NUR 213 CKD study guide Complex Health Concepts (Forsyth Technical Community College)

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NUR 213 CKD study guide 2025-
2026

Complex Health Concepts (Forsyth Technical Community
College)

Chronic Kidney Disease

Characteristics Onset
 Gradual (months to years)
% of Nephron Involvement
 Varies by stage
 Generally symptomatic with 75% loss and dialysis with 90-95%
Duration
 Progressive and permanent
 Treatment and lifestyle can slow progression and delay onset of ESKD
Prognosis
 Fatal without a renal replacement therapy (dialysis or transplantation)
 Reduced lifespan and potential for complex medical regimen even with optimal
treatment
 Clients with kidney disease do not die from renal failure; they die from
cardiovascular arrest r/t the effect on myocardium, progressive heart failure, and
arrhythmias (hyperkalemia = hypoglycemia = dysrhythmias)
 Chronic kidney disease clients with co-morbidly of diabetes are 5x more likely to
die (due to increased urea)




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CKD
Characteristics
 Progressive, irreversible kidney injury 
Kidney function does not recover
Main Causes Leading to Dialysis
 Hypertension 
Diabetes mellitus
Terminology
 End-stage kidney disease (ESKD)
 Azotemia
 Uremia
 Metallic taste in the mouth
 Anorexia
 Nausea
 Vomiting
 Muscle cramps
 Uremic “frost” on skin
 Itching
 Fatigue and lethargy
 Hiccups
 Edema
 Dyspnea
 Paresthesias
 Uremic syndrome (terminal - serious clinical manifestations of renal failure)
 Urea  nitrogen-containing compounds  come from protein intake or broken down
from body

Stages of CKD Stage 1
 GFR
 > 90
 Features
 At risk
 Normal kidney function
 Presence of urine and structural abnormalities or genetic traits
 Intervention
 Screening  Risk reduction Stage 2
 GFR




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 60-89
 Features
 Mild CKD
 Reduced kidney function
 Abnormal lab values and diagnostics
 Intervention
 Risk reduction
 Teaching
 Manage fluid volume, BP, electrolytes, and other kidney-damaging
diseases by following prescribed drug and nutrition therapies  can prevent and slow
progression to ESKD Stage 3
 GFR
 30-59
 Features
 Moderate CKD
 Azotemia
 Fluid and electrolyte imbalance
 Intervention
 Slow progression
 Glycemic  BP control
Stage 4
 GFR
 15-29
 Features
 Severe CKD
 Severe azotemia
 Fluid-electrolyte imbalance
 Intervention
 RRT
 Manage complications
Stage 5
 GFR
 < 15
 Features
 ESKD
 Severe fluid-electrolyte imbalance
 Acid-base imbalance
 Intervention




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