NUR 623 (Adult_Gero Acute) MOD #3, kidney disease part 2, quiz Questions with CORRECT
Answers (Grade A+)
Question 1:
patient with CKD comes in with diffuse bone pain, elevated phosphate, low CA, and elevated PTH.
What is most likely causing his hypocalcemia and hyperparathyroidism?
Answer:
decrease in the activation of vit D - leads to a decrease in calcitriol leads to impaired Ca absorption
-patient will then have low Ca and compensatory high PTH
Question 2:
disorder from CKD from impaired vit D activation by kidneys -leads to hyperphosphatemia,
hypocalcemia, and hyperparathyroidism
Answer:
secondary hyperparathyroidism (SPHT)
Question 3:
why does SPHT happen?
Answer:
impaired vit D activation from kidneys -PTH is released by both low Ca levels and high phosphate
levels
Question 4:
s/s SPHT (signs of hypocalcemia)
Answer:
neuro changes, muscle twitching/spasms, numbness/tingling **hyperphosphatemia by itself does
not have much symptoms
Question 5:
when to check Ca, phosphate, and PTH for CKD patients
Answer:
stage 3- check Ca, and Phosphate every 6 months -stage 4-5 with dialysis- check Ca, phosphate,
and PTH every 3 months
, Question 6:
another lab that may be elevated in hyperparathyroidism
Answer:
alkaline phosphatase
Question 7:
target labs during SPHT
Answer:
PTH: 168-74 Ca: 7.9-9.5 Phosphate: 3.6-5.2
Question 8:
again, with ESRD on dialysis, shoot for a PTH of
Answer:
2-9x normal
Question 9:
good phosphate binding drug that treats SPHT, helps lower phosphate by binding it to GI tract
Answer:
sevelamer (shown decreased mortality) *Lanthanum carbonate, calcium carbonate and ferric
citrate are other options
Question 10:
drugs used to help with the hypocalcemia caused by low calcitriol (active Ca) levels
Answer:
vit D -vit D analogs (Paricalcitol)
Question 11:
only start vit D treatment in CKD patients when they are stage
Answer:
4 and 5
Question 12:
low vit D levels, and how to treat
Answers (Grade A+)
Question 1:
patient with CKD comes in with diffuse bone pain, elevated phosphate, low CA, and elevated PTH.
What is most likely causing his hypocalcemia and hyperparathyroidism?
Answer:
decrease in the activation of vit D - leads to a decrease in calcitriol leads to impaired Ca absorption
-patient will then have low Ca and compensatory high PTH
Question 2:
disorder from CKD from impaired vit D activation by kidneys -leads to hyperphosphatemia,
hypocalcemia, and hyperparathyroidism
Answer:
secondary hyperparathyroidism (SPHT)
Question 3:
why does SPHT happen?
Answer:
impaired vit D activation from kidneys -PTH is released by both low Ca levels and high phosphate
levels
Question 4:
s/s SPHT (signs of hypocalcemia)
Answer:
neuro changes, muscle twitching/spasms, numbness/tingling **hyperphosphatemia by itself does
not have much symptoms
Question 5:
when to check Ca, phosphate, and PTH for CKD patients
Answer:
stage 3- check Ca, and Phosphate every 6 months -stage 4-5 with dialysis- check Ca, phosphate,
and PTH every 3 months
, Question 6:
another lab that may be elevated in hyperparathyroidism
Answer:
alkaline phosphatase
Question 7:
target labs during SPHT
Answer:
PTH: 168-74 Ca: 7.9-9.5 Phosphate: 3.6-5.2
Question 8:
again, with ESRD on dialysis, shoot for a PTH of
Answer:
2-9x normal
Question 9:
good phosphate binding drug that treats SPHT, helps lower phosphate by binding it to GI tract
Answer:
sevelamer (shown decreased mortality) *Lanthanum carbonate, calcium carbonate and ferric
citrate are other options
Question 10:
drugs used to help with the hypocalcemia caused by low calcitriol (active Ca) levels
Answer:
vit D -vit D analogs (Paricalcitol)
Question 11:
only start vit D treatment in CKD patients when they are stage
Answer:
4 and 5
Question 12:
low vit D levels, and how to treat
