Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Stack #38907
RRC Maintenance - Chronic Renal Disease
| question | answer |
|---|---|
| chronic renal disease | state where kidneys are no longer able to function adequatelyto excrete wastes from the body. Irreversible condition that may develop over months to years...kidneys can adapt and maintain fluid balance until function in really bad |
| cause of chronic renal disease | diabetic nephropathy, hypertension-related kidney disease, glomerulonephritis, polycystic kidney disease |
| acute on chronic renal failure | pre-existing renal insufficiency may experience an acute insult that can be pre-renal, intra-renal or post-renal in nature |
| stage 1 | reduced renal reserve (residual functioning 40-75% of normal, mild reduction in GFR, BUN/Cr normal, no symptoms) |
| stage 2 | renal insufficiency (residual functioning 20-40% of normal, moderate reduction in GFR, decreased solute clearance, ability to concentrate urine and hormone secretion; increase in BUN and Cr - mild azotemia and anemia |
| stage 3 | chronic renal failure (further decline) |
| stage 4 | end-stage renal disease ( residual function <15% of normal, severe reduction in GFR, metabolic acidosis, marked increase in BUN, Cr, PO4; marked decrease in Hgb, Hct, Ca...excretory/regulatory function severely impaired, fluid overload with uremia |
| signs of symptoms of decreased GFR | oliguria/anuria, edema, unexplained SOB, unexplained weight gain |
| uremia | occurs when renal function has significantly declined and GFR is low therefore unable to excrete nitrogenous wastes |
| hyperkalemia | may develop when GFR is already reduced due to decreased ability of kidneys to excrete K+ |
| metabolic acidosis | unable to excrete H+ (which usually combines with NH3 and HPO4 and is excreted) and does not effectively reabsorb HCO3- |
| extracellular volume expansion/excess fluid volume | results from failure to excrete Na+ and H20 as a result of GFR <10-15ml/min and compensatory mechanism become exhausted; will manifest as peripheral and pulmonary edema and hypertension |
| anemia | develops from decreased renal synthesis of erythropoietin which is a hormone responsible for bone marrow stimulation of RBC production |
| hyperphosphatemia | unable to adequately excrete PO4...may cause itchy skin or painful joints |
| hypocalcemia | can result in renal osteodystrophy as a result of lack of vitamin D necessary for Ca++ absorption in the gut |
| pericarditis | cause by toxic effects of urea inflamming pericardial membrane |
| encephalopathy | CNS irritation/inflammation from toxins |
| peripheral neuropathy/restless leg syndrome | both thought to be result of irritation and other toxins on peripheral nerves |
| skin manifestations | pruritis most common skin complication due to accumulation of toxic pigments (urochromes) in the skin |
| diagnostic tests | creatinine screening test, BUN, serum Na+ and K+ in blood, serum uric acid, urinalysis tests (protein, albumin, RBC, etc), renal ultrasound, CT scan, KUB imaging |
| risk factors | age, hypertension, diabetes mellitus, prior kidney disease, multiple UTIs |
| Why is an individual with chronic renal disease placed on a low-protein diet? | restricting protein may slow down rate of kidney function deterioration, decreases PO4 load, helps control acid levels in blood and can relieve N+V in advance disease |
| Why is there Na+ restriction regarding the diet of those with CRD? | to control BP by restricting Na which will help decrease water retention and can also cause excess thirst which can be problem when on fluid restriction |
| peritoneal dialysis | use peritoneum as dialysis membrane... dialysate instilled into peritoneal cavity via catheter surgically inserted into abdominal wall, Once in abd. movement of solutes and fluid occurs between person's capillary blood and dialysate. drain at set intvl |
| hemodialysis | blood is removed via special vascular access device through an artificial kidney (dialyzer) and then returned to circulation...can be done LT 2-4x/wk for 3-5hr/treatment |
| Why are chest sound auscultated in those with CRD? | to assess for chest congestion/pulmonary edema |
| why is temperature monitored in those with CRD? | fever is an indicator of infection in those who are immunocompromised |
| phosphate binders | to control hyperphosphatemia |
| vitamin supplementation | water-soluble vitamins are lost during dialysis |
| erythropoietin-stimulating drug | to treat anemia |
| diphenhydramine | to treat pruritis |
| sodium bicarbonate | to treat acidosis |
| vitamin D preparation/calcium supplementation | to treat hypocalcemia and prevent renal osteodystrophy |
Created by:
bella83
Popular Nursing sets