Yyy Flashcards
(118 cards)
1
Q
What is Acute Kidney Injury (AKI)?
A
Abrupt loss of kidney function
Typically reversible if treated before permanent damage occurs
2
Q
What are the categories of AKI causes?
A
Prerenal, Intrarenal, Postrenal
The cause determines the treatment
3
Q
What does prerenal AKI indicate?
A
Impaired renal perfusion due to intravascular circulation issues
Causes include dehydration and shock
4
Q
What is intrarenal AKI caused by?
A
Direct damage to the kidneys
Examples include acute tubular necrosis from nephrotoxins
5
Q
What is postrenal AKI characterized by?
A
Urinary obstruction leading to renal damage
Examples include kidney stones and BPH
6
Q
What are the phases of AKI progression?
A
Initial, Oliguric, Diuretic, Recovery
7
Q
In which phase of AKI is fluid and electrolyte retention observed?
A
Oliguric phase
8
Q
What are the assessment findings in AKI?
A
Increased BUN and creatinine, variable urine output
Oliguric phase shows fluid retention, diuretic phase shows wasting
9
Q
What metabolic condition is associated with AKI?
A
Metabolic acidosis
10
Q
What is a primary focus of AKI care?
A
Maintaining electrolyte and fluid balance
11
Q
What is another focus of care in AKI management?
A
Preventing infection
12
Q
What is the focus of promoting healing in AKI?
A
Preventing permanent renal damage
13
Q
What urine output is characteristic of the oliguric phase in AKI?
A
<400 mL/day
14
Q
What are signs of fluid overload in the oliguric phase?
A
Edema, crackles
15
Q
What electrolyte imbalance is commonly seen in the oliguric phase?
A
Hyperkalemia
16
Q
What urine output is observed in the diuretic phase of AKI?
A
3-6 L/day
17
Q
What signs indicate dehydration in the diuretic phase?
A
Dry mucous membranes
18
Q
What electrolyte imbalance can occur in the diuretic phase?
A
Hypokalemia
19
Q
A
20
Q
A
21
Q
What should be monitored to assess renal function in Acute Kidney Injury?
A
BUN and creatinine levels
Monitor potassium and sodium levels to identify imbalances.
22
Q
What is important to monitor closely in patients with Acute Kidney Injury?
A
Urine output
Measure daily weights at the same time on the same scale each day.
23
Q
What should be done to assess for dysrhythmias in patients with electrolyte imbalances?
A
Place the client on a cardiac monitor.
24
Q
What do peaked T waves indicate?
A
Hyperkalemia.
25
What do flat or inverted T waves indicate?
Hypokalemia.
26
What medications are used to treat hyperkalemia?
Polystyrene sulfonate (Kayexalate), Loop diuretics (e.g., furosemide), IV calcium gluconate, IV 50% dextrose and insulin.
27
How does Polystyrene sulfonate (Kayexalate) work?
It binds to potassium in the GI tract and facilitates excretion through stool.
28
What is the role of Loop diuretics in hyperkalemia treatment?
They excrete excess fluid and potassium through urine.
29
What does IV calcium gluconate do in hyperkalemia?
Reduces the risk of dysrhythmias caused by hyperkalemia.
30
What is the purpose of IV 50% dextrose and insulin in hyperkalemia?
Insulin shifts potassium back into cells.
31
What should be considered when administering Polystyrene sulfonate?
Do not administer to clients with bowel function issues due to the risk of intestinal necrosis.
32
What should be monitored when administering Loop diuretics?
Electrolyte levels, particularly potassium levels.
33
What is a risk associated with administering IV furosemide?
Ototoxicity; administer slowly over 1-2 minutes.
34
What should be monitored in clients with AKI and CKD for hyperkalemia?
ECG changes caused by potassium imbalances.
35
What treatment may be needed for persistent hyperkalemia?
Dialysis.
36
What is a high priority for clients with Acute Kidney Injury (AKI)?
Preventing infection is a high priority for clients with AKI due to immune suppression.
37
What techniques should be used to prevent infection in AKI clients?
Use strict aseptic technique when providing care and provide frequent skin and oral care.
38
What signs should be monitored for in clients with AKI?
Monitor closely for signs of infection such as low-grade fever and tachycardia.
39
How might clients with AKI present with infection?
Clients with AKI may not experience high fever with infection.
40
What should be avoided to promote healing in AKI?
Avoid administration of nephrotoxic medications such as contrast and vancomycin.
41
How can protein intake affect kidney workload in AKI?
Reduce protein intake to lessen the workload of the kidneys.
42
What interventions may be anticipated if less invasive treatments fail in AKI?
Anticipate continuous renal replacement therapy (CRRT) or hemodialysis.
43
What is Chronic Kidney Disease (CKD)?
CKD is a progressive, irreversible loss of kidney function over months or years.
44
What are the stages of Chronic Kidney Disease?
CKD is classified into stages based on Estimated Glomerular Filtration Rate (GFR).
45
What are common causes of CKD?
CKD is caused by conditions that impair renal perfusion or damage nephrons, such as diabetes.
46
What are some assessment findings in CKD?
Assessment findings include oliguria, fluid overload, hyperkalemia, and metabolic acidosis.
47
What is uremic syndrome?
Uremic syndrome includes symptoms like nausea, vomiting, fatigue, and skin itching.
48
What nursing care focuses on for CKD?
Nursing care focuses on managing fluid and electrolytes, preventing cardiovascular disease, and dietary modifications.
49
What should be monitored in CKD patients regarding fluid and electrolytes?
Monitor BUN, creatinine, and electrolyte levels.
50
What does peaked T waves indicate in CKD?
Peaked T waves indicate hyperkalemia.
51
What should clients avoid taking due to electrolyte content?
Clients should avoid over-the-counter medications as they can contain electrolytes.
52
What medication can be administered to treat metabolic acidosis in CKD?
Administer sodium bicarbonate to treat metabolic acidosis.
53
What is a high priority for clients with Acute Kidney Injury (AKI)?
Preventing infection is a high priority for clients with AKI due to immune suppression.
54
What techniques should be used to prevent infection in AKI clients?
Use strict aseptic technique when providing care and provide frequent skin and oral care.
55
What signs should be monitored for in clients with AKI?
Monitor closely for signs of infection such as low-grade fever and tachycardia.
56
How might clients with AKI present with infection?
Clients with AKI may not experience high fever with infection.
57
What should be avoided to promote healing in AKI?
Avoid administration of nephrotoxic medications such as contrast and vancomycin.
58
How can protein intake affect kidney workload in AKI?
Reduce protein intake to lessen the workload of the kidneys.
59
What interventions may be anticipated if less invasive treatments fail in AKI?
Anticipate continuous renal replacement therapy (CRRT) or hemodialysis.
60
What is Chronic Kidney Disease (CKD)?
CKD is a progressive, irreversible loss of kidney function over months or years.
61
What are the stages of Chronic Kidney Disease?
CKD is classified into stages based on Estimated Glomerular Filtration Rate (GFR).
62
What are common causes of CKD?
CKD is caused by conditions that impair renal perfusion or damage nephrons, such as diabetes.
63
What are some assessment findings in CKD?
Assessment findings include oliguria, fluid overload, hyperkalemia, and metabolic acidosis.
64
What is uremic syndrome?
Uremic syndrome includes symptoms like nausea, vomiting, fatigue, and skin itching.
65
What nursing care focuses on for CKD?
Nursing care focuses on managing fluid and electrolytes, preventing cardiovascular disease, and dietary modifications.
66
What should be monitored in CKD patients regarding fluid and electrolytes?
Monitor BUN, creatinine, and electrolyte levels.
67
What does peaked T waves indicate in CKD?
Peaked T waves indicate hyperkalemia.
68
What should clients avoid taking due to electrolyte content?
Clients should avoid over-the-counter medications as they can contain electrolytes.
69
What medication can be administered to treat metabolic acidosis in CKD?
Administer sodium bicarbonate to treat metabolic acidosis.
70
How should daily weights be measured in CKD patients?
Measure daily weights at the same time on the same scale each day.
71
What signs of fluid overload should be monitored in CKD patients?
Monitor for signs of fluid overload like edema and crackles.
72
What should clients report regarding their weight and symptoms?
Teach clients to report sudden weight gain, dyspnea, or edema.
73
What fluid intake restrictions apply to late-stage CKD patients?
Restrict fluid intake for late stages and clients on dialysis.
74
What should be avoided in IV fluid administration for CKD patients?
Avoid administering large volumes of IV fluids.
75
What medication is administered to remove excess fluid and potassium?
Administer loop diuretics (furosemide) to remove excess fluid and potassium.
76
Which diuretics should be avoided in CKD patients?
Avoid potassium-sparing diuretics (e.g., spironolactone).
77
What cardiovascular risks are associated with CKD?
Clients with CKD are at risk for CVD from arterial stiffness, hypertension, and atherosclerosis.
78
What should be monitored due to the risk of hypertension in CKD patients?
Monitor BP due to the increased risk of hypertension.
79
What dietary modifications should be implemented for CKD patients?
Implement a low-protein diet, except for high-protein diets for clients on peritoneal dialysis.
80
What types of foods should CKD patients avoid?
Avoid foods high in potassium, sodium, and phosphorus.
81
What medications are used to manage bone disease in CKD patients?
Administer oral phosphate binders (e.g., sevelamer, calcium acetate) with meals.
82
What supplements support bone health in CKD patients?
Administer calcium and vitamin D supplements to support bone health.
83
What should be monitored due to the risk of anemia in CKD patients?
Monitor hemoglobin and hematocrit levels due to the risk of anemia.
84
What medications treat anemia in CKD patients?
Administer erythropoietin (EPO) injections, iron supplements, and blood transfusions.
85
When are renal replacement therapies indicated?
Dialysis and kidney transplant are indicated when dietary and pharmacological interventions are insufficient.
86
What does dialysis do for CKD patients?
Dialysis removes excess fluid, waste, and toxins from the blood when the kidneys cannot.
87
What are the types of dialysis?
Types of dialysis include hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT).
88
What is required for access in hemodialysis?
HD requires surgical creation of an AV fistula or graft for access.
89
What should be assessed in a client with an AV fistula or graft?
Assess the site for patency, feel for a thrill, and listen for a bruit.
90
What should not be done in an arm with an AV fistula or graft?
Do not measure BP or perform venipuncture in an arm with an AV fistula or graft.
91
What should be monitored at the AV fistula or graft site?
Monitor site for infection or thrombosis (redness, absence of thrill or bruit).
92
What should clients avoid doing with their AV graft or fistula?
Teach clients to avoid placing pressure on AV graft or fistula.
93
What should be monitored for during and after hemodialysis?
Complications such as hypotension, air embolism, disequilibrium syndrome, and bleeding.
94
What is the intervention for hypotension during hemodialysis?
Monitor BP closely and adjust dialysis rate; administer IV fluids.
95
What is an air embolism in hemodialysis?
Air enters dialysis tubing through leaks or improper handling, blocking blood flow.
## Footnote
Monitor client for dyspnea, chest pain, or confusion.
96
What is disequilibrium syndrome?
A condition caused by rapid fluid removal during hemodialysis, leading to nausea, headache, or confusion.
## Footnote
Interventions include adjusting the dialysis rate.
97
What is the risk associated with heparin during dialysis?
Heparin is used to prevent clotting of the filter, which can cause bleeding.
## Footnote
Monitor for bleeding and have the antidote, Protamine sulfate, available.
98
What is peritoneal dialysis (PD)?
Dialysate is infused into the peritoneal cavity via a surgically implanted catheter to collect waste via osmosis.
99
What should be done when accessing the dialysis catheter for PD?
Wear sterile gloves.
100
What should be done before infusing dialysate fluid in PD?
Warm the dialysate fluid to prevent discomfort.
101
What signs indicate peritonitis during PD?
Cloudy peritoneal fluid, abdominal pain, or fever.
102
What dietary recommendation is made for clients receiving PD?
Encourage a high-protein diet to replace protein lost in dialysate fluid.
103
What should be monitored for in clients receiving PD?
Respiratory distress caused by dialysate pressing against the diaphragm and closely monitor intake and output of dialysate fluid.
104
What is continuous renal replacement therapy (CRRT)?
CRRT uses a hemodialysis machine to filter blood continuously instead of intermittently.
105
Who is CRRT used for?
Critically ill clients who cannot tolerate larger fluid shifts, such as hypotensive patients.
106
What should be monitored for during and after hemodialysis?
Complications such as hypotension, air embolism, disequilibrium syndrome, and bleeding.
107
What is the intervention for hypotension during hemodialysis?
Monitor BP closely and adjust dialysis rate; administer IV fluids.
108
What is an air embolism in hemodialysis?
Air enters dialysis tubing through leaks or improper handling, blocking blood flow.
## Footnote
Monitor client for dyspnea, chest pain, or confusion.
109
What is disequilibrium syndrome?
A condition caused by rapid fluid removal during hemodialysis, leading to nausea, headache, or confusion.
## Footnote
Interventions include adjusting the dialysis rate.
110
What is the risk associated with heparin during dialysis?
Heparin is used to prevent clotting of the filter, which can cause bleeding.
## Footnote
Monitor for bleeding and have the antidote, Protamine sulfate, available.
111
What is peritoneal dialysis (PD)?
Dialysate is infused into the peritoneal cavity via a surgically implanted catheter to collect waste via osmosis.
112
What should be done when accessing the dialysis catheter for PD?
Wear sterile gloves.
113
What should be done before infusing dialysate fluid in PD?
Warm the dialysate fluid to prevent discomfort.
114
What signs indicate peritonitis during PD?
Cloudy peritoneal fluid, abdominal pain, or fever.
115
What dietary recommendation is made for clients receiving PD?
Encourage a high-protein diet to replace protein lost in dialysate fluid.
116
What should be monitored for in clients receiving PD?
Respiratory distress caused by dialysate pressing against the diaphragm and closely monitor intake and output of dialysate fluid.
117
What is continuous renal replacement therapy (CRRT)?
CRRT uses a hemodialysis machine to filter blood continuously instead of intermittently.
118
Who is CRRT used for?
Critically ill clients who cannot tolerate larger fluid shifts, such as hypotensive patients.
