NUR 265 - Exam 1 Questions And Answers Rated A+ New Update Assured Satisfaction

What is nephrotic syndrome? - A condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted. What are the dietary restrictions on CKD? - -Protein (restrict early in disease process to preserve kidney function) -Potassium -Fluid -Sodium What are the dietary restrictions for an AKI patient? - -Low protein -Low sodium -Fluid restriction: mL day (for anything except perfusion problem) What are key features of nephrotic syndrome? - -*Massive proteinuria* -*Hypoalbuminemia* -*Edema (facial and periorbital)* -Lipiduria -Hyperlipidemia -Increased coagulation -Reduced kidney function In nephrotic syndrome, severe protein loss in the urine is greater than what? - 3.5g in 24 hours What is nephrotic syndrome treated with? - -immunosuppressant agents (if immunity based). -ACE inhibitors (decreased protein loss in urine) -statins (improve blood lipid levels). -Heparin (used to treat vascular effects and improve kidney function)Describe the "risk" stage for AKI - creatinine x 1.5 of normal, and GFR reduced by 25% Describe the "injury" stage for AKI - creatinine x2 & GFR reduced by 50% Describe the "failure" stage for AKI - creatinine x3 normal, & GFR reduced by 75% (Cant fix) Describe Prerenal AKI. Give examples. - Decreased perfusion to kidneys. -NSAIDs -Severe dehydration -Renal artery stenosis -MI or HF resulting in low ejection fraction and low cardiac output -Blood/ fluid loss Describe Intrarenal AKI. Give examples. - Tissue damage to the actual kidneys. -Glomerulonephritis or inflammation of the glomeruli -Sepsis -Intrarenal bleeding -Pyelonephritis Describe Postrenal AKI. Give examples. - Obstruction that occurs after the kidney. -Enlarged prostate (BPH) -Bladder Cancer -Kidney stonesHow do you determine the mean arterial pressure (MAP)? - Systolic + (Diastolic*2) /3 What is the MAP needed to perfuse the kidneys? - 65 mmHg What are examples of nephrotoxic drugs? - -NSAIDS -Metformin -Diuretics -Antibiotics (especially -mycin) -Contrast dye During the diuretic phase of AKI, what needs to be monitored? - Watch for dehydration and make sure output is greater than input What are the 2 most common causes of CKD? - -HTN -Uncontrolled diabetes What is azotemia? - Nitrogenous waste build up Describe peritoneal dialysis - -Sterile procedure at home where catheter is placed into the abdomen -Wear a mask -Solution may be warmed using a heating bag or blanket, not microwave! -Make sure patient turns and repositions to mix solution in the cavity What are manifestations of uremia? - •Metallic taste in mouth •Anorexia •Nausea/vomiting •Muscle cramps •Uremic frost on skin•Itching •Fatigue and lethargy •Hiccups •Edema •Dyspnea •Paresthesia's What effects can CKD have on the cardiac system - -HTN -Heart failure (major problem. Call the doctor) -Pericarditis What effects can CKD have on the Integumentary system - -Uremic frost Describe hemodialysis - -3x a week- 4-5 hours -At risk for bleeding do to heparin -Extremely fatigued post. -Vitals and weight before and after -Slight fever post is normal. Monitor