Manifestations of
Ø Hyponatremia:
Ø Hypernatremia:
Ø Hypokalemia:
Ø Hyperkalemia:
Give this one a try later!
, Ø Hyponatremia:
§ S/Sx: nausea, malaise, lethargy, headache, abdominal cramps,
apprehension, seizures
§ Management: diet, normal or hypertonic saline
Ø Hypernatremia:
§ S/Sx: Dry sticky mucus membranes, thirst, fever, restlessness,
disorientation
§ Management: fluids, diuretic agents
Ø Hypokalemia:
§ S/Sx: Anorexia, abdominal distension, paralytic ileus, muscle weakness,
ECG changes, arrhythmias
§ Management: diet, potassium replacement
Ø Hyperkalemia:
§ S/Sx: Diarrhea, colic, nausea, irritability, muscle weakness, ECG changes
§ Management: diet, IV glucose, insulin, calcium gluconate, dialysis
Types of peritoneal dialysis
§ Acute intermittent timing
§ Continuous ambulatory (CAPD):
§ Continuous cyclic:
Complications:
Give this one a try later!
§ Acute intermittent: 6ish times per day at home
§ Continuous ambulatory (CAPD): patients do own exchanges 4 -6 times
per day
§ Continuous cyclic: cycles overnight, fewer exchanges during day. M
Complications: peritonitis (cloudy fluid), leakage, bleeding
Patient education for prevention of kidney stones
Give this one a try later!
, § Avoid protein intake to decrease urinary excretion fo Ca and uric acid
§ Limit Na intake but not necessarily calcium unless true hypercalciuria
§ Drink water every 1 - 2 hours during day and 1 glass of cranberry juice
§ Drink 2 glasses of water at bedtime and one glas at each nighttime
awakening to prevent urine concentration
§ Avoid excessive hot temperatures that cause excessive sweating
§ Contact provider at signs of UTI
Ø End-Stage Kidney Disease (ESKD, ESRD)
§ Patho and Stage 5: renal function declines, kidney cannot concentrate or dilute the
urine -> uremia and waste product buildup. Affects every system relative to waste
buildup.
§ Diagnostic findings:
· GFR: decreased GFR and Cr clearance
· Na/H20 retention: Na and H2O retention with anemia
· Acidosis: due to buildup of ammonia chloride and Po with reduced bicarb
reabsorption
· Ca & Po imbalance: increased serum phosphate with reciprocal decreased serum
calcium associated with reduced active vitamin D -> bone disease
· Anemia: inadequate erythropoietin and shortened RBC lifespan
§ Assessment: fluid status, nutrition, activity, psychosocial. Body systems- neurologic
(mental status), integumentary, cardiovascular, pulmonary, gastrointestinal,
hematologic, reproductive (amenorrhea), musculoskeletal (spasms, fractures),
Give this one a try later!
Ø End-Stage Kidney Disease (ESKD, ESRD)
§ Patho and Stage 5: renal function declines, kidney cannot concentrate or
dilute the urine -> uremia and waste product buildup. Affects every system
relative to waste buildup.
§ Diagnostic findings:
· GFR: decreased GFR and Cr clearance
· Na/H20 retention: Na and H2O retention with anemia
· Acidosis: due to buildup of ammonia chloride and Po with reduced bicarb
reabsorption
· Ca & Po imbalance: increased serum phosphate with reciprocal
decreased serum calcium associated with reduced active vitamin D -> bone
Ø Hyponatremia:
Ø Hypernatremia:
Ø Hypokalemia:
Ø Hyperkalemia:
Give this one a try later!
, Ø Hyponatremia:
§ S/Sx: nausea, malaise, lethargy, headache, abdominal cramps,
apprehension, seizures
§ Management: diet, normal or hypertonic saline
Ø Hypernatremia:
§ S/Sx: Dry sticky mucus membranes, thirst, fever, restlessness,
disorientation
§ Management: fluids, diuretic agents
Ø Hypokalemia:
§ S/Sx: Anorexia, abdominal distension, paralytic ileus, muscle weakness,
ECG changes, arrhythmias
§ Management: diet, potassium replacement
Ø Hyperkalemia:
§ S/Sx: Diarrhea, colic, nausea, irritability, muscle weakness, ECG changes
§ Management: diet, IV glucose, insulin, calcium gluconate, dialysis
Types of peritoneal dialysis
§ Acute intermittent timing
§ Continuous ambulatory (CAPD):
§ Continuous cyclic:
Complications:
Give this one a try later!
§ Acute intermittent: 6ish times per day at home
§ Continuous ambulatory (CAPD): patients do own exchanges 4 -6 times
per day
§ Continuous cyclic: cycles overnight, fewer exchanges during day. M
Complications: peritonitis (cloudy fluid), leakage, bleeding
Patient education for prevention of kidney stones
Give this one a try later!
, § Avoid protein intake to decrease urinary excretion fo Ca and uric acid
§ Limit Na intake but not necessarily calcium unless true hypercalciuria
§ Drink water every 1 - 2 hours during day and 1 glass of cranberry juice
§ Drink 2 glasses of water at bedtime and one glas at each nighttime
awakening to prevent urine concentration
§ Avoid excessive hot temperatures that cause excessive sweating
§ Contact provider at signs of UTI
Ø End-Stage Kidney Disease (ESKD, ESRD)
§ Patho and Stage 5: renal function declines, kidney cannot concentrate or dilute the
urine -> uremia and waste product buildup. Affects every system relative to waste
buildup.
§ Diagnostic findings:
· GFR: decreased GFR and Cr clearance
· Na/H20 retention: Na and H2O retention with anemia
· Acidosis: due to buildup of ammonia chloride and Po with reduced bicarb
reabsorption
· Ca & Po imbalance: increased serum phosphate with reciprocal decreased serum
calcium associated with reduced active vitamin D -> bone disease
· Anemia: inadequate erythropoietin and shortened RBC lifespan
§ Assessment: fluid status, nutrition, activity, psychosocial. Body systems- neurologic
(mental status), integumentary, cardiovascular, pulmonary, gastrointestinal,
hematologic, reproductive (amenorrhea), musculoskeletal (spasms, fractures),
Give this one a try later!
Ø End-Stage Kidney Disease (ESKD, ESRD)
§ Patho and Stage 5: renal function declines, kidney cannot concentrate or
dilute the urine -> uremia and waste product buildup. Affects every system
relative to waste buildup.
§ Diagnostic findings:
· GFR: decreased GFR and Cr clearance
· Na/H20 retention: Na and H2O retention with anemia
· Acidosis: due to buildup of ammonia chloride and Po with reduced bicarb
reabsorption
· Ca & Po imbalance: increased serum phosphate with reciprocal
decreased serum calcium associated with reduced active vitamin D -> bone
