NSG 4100 Exam 1 Review
in the progression of CKD, ESKD is the
What does ESKD meaning have to do
final stage where kidneys are no longer
with the pathway of CKD?
functioning adequately to support life.
- pruritus
- anemia (low H&H)
- uremic frost
S/S of ESKD
- edema
- anorexia
- asterixis
ACE inhibitors, CCB's, thiazides -> HTN
erythropoietin
Phos binders
Doctors order for ESKD
dialysis
Vit B C
Pepcid - NO ANTACIDS
assess FV Q4h
DW & I/O
nursing interventions for ESKD monitor electrolytes
DIET: high calorie + Ca (not from dairy);
Restrict protein, Na, K, Phos
Metabolic acidosis
expected ABG for ESKD - low pH (>7.35)
- low HCO3 (>22)
high Na (135-145)
high K (3.5-5)
ESKD electrolytes
high Phos (2-4.5)
Low Ca (9-10.5)
notify Dr
interventions for ESKD pt with hyper-
continuous ECG
kalemia
kayexalate
- diet teaching (high calorie & Ca; low
protein, Na, K, & Phos
ESKD teaching - drink plenty fluids to avoid constipation
+ stool softeners
- pepcid only for indigestion
ESKD nutrition
1/8
, NSG 4100 Exam 1 Review
increase calories & Ca but not from dairy
products
protein restriction 1.2g/kg/day
low Phos & Na
Low K - NO milk, bananas, potatoes,
cantaloupes, avocadoes
build up of waste products in the blood
what is uremia?
d/t poor excretion
altered LOC
metallic taste in mouth
s/s of uremia uremic frost
bruising
pericardial friction = EMERGENCY
what would you prepare for if a pt pre-
dialysis
sents with uremic pericarditis?
pt returns from HD with low BP, what Dialysis Disequilibrium Syndrome
does this indicate? hypovolemia
continuous renal replacement therapy
What is CRRT and why use it compared that occurs for 24 hours continuously
to HD? pulls slower & more gently for critically ill
or hemodynamically unstable pts.
whats the difference between continu-
CVVHD uses dialysate, more agressive
ous venovenous hemodialysis (CVVHD)
CVVH does NOT use dialysate, uses
and continuous venovenous hemofiltra-
smaller blood pump, nad better tolerated
tion (CVVH)?
- monitor for infection ( fever, pain, tachy-
cardia)
- monitor for rejection (edema, fever,
post-op Kidney transplant teaching HTN, weight gain)
- take immunosupressants for life (cy-
closporine & tacrolimus)
- corticosteroid tx
what is done with the old kidney after a
old kidney is NOT removed, left in pts
transplant assuming there was not poly-
body
cystic kidney disease present?
2/8
in the progression of CKD, ESKD is the
What does ESKD meaning have to do
final stage where kidneys are no longer
with the pathway of CKD?
functioning adequately to support life.
- pruritus
- anemia (low H&H)
- uremic frost
S/S of ESKD
- edema
- anorexia
- asterixis
ACE inhibitors, CCB's, thiazides -> HTN
erythropoietin
Phos binders
Doctors order for ESKD
dialysis
Vit B C
Pepcid - NO ANTACIDS
assess FV Q4h
DW & I/O
nursing interventions for ESKD monitor electrolytes
DIET: high calorie + Ca (not from dairy);
Restrict protein, Na, K, Phos
Metabolic acidosis
expected ABG for ESKD - low pH (>7.35)
- low HCO3 (>22)
high Na (135-145)
high K (3.5-5)
ESKD electrolytes
high Phos (2-4.5)
Low Ca (9-10.5)
notify Dr
interventions for ESKD pt with hyper-
continuous ECG
kalemia
kayexalate
- diet teaching (high calorie & Ca; low
protein, Na, K, & Phos
ESKD teaching - drink plenty fluids to avoid constipation
+ stool softeners
- pepcid only for indigestion
ESKD nutrition
1/8
, NSG 4100 Exam 1 Review
increase calories & Ca but not from dairy
products
protein restriction 1.2g/kg/day
low Phos & Na
Low K - NO milk, bananas, potatoes,
cantaloupes, avocadoes
build up of waste products in the blood
what is uremia?
d/t poor excretion
altered LOC
metallic taste in mouth
s/s of uremia uremic frost
bruising
pericardial friction = EMERGENCY
what would you prepare for if a pt pre-
dialysis
sents with uremic pericarditis?
pt returns from HD with low BP, what Dialysis Disequilibrium Syndrome
does this indicate? hypovolemia
continuous renal replacement therapy
What is CRRT and why use it compared that occurs for 24 hours continuously
to HD? pulls slower & more gently for critically ill
or hemodynamically unstable pts.
whats the difference between continu-
CVVHD uses dialysate, more agressive
ous venovenous hemodialysis (CVVHD)
CVVH does NOT use dialysate, uses
and continuous venovenous hemofiltra-
smaller blood pump, nad better tolerated
tion (CVVH)?
- monitor for infection ( fever, pain, tachy-
cardia)
- monitor for rejection (edema, fever,
post-op Kidney transplant teaching HTN, weight gain)
- take immunosupressants for life (cy-
closporine & tacrolimus)
- corticosteroid tx
what is done with the old kidney after a
old kidney is NOT removed, left in pts
transplant assuming there was not poly-
body
cystic kidney disease present?
2/8
