NUR 114/115 Exam 3: Module 4 & 5 – Questions With
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Terms in this set (110)
1. hydrogen ions (H+)
What does the kidney
2.BUN
filter?
3.Creatine
How much blood is 85-105 mL
expected to filter in 1
minute?
How many ml/min of blood < 60ml/min
being filtered indicates
kidney disease?
Description: Rapid loss of kidney function from renal
cell damage.
-Occurs abruptly and can be reversible.
Acute Renal Failure aka -Leads to cell hypo perfusion, cell death, and
Acute Kidney Injury (AKI) decomposition of renal function.
-Phase 1: Oliguric
-Phase 2: Diuresis/Diuretic
-Phase 3: Recovery (Kidney is recovering)
Oliguric: Kidneys are insulted.
-Caused by DM, Meds (Vancomycin, Gentomycin,
AKI: Phase 1 Metformin), IV contrast, dehydration or trauma
-Expect: cloudy, dark urine, increased BUN & Creatinine,
decreased specific gravity, decreased GFR
Diuretic: Kidney tries to push fluid through
-Expect: more dilute, clear, yellow urine, gradual
AKI: Phase 2
decrease in BUN & Creatinine, decreased specific
gravity b/c urine is more dilute, improving GFR
, Recovery: Kidney is recovering
-Expect: increased GFR, stabilization or continual
AKI: Phase 3
decline in BUN & Creatinine toward normal, complete
recovery may take 1-2 yrs
1. Hypotension: decreased blood volume = not
circulating well, low volume = low O2 = decreased
3 H's of Acute Renal Failure perfusion. Ex. Hemorrhage
2. Hypovolemia: not enough to push through the body
3. Hypoperfusion: not enough perfusion
A MAP of what indicates <65 MAP
the kidneys are NOT
perfusing?
BUN & Creatinine increased some type of kidney issue
=?
BUN & Creatinine normal = Dehydration
?
Specific Gravity 1.010-1.030
10-20
BUN
*will be elevated with AKI
Creatinine *Adult 0.7-1.4
GFR <15 = end stage kidney disease
- 10:1 ratio
Intra Renal Failure -BUN: creatinine
-oliguria: low urine output
-Pre renal failure
Extra Renal Failure -20:1 ratio
-BUN: creatinine
Seeing dark amber colored -not being excreted
urine means what? -holding on to K+
*want to get into diuretic phase (HDTV)
H: hyperkalemia (cardiac monitor, K+ > 5, kayexelate)
poop out K+
D: Dopamine (dilate renal artery, increase perfusion,
How to reverse oliguria?
push bl to the kidney) (Don't give to Raynaud's pt)
T: increase Total volume (tickle kidney, IV BOLUS NS,
challenge kidney with fluids)
V: volume depletion: Diuretic, furosemide
, -slow, progressive, irreversible loss in kidney function
-what is causing the problem?
Chronic Kidney/Renal -Diabetes: see sugars, proteins, ketones
Failure -Hypertension
-May follow AKI, DM, and other metabolic recurrent
infections, renal artery occlusion, autoimmune disorders
-< 15 GFR = ESKD (end stage kidney disease)
-loss of total renal function
-no regeneration of kidney death
How bad is it? -3 options:
1. transplant
2. hemodialysis
3. peritoneal dialysis
-Intermittent renal replacement therapy involving the
process of cleansing the pmts blood
-Acts as kidney. Cleans the blood, removes the
byproducts of protein metabolism (urea, creatinine, etc),
Hemodialysis removes excess body fluids, corrects electrolytes
-Check vital signs during, before and after, labs, fluid
overload/deficit, weight, latency of blood access
device, monitor for bleeding r/t heparin, hypovolemia,
adequate nutrition, pts reaction to treatment
-subclavian or femoral catheter (short term or
temporary with AKI)
-cath is used when fistula or graft matures (6wks) or
when fistula/graft has failed r/t clotting or infection
Access for hemodialysis -shunts
-these are good vessels
-assess for hematoma, bleeding, Cath dislodgment and
infection. ONLY used for dialysis by dialysis personnel.
Keep occlusive dressing on insertion site.
- cath is usually filled with heparin and capped to
maintain latency between treatments. Heparin is
aspirated and wasted from the line b4 tx.
Subclavian vein catheter
-NEVER flush heparin to pt
-not to be uncapped except for treatment
-left in place up to 6 wks if no complications occur
Complete Solutions
Save
Terms in this set (110)
1. hydrogen ions (H+)
What does the kidney
2.BUN
filter?
3.Creatine
How much blood is 85-105 mL
expected to filter in 1
minute?
How many ml/min of blood < 60ml/min
being filtered indicates
kidney disease?
Description: Rapid loss of kidney function from renal
cell damage.
-Occurs abruptly and can be reversible.
Acute Renal Failure aka -Leads to cell hypo perfusion, cell death, and
Acute Kidney Injury (AKI) decomposition of renal function.
-Phase 1: Oliguric
-Phase 2: Diuresis/Diuretic
-Phase 3: Recovery (Kidney is recovering)
Oliguric: Kidneys are insulted.
-Caused by DM, Meds (Vancomycin, Gentomycin,
AKI: Phase 1 Metformin), IV contrast, dehydration or trauma
-Expect: cloudy, dark urine, increased BUN & Creatinine,
decreased specific gravity, decreased GFR
Diuretic: Kidney tries to push fluid through
-Expect: more dilute, clear, yellow urine, gradual
AKI: Phase 2
decrease in BUN & Creatinine, decreased specific
gravity b/c urine is more dilute, improving GFR
, Recovery: Kidney is recovering
-Expect: increased GFR, stabilization or continual
AKI: Phase 3
decline in BUN & Creatinine toward normal, complete
recovery may take 1-2 yrs
1. Hypotension: decreased blood volume = not
circulating well, low volume = low O2 = decreased
3 H's of Acute Renal Failure perfusion. Ex. Hemorrhage
2. Hypovolemia: not enough to push through the body
3. Hypoperfusion: not enough perfusion
A MAP of what indicates <65 MAP
the kidneys are NOT
perfusing?
BUN & Creatinine increased some type of kidney issue
=?
BUN & Creatinine normal = Dehydration
?
Specific Gravity 1.010-1.030
10-20
BUN
*will be elevated with AKI
Creatinine *Adult 0.7-1.4
GFR <15 = end stage kidney disease
- 10:1 ratio
Intra Renal Failure -BUN: creatinine
-oliguria: low urine output
-Pre renal failure
Extra Renal Failure -20:1 ratio
-BUN: creatinine
Seeing dark amber colored -not being excreted
urine means what? -holding on to K+
*want to get into diuretic phase (HDTV)
H: hyperkalemia (cardiac monitor, K+ > 5, kayexelate)
poop out K+
D: Dopamine (dilate renal artery, increase perfusion,
How to reverse oliguria?
push bl to the kidney) (Don't give to Raynaud's pt)
T: increase Total volume (tickle kidney, IV BOLUS NS,
challenge kidney with fluids)
V: volume depletion: Diuretic, furosemide
, -slow, progressive, irreversible loss in kidney function
-what is causing the problem?
Chronic Kidney/Renal -Diabetes: see sugars, proteins, ketones
Failure -Hypertension
-May follow AKI, DM, and other metabolic recurrent
infections, renal artery occlusion, autoimmune disorders
-< 15 GFR = ESKD (end stage kidney disease)
-loss of total renal function
-no regeneration of kidney death
How bad is it? -3 options:
1. transplant
2. hemodialysis
3. peritoneal dialysis
-Intermittent renal replacement therapy involving the
process of cleansing the pmts blood
-Acts as kidney. Cleans the blood, removes the
byproducts of protein metabolism (urea, creatinine, etc),
Hemodialysis removes excess body fluids, corrects electrolytes
-Check vital signs during, before and after, labs, fluid
overload/deficit, weight, latency of blood access
device, monitor for bleeding r/t heparin, hypovolemia,
adequate nutrition, pts reaction to treatment
-subclavian or femoral catheter (short term or
temporary with AKI)
-cath is used when fistula or graft matures (6wks) or
when fistula/graft has failed r/t clotting or infection
Access for hemodialysis -shunts
-these are good vessels
-assess for hematoma, bleeding, Cath dislodgment and
infection. ONLY used for dialysis by dialysis personnel.
Keep occlusive dressing on insertion site.
- cath is usually filled with heparin and capped to
maintain latency between treatments. Heparin is
aspirated and wasted from the line b4 tx.
Subclavian vein catheter
-NEVER flush heparin to pt
-not to be uncapped except for treatment
-left in place up to 6 wks if no complications occur
