Term
| Early signs of renal failure? |
|
Definition
| -Sharp decrease in urine output |
|
|
Term
|
Definition
-IV contract reaction is the big cause. The drug hurts kidney, not property perfused with blood.
-Decreased blood supply
-Hypovolemia, sepsis, anaphylaxis, cardiogenic shock, heart failure, decreased renal perfusion due to drugs, contrast agents and vasoactive mediators
-Normal kidney receives 22% of CO
-Characterized by marked decrease in renal blood flow: When blood flow falls below 25% of normal, ischemic changes occur to tubules. Because of high metabolic rate, the tubular epithelia cells are most vulnerable to ischemic injury. Improperly treated, prolonged renal hypoperfusion can lead to ischemic tubular necrosis.
-Vasoactive mediators, drugs and contrast agents may stimulate intense intrarenal vasoconstriction and induce glomerular hypoperfusion and prerenal failure
-Sharp decrease in urine output First sign with disproportionate elevation of BUN in relation to serum creatinine (increased and kidney in trouble)
-Reversible with treatment Flood with fluid. |
|
|
Term
| Which type of acute renal failure (ARF) would be most likely to accompany benign prostatic hypertrophy? |
|
Definition
|
|
Term
|
Definition
-Urine flow is blocked
-Stones, tumors, ***enlarged prostate*** (bladder outlet obstruction, uretreral)
-Results from obstruction of urine outflow from kidneys
-Ureter – calculi and strictures
-Bladder – tumors or neurogenic bladder |
|
|
Term
| Effect of sex and age on post renal failure? |
|
Definition
| -Sexual-alterations in physiologic sexual response and reproductive ability and libido common |
|
|
Term
| Name the organ that is impacted? |
|
Definition
Prostate
Urethra – BPH (benign prostatic hyperplasia in Men) |
|
|
Term
Intrinsic
Acute tubular necrosis description? |
|
Definition
-Kidney tubule function is decreased-acute tubular necrosis(Are my tubular necrosised?)
-Is characterized by destruction of tubular epithelial cells with acute suppression of renal function |
|
|
Term
| Intrinsic-acute tubular necrosis Causes |
|
Definition
Injury to the tubule is most common; ischemic or toxic in origin.
-Prolonged renal ischemia, nephrotoxic drugs/metals/organic solvents, -toxins from massive infection (sepsis), -nephrotoxic effects of drugs, |
|
|
Term
Intrinsic-acute tubular necrosis
Conditions causing damage to structures within the kidney |
|
Definition
| glomerular, tubular, or interstitial. Intratubular obstruction(myoglobinuria), acute renal disease(glomerulonephritis) |
|
|
Term
| Intrinsic-acute tubular necrosis is it reversible? |
|
Definition
| -Depends of recovery of injured cells, removal of necrotic cells/casts, and regeneration of tubular cells |
|
|
Term
T/F?
GFR does not improve with restoration of blood flow |
|
Definition
|
|
Term
|
Definition
| -Major surgery, severe hypovolemia, trauma, burns, sepsis (toxins sensitize renal tubular cells to damaging effects of ischemia); frequently multifactorial. Restore BF, BV, maximum the GFR |
|
|
Term
| Nephrotoxic –toxins I gave |
|
Definition
| -Induce varying combination of renal vasoconstriction, direct tubular damage or intratubular obstruction: antimicrobials including aminoglycosides, chemotherapy, radiocontrast, heavy metals and organic solvents; vulnerable because of rich blood supply and ability to concentrate toxins. |
|
|
Term
|
Definition
| -Myoglobin(muscle trauma), hemoglobin(transfusion reaction), uric acid and myeloma(widespread malignancy or massive tumor destruction by therapeutic agents. Gout, myoloma, tumors, clog tubules & obstruct them. |
|
|
Term
| Onset or initiating phase of (Acute tubular necrosis)ATN? |
|
Definition
| -Lasts hours or days from onset of precipitating event until tubular injury occurs |
|
|
Term
| Maintenance phase of ATN (Acute tubular necrosis)? |
|
Definition
-Marked decrease in GFR, sudden retention of urea, K, and creatinine
-Low urine output, edema, pulmonary congestion
-May be non-oliguric |
|
|
Term
| Recovery or convalescent phase of ATN (Acute tubular necrosis)? |
|
Definition
oRenal tissue repair occurs, diuresis may begin before renal function has fully returned to normal
oBUN and creatinine begin to return to normal |
|
|
Term
| What is the mortality rate of ATN |
|
Definition
| Mortality rate can range from 42-88% and threatens ICU patient |
|
|
Term
| Prevention and early treatment of ATN recovery or convalescent phase? |
|
Definition
•Carefully monitor urine output, urine osmolarity, and specific gravity-early manifestation is loss of concentrating ability
•Urinalysis - casts, proteinuria, hemoglobinuria
•Blood - BUN and creatinine + GFR |
|
|
Term
| Identify and treat cause of ATN recovery or convalescent phase? |
|
Definition
•Adequate calorie intake to prevent protein breakdown
•Treat infections
•Dialysis, CRRT (continuous renal replacement therapy) |
|
|
Term
| Chronic renal failure effects what population and conditions? |
|
Definition
| - Prevalence and incidence continues to rise (elderly, hypertension and diabetes) = 9.6% of adults |
|
|
Term
| Chronic renal failure causes |
|
Definition
-Irreversible renal failure caused by diabetes, hypertension glomerulonephritis and polycystic disease
•As kidney structures are destroyed, the remaining nephrons undergo structural and functional hypertrophy, each increasing function as a means of compensation
•Regardless of cause CRF results in progressive deterioration of glomerular filtration, tubular reabsorption capacity and endocrine function |
|
|
Term
|
Definition
| Kidney damage with normal or increased GFR >90 |
|
|
Term
|
Definition
| Kidney damage with mild decrease in GFR 60-89 |
|
|
Term
|
Definition
| Modearte decrease in GFR 30-59 |
|
|
Term
|
Definition
| Severe decrease in GFR 15-29 |
|
|
Term
|
Definition
| Kidney failure <15 (or dialysis) |
|
|
Term
Clinical manifestations of chronic renal failure-
***Accumulation of nitrogenous wastes*** |
|
Definition
| –BUN may rise as high as 800 mg/dl; with creatinine levels of 10 mg or more it is assumed that 90% of renal function is lost |
|
|
Term
Clinical manifestations of chronic renal failure
***Disorders of water, electrolyte, and acid base balance*** |
|
Definition
–Dehydration or fluid overload depending on phase and disorder
–Hyperkalemia and metabolic acidosis |
|
|
Term
Clinical manifestations of chronic renal failure
***Mineral metabolism and skeletal disorders*** |
|
Definition
–Phosphate elevation, calcium fall, PTH stimulated, hyperparathyroidism develops, calcium levels maintained at expense of skeletal system and body organs.
-Bone matrix formation and mineralization impacted |
|
|
Term
Clinical manifestations of chronic renal failure
***Hematologic disorders*** |
|
Definition
–Chronic anemia due to erythropoietin deficiency, uremic toxins and iron deficiency;
-recombinant human erythropoietin (rhEPO) corrects |
|
|
Term
Clinical manifestations of chronic renal failure
***What is the cause of anemia?*** |
|
Definition
-Kidney metabolic functions decrease
–Decreased erythropoietin |
|
|
Term
Clinical manifestations of chronic renal failure
Cardiovascular disorders |
|
Definition
–Hypertension,
-LV hypertrophy,
-pericarditis |
|
|
Term
Clinical manifestations of chronic renal failure
GI Gastrointestional |
|
Definition
| anorexia, nausea, vomiting and hiccups |
|
|
Term
Clinical manifestations of chronic renal failure
Neuro |
|
Definition
| alterations in peripheral and central nervous system function |
|
|
Term
Clinical manifestations of chronic renal failure
Altered immune |
|
Definition
| –Infection common, altered humoral and cell-mediated immunity, defective phagocyte function and decrease granulocytes; skin and mucosal barriers to infection may be defective; may not have fever |
|
|
Term
Clinical manifestations of chronic renal failure
Skin integrity |
|
Definition
| Pruritus common, dry, bruising, pale, sallow |
|
|
Term
Clinical manifestations of chronic renal failure
***Sexual*** |
|
Definition
| alterations in physiologic sexual response and reproductive ability and libido common |
|
|
Term
| What is impact on calcium? Why are his bones brittle even though he eats dairy products? |
|
Definition
| –Decreased Vitamin D activation taken with Vit C. |
|
|
