Wk 5 Chronic Kidney Disease (CKD)

Question 1

How many stages of CKD is there?

Answer 1

6

Question 2

What is the GFR for stage 1 CKD?

Answer 2

> 90

Question 3

What is the GFR for stage 2 CKD?

Answer 3

60-89

Question 4

What is the GFR for stage 3a CKD?

Answer 4

45-59

Question 5

What is the GFR for stage 3b CKD?

Answer 5

30-44

Question 6

What is the GFR for stage 4 CKD?

Answer 6

15-29

Question 7

What is the GFR for stage 5 CKD?

Answer 7

15 or less

Question 8

What are the manifestations for stage 1 CKD?

Answer 8

Asymptomatic

Question 9

What are the manifestations for stage 2 CKD?

Answer 9

Asymptomatic, possibly hypertension

Question 10

What are the manifestations for stage 3a and 3b CKD?

Answer 10

Hypertension, otherwise asymptomatic

Question 11

What are the manifestations for stage 5 CKD?

Answer 11

Uremia

Question 12

What stage of CKD are most people diagnosed at?

Answer 12

Stage 4

Question 13

What stage of CKD is the patient prepped for renal transplant and on dialysis?

Answer 13

Stage 4

Question 14

What are the electrolyte imbalances associated with CKD due to edema?

Answer 14

Hyperkalemia
Hyperphosphatemia
Hypermagnesemia
Hyponatremia
Hypocalcemia

Question 15

Because in CKD, the kidneys can no longer removes wastes from the blood, what results?

Answer 15

Anorexia
Malnutrition
Itching
CNS changes

Question 16

Why are patients with CKD often anemic?

Answer 16

Decreased production of erythropoietin

Question 17

What causes renal osteodystrophy?

Answer 17

Decreased synthesis of vitamin D and hypocalcemia

Question 18

What are the two leading causes of CKD?

Answer 18

Hypertension and diabetes

Question 19

What are nursing interventions for fluid volume overload?

Answer 19

Monitor for FVO, weigh daily, fluid restrictions

Question 20

What are nursing interventions for malnutrition?

Answer 20

Monitor for nausea and vomiting
Weight trends
Serum protein levels
H&H
Provide foods that the patient likes

Question 21

Why is a patient with CKD at risk for injury?

Answer 21

R/t renal osteodystrophy

Question 22

What are nursing interventions for CKD?

Answer 22

Monitor electrolyte levels
Administer prescribed supplements (calcium, Vit D)

Question 23

What are nursing interventions for grieving?

Answer 23

Listen to expressions of grief
Identify community support resources
Encourage family involvement

Question 24

Why is a patient with CKD at risk for infection?

Answer 24

They have a suppressed immune system

Question 25

What are nursing interventions for risk for infection?

Answer 25

Monitor for signs and symptoms of infection Screen visitors Limit number of visitors Ensure aseptic technique during care

Question 26

How does CKD cause immune system deficiency?

Answer 26

defective dendritic cells (DCs), premature aging of T cells and impaired cellular and humoral responses

Question 27

Why do patients with CKD have activity intolerance?

Answer 27

Anemia due to decreased erythropoietin

Question 28

What are nursing interventions for activity intolerance?

Answer 28

Provide rest periods Administer anti-anemic medications Monitor H&H

Question 29

If a patient has CKD and needs a procedure that uses contrast, what might they have ordered?

Answer 29

Actylcysteine and forced fluids after the procedure

Question 30

What is important to consider about procedures and a patient with CKD?

Answer 30

Contrast dye is nephrotoxic

Question 31

What drugs are nephrotoxic?

Answer 31

NSAIDs Aminoglycosides etc

Question 32

What is the antidote for tylenol overdose?

Answer 32

Acetylcysteine

Question 33

What is the chemical abbreviation of phosphorous?

Answer 33

PO4

Question 34

CKD causes elevated __ formation so they are often on statin drugs

Answer 34

lipid

Question 35

What are the end products of protein metabolism?

Answer 35

urea nitrogren and creatinine

Question 36

What is the typical renal diet?

Answer 36

Low potassium, protein, sodium, and fluid restriction

Question 37

What are alternative ways to reduce thirst?

Answer 37

Sucking on ice cubes, hard candy, lemon

Question 38

When should the nurse report to the HCP about weight gain in a CKD patient?

Answer 38

Greater than 4 pounds in 1-2 days