ANSWERS GRADED A+
✔✔People with CKD can slow the process by - ✔✔Keeping blood sugar in range, blood
pressure within target, avoid nsaids, quit smoking
✔✔Stages of CKD - ✔✔1 GFR >90
2 GFR 60-89
3 GFR 30-59
4 GFR 15-29
5 GFR <15
✔✔Causes of kidney failure - ✔✔Diabetes, hypertension, glomerular disease
✔✔Type 1 diabetes - ✔✔Immune system kills cells in the pancreas that creates insulin
✔✔type 2 diabetes - ✔✔the pancreas doesn't produce enough insulin, cells are
resistant to insulin, or both.
#1 cause of kidney failure
Leading cause of blindness and limb loss
Native Americans, African Americans and Hispanics are at higher risk.
✔✔How to prevent diabetes type 2 - ✔✔Losing 5% of body weight, exercising 30 mins a
days 5 days a week can decrease risk by 34%
✔✔Why does high BP cause CKD - ✔✔It can damage the blood vessels and the tiny
glomeruli that lead to the kidneys
✔✔Primary (essential) hypertension - ✔✔No identifiable cause, develops over years
✔✔secondary hypertension - ✔✔high blood pressure caused by the effects of another
disease
✔✔glomerular disease - ✔✔Make up 9% of people with kidney failure
✔✔glomerulonephritis - ✔✔inflammation of the glomeruli of the kidney
✔✔glomerulosclerosis - ✔✔hardening of the glomeruli
✔✔polysystic kidney disease (PKD) - ✔✔multiple fluid-filled sacs (cysts) within and on
the kidney
,✔✔Other cause of CKD - ✔✔Birth defect, large kidney stones, lupus, use of street
drugs, kidney infections, cancer, HIV/AIDS, sickle cell disease, some are unknown
✔✔Anemia - ✔✔a deficiency of red blood cells, fewer RBCs mean not enough oxygen
reaches tissues and causes fatigue, weakness, mental confusion, cold all the time, pale
skin/gum/nail beds
✔✔Anemia is linked to - ✔✔Left ventricular hypertrophy
✔✔left ventricular hypertrophy - ✔✔increase in thickness of myocardial wall that occurs
when the heart pumps against chronic outflow obstruction, causes heart to fail
✔✔Technician role in anemia - ✔✔Rinse back as much blood as possible
Tell nurse about insulation bleedings
Tell nurse of infection
Try using smaller blood tubes for labs
Urge pts to come to tx and stay full time
If reuse tell nurse of dialyzer doesn't pass test
✔✔Secondary hyperparathyroidism - ✔✔When parathyroid makes to much parathyroid
horomone
✔✔Why would the parathyroid make to much parathyroid horomone - ✔✔Healthy
kidneys make calcitrol
Calcitrol let's gut absorb calcium
Failing kidney makes less calcitriol
Gut absorbs less calcium, lower Ca in blood
Drop in Ca tells parathyroid to release PTH
PTH steals Ca from bones to keep blood in balance
Since no calcitriol, glands continue to make PTH
Gland eventually grows so large it's unable to shut off
✔✔Symptoms of Secondary hyperparathyroidism - ✔✔Joint and bone pain
Muscle pain
Weakness that causes trouble walking
Can cause calcium deposits in heart and blood vessels
✔✔Technician role in secondary hyperparathyroidism - ✔✔Listen to symptoms and
report to nurse
Reinforce teachings from nurse de dieticians
Urge pts to take meds and follow diet plan
✔✔(symptoms) pruritus - ✔✔Itching.
Disrupts sleep
, Can reduce quality of life
Raise risk of hospitalization
✔✔neuropathy - ✔✔Nerve damage, peripheral neuropathy is in hands and feet
✔✔Symptoms of neuropathy - ✔✔Burning of hands and feet
Pins and needle feeling
Muscle weakness
Erectile dysfunction
Walking problems
Vitamin b6 helps ease pain
✔✔sleeping problems - ✔✔Common in CKD along with sleep apnea, unclear why.
Nocturnal HD is known to help with these problems because it can help bring back the
normal rhythm of melatonin
✔✔Electrolyte - ✔✔Carry electrical current like a nerve signal
✔✔Sodium - ✔✔Is an electrolyte that helps help water balanced
✔✔Hypernatremia - ✔✔to much sodium, increase thirst, flushed skin,fever, seizures
and death
✔✔Hyponatremia - ✔✔low sodium in the blood, low BP cramps, resltlessness, anxiety,
access pain, headaches and nausea
✔✔Potassium - ✔✔Controls nerves and muscles, also can help with water balance and
the bodies use of glucose
✔✔Lab value for Potassium - ✔✔3.5-5.5 mEq/L
✔✔Foods high in potassium - ✔✔• Avocado
• Bananas
• Cantaloupe
• Carrots
• Fish
• Mushrooms
• Oranges
• Potatoes
• Pork, Beef, Veal
• Raisins
• Spinach
• Strawberries
• Tomatoes