NUR 265 Exam 1 m m m
• What is nephrotic syndrome?: A condition of increased glo
m m m m m m m m
merular permeabil- m
mity that allows larger molecules to pass through the membrane into t
m m m m m m m m m m m
he urine andthen be excreted.
m m m m
• What are key features of nephrotic syndrome?: -
m m m m m m m
*Massive proteinuria* m
-*Hypoalbuminemia*
-*Edema (facial and periorbital)*
m m m
-Lipiduria
-Hyperlipidemia
-Increased coagulation m
-Reduced kidney function m m
• In nephrotic syndrome, severe protein loss in the
m m m m m m m
murine is greater thanwhat?: 3.5g in 24 hours
m m m m m m m
• What is nephrotic syndrome treated with?: -
m m m m m m
mimmunosuppressant agents (ifimmunity based). m m m
-ACE inhibitors (decreased protein loss in urine)
m m m m m m
-statins (improve blood lipid levels).
m m m m
-Heparin (used to treat vascular effects and improve kidney function)
m m m m m m m m m
• Describe Prerenal AKI. Give examples.: Decreased
m m m m m
perfusion to kidneys.
m m m
-NSAIDs
-Severe dehydration m
-Renal artery stenosis
m m
-MI or HF resulting in low ejection fraction and low cardiac output
m m m m m m m m m m m
-Blood/ fluid loss m m
,• Describe Intrarenal AKI. Give examples.: Tissue damage
m m m m m m
mto the actual kid-neys.
m m m
-Glomerulonephritis or inflammation of the glomeruli m m m m m
-Sepsis
-Intrarenal bleeding m
-Pyelonephritis
• Describe Postrenal AKI. Give examples.: Obstruction
m m m m m
mthat occurs after thekidney.
m m m
-Enlarged prostate (BPH) m m
-Bladder Cancer m
-Kidney stones m
• How do you determine the mean arterial pressure
m m m m m m m
m(MAP)?: Systolic + (Dias-tolic*2) /3
m m m m
• What is the MAP needed to perfuse the kidneys?: 65
m m m m m m m m m m
mmHg
• What are examples of nephrotoxic drugs?: -NSAIDS
m m m m m m
-Metformin
-Diuretics
-Antibiotics (especially -mycin) m m
-Contrast dye m
• During the diuretic phase of AKI, what needs to be
m m m m m m m m m
mmonitored?: Watch fordehydration and make sure output is
m m m m m m m m
greater than input
m m
• What are the dietary restrictions for an AKI patient?: -
m m m m m m m m m
Low protein
m m
-Low sodium m
,-Fluid restriction: 1000-
m m
1500mL day (for anything except perfusion problem)
m m m m m m
• What are the 2 most common causes of CKD?: -HTN
m m m m m m m m m
-Uncontrolled diabetes m
• What is azotemia?: Nitrogenous waste build up
m m m m m m
• What are manifestations of uremia?: •Metallic taste in
m m m m m m m
mmouth
• Anorexia
• Nausea/vomiting
• Muscle cramps m
• Uremic frost on skin
m m m
• Itching
• Fatigue and lethargy
m m
• Hiccups
• Edema
• Dyspnea
• Paresthesia's
• What effects can CKD have on the cardiac system: -
m m m m m m m m m
mHTN
-Heart failure (major problem. Call the doctor)
m m m m m m
-Pericarditis
• What effects can CKD have on the Integumentary
m m m m m m m m
system: -Uremic frost m m
• What are the dietary restrictions on CKD?: -
m m m m m m m
Protein (restrict early in diseaseprocess to preserve kidney fun
m m m m m m m m
ction)
-Potassium
, -Fluid
-Sodium
• Describe hemodialysis: -3x a week- 4-5 hours
m m m m m m
-At risk for bleeding do to heparin
m m m m m m
-Extremely fatigued post. m m
-Vitals and weight before and after
m m m m m
-Slight fever post is normal. Monitor.
m m m m m
• Describe peritoneal dialysis: - m m m
Sterile procedure at home where catheter isplaced into the abdo
m m m m m m m m m
men
-Wear a mask m m
-
Solution may be warmed using a heating bag or blanket, not microwav
m m m m m m m m m m m
e!
-Make sure patient turns and repositions to mix solution in the cavity
m m m m m m m m m m m
• Describe nursing care for an AV fistula.: - m m m m m m m
Palpate and auscultate- bruit andthrill
m m m m
-Distal pulses m
-ROM- helps form the fistula
m m m m
-Monitor for infection m m
-No heavy lifting or carrying
m m m m
-No pressure
m
-Aneurysm can form at AV fistula sitem m m m m m
• Describe dialysis disequilibrium syndrome: - m m m m
Life threatening! (occurs if fluidis pulled off too fast)
m m m m m m m m
-S/S: restless, headache, decreased LOC, seizures, coma
m m m m m m
-Call a rapid immediately
m m m
-Give barbiturates and anticonvulsants
m m m
• What is nephrotic syndrome?: A condition of increased glo
m m m m m m m m
merular permeabil- m
mity that allows larger molecules to pass through the membrane into t
m m m m m m m m m m m
he urine andthen be excreted.
m m m m
• What are key features of nephrotic syndrome?: -
m m m m m m m
*Massive proteinuria* m
-*Hypoalbuminemia*
-*Edema (facial and periorbital)*
m m m
-Lipiduria
-Hyperlipidemia
-Increased coagulation m
-Reduced kidney function m m
• In nephrotic syndrome, severe protein loss in the
m m m m m m m
murine is greater thanwhat?: 3.5g in 24 hours
m m m m m m m
• What is nephrotic syndrome treated with?: -
m m m m m m
mimmunosuppressant agents (ifimmunity based). m m m
-ACE inhibitors (decreased protein loss in urine)
m m m m m m
-statins (improve blood lipid levels).
m m m m
-Heparin (used to treat vascular effects and improve kidney function)
m m m m m m m m m
• Describe Prerenal AKI. Give examples.: Decreased
m m m m m
perfusion to kidneys.
m m m
-NSAIDs
-Severe dehydration m
-Renal artery stenosis
m m
-MI or HF resulting in low ejection fraction and low cardiac output
m m m m m m m m m m m
-Blood/ fluid loss m m
,• Describe Intrarenal AKI. Give examples.: Tissue damage
m m m m m m
mto the actual kid-neys.
m m m
-Glomerulonephritis or inflammation of the glomeruli m m m m m
-Sepsis
-Intrarenal bleeding m
-Pyelonephritis
• Describe Postrenal AKI. Give examples.: Obstruction
m m m m m
mthat occurs after thekidney.
m m m
-Enlarged prostate (BPH) m m
-Bladder Cancer m
-Kidney stones m
• How do you determine the mean arterial pressure
m m m m m m m
m(MAP)?: Systolic + (Dias-tolic*2) /3
m m m m
• What is the MAP needed to perfuse the kidneys?: 65
m m m m m m m m m m
mmHg
• What are examples of nephrotoxic drugs?: -NSAIDS
m m m m m m
-Metformin
-Diuretics
-Antibiotics (especially -mycin) m m
-Contrast dye m
• During the diuretic phase of AKI, what needs to be
m m m m m m m m m
mmonitored?: Watch fordehydration and make sure output is
m m m m m m m m
greater than input
m m
• What are the dietary restrictions for an AKI patient?: -
m m m m m m m m m
Low protein
m m
-Low sodium m
,-Fluid restriction: 1000-
m m
1500mL day (for anything except perfusion problem)
m m m m m m
• What are the 2 most common causes of CKD?: -HTN
m m m m m m m m m
-Uncontrolled diabetes m
• What is azotemia?: Nitrogenous waste build up
m m m m m m
• What are manifestations of uremia?: •Metallic taste in
m m m m m m m
mmouth
• Anorexia
• Nausea/vomiting
• Muscle cramps m
• Uremic frost on skin
m m m
• Itching
• Fatigue and lethargy
m m
• Hiccups
• Edema
• Dyspnea
• Paresthesia's
• What effects can CKD have on the cardiac system: -
m m m m m m m m m
mHTN
-Heart failure (major problem. Call the doctor)
m m m m m m
-Pericarditis
• What effects can CKD have on the Integumentary
m m m m m m m m
system: -Uremic frost m m
• What are the dietary restrictions on CKD?: -
m m m m m m m
Protein (restrict early in diseaseprocess to preserve kidney fun
m m m m m m m m
ction)
-Potassium
, -Fluid
-Sodium
• Describe hemodialysis: -3x a week- 4-5 hours
m m m m m m
-At risk for bleeding do to heparin
m m m m m m
-Extremely fatigued post. m m
-Vitals and weight before and after
m m m m m
-Slight fever post is normal. Monitor.
m m m m m
• Describe peritoneal dialysis: - m m m
Sterile procedure at home where catheter isplaced into the abdo
m m m m m m m m m
men
-Wear a mask m m
-
Solution may be warmed using a heating bag or blanket, not microwav
m m m m m m m m m m m
e!
-Make sure patient turns and repositions to mix solution in the cavity
m m m m m m m m m m m
• Describe nursing care for an AV fistula.: - m m m m m m m
Palpate and auscultate- bruit andthrill
m m m m
-Distal pulses m
-ROM- helps form the fistula
m m m m
-Monitor for infection m m
-No heavy lifting or carrying
m m m m
-No pressure
m
-Aneurysm can form at AV fistula sitem m m m m m
• Describe dialysis disequilibrium syndrome: - m m m m
Life threatening! (occurs if fluidis pulled off too fast)
m m m m m m m m
-S/S: restless, headache, decreased LOC, seizures, coma
m m m m m m
-Call a rapid immediately
m m m
-Give barbiturates and anticonvulsants
m m m
