Term
| What are the renal diagnostic tests? |
|
Definition
Creatinine, BUN
IVP
CT guided renal biopsy
KUB
Bladder Scan
Cystoscopy |
|
|
Term
| What are normal creatinine levels? |
|
Definition
|
|
Term
| What are normal BUN levels? |
|
Definition
|
|
Term
| What are normal phosphorus levels? |
|
Definition
|
|
Term
| What are normal potassium levels? |
|
Definition
|
|
Term
| What is normal protein level? |
|
Definition
|
|
Term
| What is a normal calcium level? |
|
Definition
|
|
Term
| What is the relationship with phosphorus and calcium? |
|
Definition
When calcium is LOW, phos is HIGH
When calcium is HIGH, phos is LOW |
|
|
Term
| What is acute glomeruphrenitis? |
|
Definition
| Inflammation of the glomerular capillaries |
|
|
Term
| What are the s/s of ACTUE glomerulophrenitis? |
|
Definition
| hematuria, edema, azotemia (excessive nitrogenous wastes in the blood), and proteinuria |
|
|
Term
| What is the treatment of acute glomerulonephritis? |
|
Definition
| protein and sodium restriction and antibiotic administration |
|
|
Term
| What are the complications of acute glomerulonephritis? |
|
Definition
| hypertensive encephalopathy, heart failure, and pulmonary edema |
|
|
Term
| Why is there proteinurea in acute glomerulonephritis? |
|
Definition
| There are abnormalities in the capillary wall of the glomerulus which causes protein to spill out |
|
|
Term
A nurse is providing care for a patient with acute glomerulonephritis. Which of the following assessments should the nurse prioritize?
Daily weights
Ankle-brachial index
Pain assessment
Blood glucose levels |
|
Definition
|
|
Term
| What is chronic glomuerlonephritis? |
|
Definition
| proteinuria, usually caused by repeated episodes of glomerular injury that results in renal destruction and broad manifestations |
|
|
Term
| What is the major complication of chronic glomerulonephritis? |
|
Definition
| chronic renal failure or end-stage renal disease (ESRD |
|
|
Term
| What are assessment priorities of chronic glomerulonephritis? |
|
Definition
| fluid and electrolyte status, cardiac status, and neurologic status |
|
|
Term
| What are the causes of a non functioning kidneys? |
|
Definition
Renal Failure
Acute
Chronic |
|
|
Term
| What assessments are key with non-functioning kidneys? |
|
Definition
Daily weights
STRICT I&O
Lab values |
|
|
Term
| What are the interventions for a non-functioning kidneys? |
|
Definition
Restrict Fluids
Dietary Restrictions
Dialysis |
|
|
Term
| What is nephrotic syndrome? |
|
Definition
| A cluster of clinical findings that can occur with almost any intrinsic renal disease or systemic disease that affects the glomerulus |
|
|
Term
| What is the most common cause of nephrotic syndrome? |
|
Definition
|
|
Term
| What does diabetic neuropathy of the bladder indicate? |
|
Definition
|
|
Term
| How is nephrotic syndrome treated? |
|
Definition
| Dietary modification and medication |
|
|
Term
| What is Acute Renal Failure? |
|
Definition
| A typically reversible clinical syndrome in which there is an abrupt loss of kidney function and GFR over a period of hours to days |
|
|
Term
|
Definition
| Caused by reduced blood flow to the kidney - HEART PROBLEM |
|
|
Term
|
Definition
| The result of parenchymal damage to the glomeruli or kidney tubules |
|
|
Term
|
Definition
| The result of an obstruction - PROSTATIC |
|
|
Term
| What are the 4 clinical phases of ARF? |
|
Definition
| Initiation or onset, oliguric, diuretic, and recovery |
|
|
Term
Is the following statement true or false?
An older adult with benign prostatic hyperplasia (BPH) is at risk for the postrenal type of ARF. |
|
Definition
T
anywhere from the collecting ducts of the kidney to the urethra |
|
|
Term
| What are the interventions of ARF? |
|
Definition
Medications
Nutritional promotion
Bed rest
Infection control
Skin care |
|
|
Term
| What is chronic renal failure/end-stage renal disease? |
|
Definition
| A progressive and irreversible deterioration in renal function taking place over months to years |
|
|
Term
| What is the pathophys of CRF/ESRD? |
|
Definition
| The end products of protein metabolism, normally excreted in urine, accumulate in the blood |
|
|
Term
| What are the risk factors for CRF/ESRD? |
|
Definition
| diabetes, hypertension, proteinuria, family history, and increasing age |
|
|
Term
| What are the medications for CRF/ERSD? |
|
Definition
| phosphate-binding agents, calcium supplements, antihypertensive and cardiac medications, antiseizure medications, and erythropoietin. |
|
|
Term
| What are the lab changes with chronic renal failure? |
|
Definition
elevated:
-K
-Mg
-Phos
-Creatinine
-BUN
-Metabolic Acidosis
-Na
Lowered:
-Hgb/Hct
-Calcium |
|
|
Term
| What is acute tubular necrosis? |
|
Definition
usually caused by a lack of oxygen to the kidney tissues (ischemia of the kidneys). It may also occur if the kidney cells are damaged by a poison or harmful substance.
can be caused by:
Blood transfusion reaction
Injury or trauma that damages the muscles
Low blood pressure (hypotension) that lasts longer than 30 minutes
Recent major surgery
Septic shock due to severe infection |
|
|
Term
| What is the fxn of dialysis? |
|
Definition
Rid the body of excess F&E
A/B balance
Eliminate wastes
Restore internal homestasis by osmosis, diffusion, and ultrafiltration
Does NOT replace hormone function! |
|
|
Term
|
Definition
Shunts blood from body, to dialyzer and back into circulation
Requires internal or external access device
Usually 3X/week |
|
|
Term
| How do patients get hemodialysis? |
|
Definition
Vascular access is achieved by a temporary device, an arteriovenous fistula, or an arteriovenous graft
Assess for thrill, bruit, and s/s of infection, no sticks or BP on that side |
|
|
Term
|
Definition
Renal insufficiency
ARF
CRF
Drug overdose
Persistent hyperkalemia
Hypervolemia unresponsive to diuretics (extracorpeal ultrafiltration) |
|
|
Term
| What do you do before hemodialysis? |
|
Definition
Assess for patency of access site (bruit, thrill, pulses, circulation)
V/S
Labs (BMP, H&H)
Weight
Discuss any meds to be withheld
Emotional support
Avoid taking B/P or stick s in arm with access device |
|
|
Term
| What do you look for after hemodialysis? |
|
Definition
Hypotension
Access clotting
HA
Muscle cramps
Bleeding
Disequilibrium syndrome (n/v, LOC, SZ, agitation)
Hepatitis
Infection
n/v
LOC
Hypovolemia
Avoid invasive procedures for 4-6 hours after dialysis
Elevate extremity |
|
|
Term
| What patient teaching is involved w/ hemodialysis? |
|
Definition
Avoid lifting heavy objects with access-site arm
Avoid carrying objects that compress affected extremity
Avoid sleeping with body weight on top of affected extremity
Perform hand exercise that promote fistula maturation |
|
|
Term
A patient with ESRD is scheduled to begin a hemodialysis treatment. The dialysis nurse should be aware that the patient will be vulnerable to:
Urosepsis
Abdominal pain
Hypotension
Metabolic alkalosis |
|
Definition
C. Hypotension
Rationale: The patient undergoing hemodialysis is vulnerable to hypotension because of the sudden alteration in normal blood flow and fluid balance. Urosepsis, abdominal pain, and alkalosis are not among the most common complications of dialysis. |
|
|
Term
| What is peritoneal dialysis? |
|
Definition
Peritoneum serves as filtration membrane
Fewer complications than HD |
|
|
Term
| How does hemodialysis work? |
|
Definition
| Patient fills bag with fluid, filtrates through peritoneal cavity, fluid comes out. |
|
|
Term
| What happens if fluid does not come out? |
|
Definition
|
|
Term
| What should you tell the patient if they are not getting good return on peritoneal dialysis? |
|
Definition
-Milk tubing
-Turn back and forth
-Check tubing |
|
|
Term
| What do you do before peritoneal dialysis? |
|
Definition
Labs (BMP)
Weight
Warm the dialysate |
|
|
Term
| What do you do during peritoneal dialysis? |
|
Definition
Follow prescribed times for infusion, dwell, and outflow
Maintain asepsis
Keep outflow bag lower than abd
Reposition patient if outflow is inadequate
Carefully milk catheter if fibrin clot has form
Teach patient home care f access site
Emotional support to patient and family |
|
|
Term
| What complications do you monitor for after peritoneal dialysis? |
|
Definition
Infection
Increase protein diet
Monitor for hyperglycemia |
|
|
Term
| Who gets kidney transplants? |
|
Definition
| The treatment of choice for most patients with ESRD |
|
|
Term
| What are the preoperative goals of kidney transplants? |
|
Definition
| Preoperative management goals include bringing the patient’s metabolic state to a level close to normal, making sure that the patient is free of infection, and initiating immunosuppressants |
|
|
Term
| Does the size of the kidney or person matter? |
|
Definition
|
|
Term
| What are the postoperative care priorities in kidney transplants? |
|
Definition
Administering medications
Preventing infection
Monitoring urinary function |
|
|
Term
| What are the s/s of hyper acute kidney rejection? |
|
Definition
| within 48 hours. (fever, HTN, pain) |
|
|
Term
| What are the s/s of acute kidney rejection? |
|
Definition
| 1-2 weeks (oliguria, anuria, low –grade fever, HTN, tenderness, lethargy, azotemia, fluid retention) |
|
|
Term
| What are the s/s of chronic kidney rejection? |
|
Definition
| (azotemia, fluid retention, electrolyte imbalance, fatigue) |
|
|
Term
| What are the indications for kidney transplant? |
|
Definition
| (anuria, proteinuria, azotemia, F+E≠, uremic lung |
|
|
Term
Which of the following is not a function of dialysis?
Sustains the life of patients with RF
Restores fluid and electrolyte function
Maintains homeostasis
Replaces several important hormone functions of kidneys |
|
Definition
| Replaces several important hormone functions of kidneys |
|
|
Term
A patient waiting for a kidney transplant asks the nurse what signs and symptoms most likely indicate rejection. What would be the nurse's best response?
“Low urine output can be a sign of rejection.”
“Shortness of breath is often a sign of rejection.”
“Decreasing blood pressure is a sign of rejection.”
“Weight loss is a sign of rejection.” |
|
Definition
| “Low urine output can be a sign of rejection.” |
|
|
Term
| What are the most common renal traumas>? |
|
Definition
| contusions, lacerations, ruptures, and renal pedicle injuries or small internal lacerations |
|
|
Term
| What are the goals of management of renal traumas? |
|
Definition
| control hemorrhage and pain, and prevent infection, as well as to preserve and restore renal function |
|
|
Term
Which observation indicates the most common side effect of Trimethoprim-sulfamethoxazole (Bactrim)?
Hypotonia
Loss of hearing
Hypotension
Urticaria |
|
Definition
|
|
Term
A client transferred from a nursing home has an indwelling urinary catheter. The urine is foul smelling and cloudy. Which would be best?
Clean the urinary meatus every other day.
Encourage the client to increase fluid intake.
Empty the drainage bag q2-4h.
Irrigate the Foley q8 hours. |
|
Definition
| Encourage the client to increase fluid intake. |
|
|
Term
The client has been diagnosed with chronic glomerulonephritis. The nurse should teach the client that the disease may progress to:
A. thromboemboli.
B. systemic lupus erythematosus.
C. diabetes mellitus.
D. end stage renal disease. |
|
Definition
| D. end stage renal disease. |
|
|
Term
The client with end stage renal disease has received a kidney transplant. The client asks “Why do I need to take cyclosporine (sandimmune)?” The nurse’s best response is:
A. “It will help prevent infection.”
B. “It will increase your immune system to prevent rejection.”
C. “It increases bone marrow cell production to assist in preventing rejection.”
D. “It will help prevent rejection of the kidney by suppressing your immune system.” |
|
Definition
| D. “It will help prevent rejection of the kidney by suppressing your immune system.” |
|
|
Term
The client has just returned from hemodialysis. It is essential for the nurse to evaluate the client for:
congestive heart failure.
hyperkalemia.
peripheral edema and headache.
signs of disequilibrium syndrome. |
|
Definition
| signs of disequilibrium syndrome. |
|
|
Term
The nurse is preparing to administer Phoslo to a patient in chronic renal failure. Which of the following serum lab values would cause the nurse to question the dose? Select all that apply.
a. phosphorus 8.4 mg/dL
b. phosphorus 2.0 mg/dL
c. calcium 12 mg/dL
d. calcium 5 mg/dL |
|
Definition
b. phosphorus 2.0 mg/dL
c. calcium 12 mg/dL |
|
|
Term
| What is the most common cause of kidney failure? |
|
Definition
|
|
