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87 Cards in this Set
- Front
- Back
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acute nephritic syndrome
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type of renal failure with glomerular inflammation
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acute renal failure
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sudden rapid deterioration of kidney function that is sometimes reversible
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acute tubular necrosis
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type of acute renal failure in which there is actual damage to the kidney tubules
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anuria
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total urine output less than 50ml in 24 hours
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arteriovenous fistula
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type of vascular access for dialysis; created by surgically connecting an artery to a vein.
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arteriovenous graft
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type of surgically created vascular access for dialysis by which a piece of biologic, semibiologic, or synthetic graft material connects the patient's artery to a vein
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azotemia
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abnormal concentration of nitrogenous wastes in the blood
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chronic kidney disease
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chronic progressive and irreversible diseases of the kidneys
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Continuous ambulatory peritoneal dialysis
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method of peritoneal dialysis whereby a patient manually performs four or five complete exchanges or cycles throughout the day
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continuous cyclic peritoneal dialysis
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method of peritoneal dialysis in which a peritoneal dialysis machine (cycler) automatically performs exchanges, usually while the patient sleeps
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continuous renal replacement therapy
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variety of methods used to replace normal kidney function by circulating the patient's blood through a filter and returning it to the patient
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dialysate
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solution that circulates through the dialyzer in hemodialysis and through the peritoneal membrane in peritoneal dialysis
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dialyzer
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"artificial kidney" or dialysis machine; contains a semipermeable membrane through which particles of a certain size can pass
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diffusion
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movement of solutes (waste products) from an area of higher concentration to an area of lower concentration
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effluent
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term used to describe the drained the drained fluid from a peritoneal dialysis exchange
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end-stage renal disease
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final stage of renal failure that results in retention of uremic waste products and the need for renal replacement therapies
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exchange (peritoneal dialysis)
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complete cycle of peritoneal dialysis includes fill, dwell, and drain phases
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glomerulonephritis
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inflammation of the glomerular capillaries
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hemodialysis
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procedure during which a patient's blood is circulated through a dialyzer to remove waste products and excess fluid
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interstitial nephritis
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inflammation within the renal tissue
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nephrosclerosis
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hardening of the renal arteries
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nephrotic syndrome
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type of renal failure with increased glomerular permeability and massive proteinuria
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nephrotoxic
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any substance, medication, or action that destroys kidney tissue
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Osmosis
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movement of water through a semipermeable membrane from an area of lower solute concentration to an area of higher solute concentration
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peritoneal dialysis
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procedure that uses the lining of the patient's peritoneal cavity as the semipermeable membrane for exchange of fluid and solutes
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peritonitis
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inflammation of the peritoneal membrane (lining of the peritoneal cavity)
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pyelonephritis
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inflammation of the renal pelvis
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ultrafiltration
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process whereby water is removed from the blood by means of a pressure gradient between the patient's blood and the dialysate
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uremia
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an excess of urea and other nitrogenous wastes in the blood
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urinary casts
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proteins secreted by damaged kidney tubules
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The renal system helps ?
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regulate the body's internal environment and is essential for the maintenance of life
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what is fluid overload ?
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the patient whose fluid intake exceeds the ability of the kidneys to excrete fluid
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fluid volume deficit
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fluid intake is inadequate, the patient is said to be volume depleted and may show signs and symptoms
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Why is the fluid intake and output (I&O) record important ?
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A key monitoring tool, is used to document important fluid parameters, including the amount of fluid taken in (orally or parenterally), the volume of urine excreted, and other fluid losses (diarrhea, vomiting, diaphoresis)
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Is a patients weight important with renal disorders ?
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Yes - documenting trends in weight is a key assessment strategy essential for determining the daily fluid allowance and indicating signs of fluid overload or deficit
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With aging the kidney is less able to what ?
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Respond to acute fluid and electrolyte changes
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Elderly patients may develop what ?
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Atypical and nonspecific signs and symptoms of disturbed renal function and fluid and electrolyte imbalances
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A fluid balance deficit in the elderly can lead to ?
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constipation, falls, medication toxicity, urinary tract and respiratory tract infections, delirium, seizures, electrolyte imbalances, hyperthermia, and delayed wound healing
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Chronic kidney disease (CKD) is ?
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an umbrella term that describes kidney damage or a decrease in the glomerular filtration rate (GFR) for 3 or more months
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CKD is associated with what ?
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decreased quality of life, increased health care expenditures, and premature death
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Untreated CKD can result in ?
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end-stage renal disease (ESRD) and necessitate renal replacement therapy (dialysis or kidney transplantation)
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Risk factors of untreated CKD
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cardiovascular disease, diabetes, hypertension, and obesity
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what percentage of the U.S. population aged 20 years and older have CKD ?
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16.8 %
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Sodium deficit manifestations
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Nausea, malaise, lethargy, headache, abdominal cramps, apprehension, seizures
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Sodium deficit management
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diet, normal saline or hypertonic saline solutions
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sodium excess manifestations
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dry, sticky mucous membranes, thirst, rough dry tongue, fever, restlessness, weakness, disorientation
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sodium excess management
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fluid, diuretics, dietary restriction
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Potassium deficit manifestation
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anorexia, abdominal distention, paralytic ileus, muscle weakness, ECG changes, dysrhythmias
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Potassium deficit management
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diet, oral or parenteral potassium replacement therapy
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Potassium excess manifestation
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diarrhea, colic, nausea, irritability, muscle weakness, ECG changes
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Calcium deficit manifestations
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Abdominal and muscle cramps, stridor, carpopedal spasm, hyperactive reflexes, tetany, positive Chvostek's or Trousseau's sign, tingling of fingers and around mouth, ECG changes
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Calcium deficit management
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diet, oral or parenteral calcium salt replacement
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Calcium excess manifestation
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Deep bone pain, flank pain, muscle weakness, depressed deep tendon reflexes, constipation, nausea and vomiting, confusion, impaired memory, polyuria, polydipsia, ECG changes
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Calcium excess management
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fluid replacement, etidronate, pamidronate, mithramycin, calcitonin, glucocorticoids, phosphate salts
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Bicarbonate deficit manifestation
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Headache, confusion, drowsiness, increased respiratory rate and depth, nausea and vomiting, warm flushed skin
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Bicarbonate deficit management
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Bicarbonate replacement, dialysis
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Bicarbonate excess manifestation
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Depressed respirations, muscle hypertonicity, dizziness, tingling of fingers and toes
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Bicarbonate excess management
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fluid replacement if volume depleted; ensure adequate chloride
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Protein deficit manifestations
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Chronic weight loss, emotional depression, pallor, fatigue, soft flabby muscles
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Protein deficit management
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diet, dietary supplements, hyperalimentation, albumin
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Magnesium deficit manifestations
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dysphagia, muscle cramps, hyperactive reflexes, tetany, positive Chvostek's or Trousseau's sign, tingling of fingers, dysrhythmias, vertigo
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Magnesium deficit management
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diet, oral or parenteral magnesium replacement therapy
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Magnesium excess manifestations
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Facial flushing, nausea and vomiting, sensation of warmth, drowsiness, depressed deep tendon reflexes, muscle weakness, respiratory depression, cardiac arrest
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Magnesium excess management
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Calcium gluconate, mechanical ventilation, dialysis
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Phosphorus deficit manifestations
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Deep bone pain, flank pain, muscle weakness and pain, paresthesia, apprehension, confusion, seizures
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Phosphorus deficit management
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diet, oral or parenteral phosphorus supplementation therapy
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Phosphorus excess manifestations
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Tetany, tingling of fingers and around mouth, muscle spasms, soft tissue calcification
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Phosphorus excess management
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diet restriction, phosphate binders, normal saline solution, IV dextrose solution, and insulin
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What is the primary cause of CKD ?
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Diabetes
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Percentages of type 1 diabetes patients that will develop kidney damage ?
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Between 25% and 40%
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Percentages of type 2 diabetes patients that will develop kidney damage ?
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5% to 40%
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What is the leading cause of renal failure in patients starting renal replacement therapy ?
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Diabetes
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The second leading cause of renal failure in patients starting renal replacement therapy ?
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hypertension, followed by glomerulonephritis and pyelonephritis; polycystic, hereditary, or congenital disorders; and renal cancers
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Pathophysiology of CKD
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It is not yet clearly understood, but the damage to the kidneys is thought to be caused by prolonged acute inflammation that is not organ specific and thus has subtle systemic manifestations
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How many stages of chronic kidney disease our there ?
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5 stages
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When does stage 5 result ?
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Results when the kidneys cannot remove the body's metabolic wastes or perform their regulatory functions and renal replacement therapies are required to sustain life.
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Stage 1 CKD
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GFR greater than or equal too 90 ml
Kidney damage with normal or increased GFR |
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Stage 2 CKD
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GFR equal too 60-89 ml
Mild decrease in GFR |
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Stage 3 CKD
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GFR equal too 30-59 ml
Moderate decrease in GFR |
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Stage 4 CKD
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GFR equal too 15-29 ml
Severe decrease in GFR |
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Stage 5 CKD
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GFR less than 15 ml
Kidney failure (end-stage renal disease [ESRD] ) |
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Patients with CKD are at increased risk for ?
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cardiovascular disease, the leading cause of morbidity and mortality
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What can help to slow CKD disease progression and improve patient outcomes ?
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treatment of hypertension, anemia, and hperglycemia and detection of proteinuria
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What does an elevated serum creatinine level indicate ?
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underlying kidney disease ; as the creatinine level increases, symptoms of chronic kidney disease begin
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Symptoms of CKD that begin as creatinine levels increase are ?
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Anemia - due to decreased erythropoietin production by the kidney
Metabolic acidosis , and abnormalities in calcium and phosphorus herald the development of CKD Fluid retention, evidenced by both edema and congestive heart failure develops |
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As CKD progresses you will see ?
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Abnormalities in electrolytes occur, heart failure worsens and hypertension becomes more difficult to control
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Assessment and diagnostic findings of CKD
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GFR is the amount of plasma filtered through the glomeruli per unit of time. Creatinine clearance is a measure of the amount of creatinine the kidneys are able to clear in a 24 hour period.
Normal values differ in men and women. |
