urine volume
6
Q
define anuria
A
- absence of urine production
7
Q
define azotemia
A
- the accumulation of metabolic wastes that are typically excreted by the kidneys in the blood
8
Q
describe the effect of CKD on carb metabolism; what does this cause
A
- insulin resistance occurs resulting in impaired glucose use & defective carb metabolism
- this causes hyperglycemia & hyperinsulinemia
- hyperinsulinemia then causes elevated triglycerides & dyslipidemia
9
Q
describe the clinical manifestations of CKD on the urinary system
A
- in the early stages, we get polyuria & nocturia bc of increased GFR due to increased wokrload on the remaining nephrons
- eventually get oliguria & anuria as loss of renal function progresses
10
Q
define proteinuria
A
- protein in the urine
11
Q
what is urine osmolality? what does a large value indicate? small?
A
- a measure of urine conc
- high value = v concentrated
- small = not v concentrated/diluted
12
Q
what is a pleural effusion
A
- fluid in the pleural cavity
13
Q
define pruitis
A
- itching
14
Q
define pericarditis
A
- inflamamtion of the pericardium (membrane around the heart)
15
Q
define thrombocytopenia
A
- low plt levels
16
Q
define stomatitis
A
- inflammation of the mouth & lips
17
Q
define paresthesias
A
- abnormal sensation of the skin
- tingling, prickling feeling
18
Q
define paresthesias
A
- abnormal sensation of the skin
- tingling, prickling feeling
19
Q
define uremic frost
A
- deposits of tiny yellow-white urea crystals on the skin
20
Q
define renal osteodystrophy
A
- deformities of the bone that occur due to abnormal blood levels of calcium & phosphate, leading to demineralization
21
Q
define asterixis
A
- tremor of the hand when the wrist is extended
- “hand flapping”
22
Q
define hyperparathyroidism
A
- excessive parathyroid hormone due to overactivity of the parathyroid gland
23
Q
define ecchymosis
A
- bruise
24
Q
define encephalopathy
A
- damage or disease that effects the brain
25
what is acute tubular necrosis
- the most common intrarenal cause of AKI
| - necrotic death of tubule epithelia cells
26
define peritoneal dialysis; how does it work
- dialysis that involves the use of the peritoneum as a natural semipermeable membrane (filter) to remove wastes and excesss fluid from the body
- fluid is infused into the peritoneum, excess fluid & wastes cross the membrane into the fluid, which is then drained out
27
define hemodialysis
- dialysis that uses a machine with an artificial semipermeable membrane to filter wastes out of your blood
28
what is an arteriovenous fistula
- hemodialysis that requires the connection of an artery & vein
29
what is chemotherapy
- pharmacologic treatment for cancer
30
what is dialysis
- movement of fluid & molecules acorss semipermeable membrane from one compartment to another
- clinically, it is a technique in which substances move from the blood thru a semipermeable membrane (dialyzer) and into a dialysis solution (dialysate)
31
what are the 2 types of dialysis
- peritoneal dialysis
| - hemodialysis
32
when is dialysis therapy initiated
- when CKD progresses to the point that the pt's symptoms, fluid volume status, or both can not be managed without dialysis
- usually when GFR < 15
33
what are the pros to peritoneal dialysis (7)
- less complicated than hemo
- portable system
- fewer diet restriction
- short training time
- usable in pt's with vascular access problems
- less cardio stress
- preferred for the diabetic pt
34
list the cons to peritoneal dialysis (8)
- protein loss into dialysate
- exit site & tunnel infection
- self-image problems w catheter placement
- hyperglycemia
- surgery required for catheter
- catheter can migrate
- contraindication in patients with multiple abdom surgeries, unrepaired hernia, trauma
- bacterial or chemic peritonitis
35
list the pros to hemodialysis (7)
- rapid fluid removal
- rapid removal of urea & creatinine
- effective K+ removal
- less protein loss
- lowering of serum triglycerides
- home dialysis possible
- temp access can be placed at bedside
36
list the cons to hemodialysis
- vascular access problems
- dietary & fluid resitrctions
- heparinization may be required
- hypotension during dialysis
- added blood loss contributes to anemia
- surgery for perm access placement
- self-image problems w perm access
37
how often do patients receive dialysis?
- minimum 3 days/week
| - 3-5 hrs long
38
list 2 other options for a person w end-stage renal disease
- continuous renal replacement therapy
| - kidney transplant
39
what is continuous renal replacement theraoy
-
40
why do some people w ESRD get kidney transplants? (3)
- when normal kidney function is restored, the pathophysiological changes associated w renal failrue are reversed
- eliminates dependence on dialysis & diety and fluid restrictions
- less expensive than dialsysis after the first year
