FCCN Renal Concepts exam with complete verified solutions

Effects of renal disease: Anemia of CKD d/t decreased erythropoietin production -may have iron deficiency/ blood loss Effects of renal disease: bone/mineral disorders abnormalities in Ca, Ph, PTH, and vitamin D metabolism can lead to bone disorders -weakened bones, increased fall risk Treatment options for kidney failure Hemodialysis Periotneal Dialysis Cont Renal Replacement Therapy Kidney Transplant No treatment Hemodialysis Fluid removal (*Ultrafiltration) and waste removal; electrolyte correction (BUN, creatinine, electrolytes, phosphorus, bicarbonate, dextrose) Diffusion: the process of wastes and electrolytes removed during dialysis -through patient's blood Peritoneal dialysis Fluid and waste removal -through the peritoneal membrane that lines the abdominal cavity Home treatment performed daily Best time to give patient blood transfusion during dialysis CRRT Aim: 24 hours/day blood purification therapy ICU only (fewer hemodynamic changes vs. conventional HD, fluid removal over longer period of time (24 hours vs. 3-4 hours), less instability of electrolyte and acid-base balances, continuous toxin removal) Kidney Transplant Treatment of choice for many patients, especially children (don't need dialysis longterm) Not a cure (rejection, infection risk, issues of adherence to transplant meds, original disease returns) Thorough transplant eval (no active malignancy, functioning bladder, adequate cardiac func, no active infect) adherence + financial resources for anti rejection meds can be barriers post transplant No treatment multiple compiccations and co morbidities are often he reason patients stop Death occurs within days to weeks, depending on electrolyte and waste status Access care and assessment Fistula and Graft Listen to Bruit (swooshing sound) and feel for thrill (gentle pulling sensation) each assessment Observe for redness, bleeding or swelling; after HD remove band aids over needle sites the next day Restricted access- no blood pressures, art lines, IVs or lab draws on access arm. Use restricted access armband to communicate this Access care and assessment Hemodialysis Catheters Sterile site care with Biopatch