Fall 2025 NUR 265 Exam 1 Review 1 of 5
I. KIDNEYS
• functions(filter, make urine, regulate BP, process meds, erythropoietin, electrolytes, ABG balance specifically
metabolic acidosis)
What do we want the kidneys to keep vs. toss?
KEEP TOSS
• Protein • Urea
• Glucose • Ammonia
• RBC’s • K+
• WBC’s
A. Acute Kidney Injury
1. GFR >90
2. Creatinine 1.0
3. BUN 10-20(Cr is PRIORITY for ACUTE)
3 Causes
Pre-renal Intra-Renal Post-renal
• Heart failure(any heart issue) • NSAIDs • Tumors
• Dehydration(vomitting/diarrhea) • Metformin • Enlarged prostate
• Hypovolemia • Contrast dye • Stones
• Hemorrhage/burns • Tylenol
• NG suctioning • Aminoglycosides
• Sepsis • Myoglobinuria
• Asthma • Acute polynephritis
• Diabetes
• Head injury
• Smoking
B. Chronic Kidney Injury
1. look at GFR for CHRONIC
a) the BUN or Cr will typically always be off because it’s CHRONIC
b) Muscle cramping, uremic frost on skin
2. Dietary Guidlines for CKD
a) Limit Na, K+, protein, fluids
, Fall 2025 NUR 265 Exam 1 Review 2 of 5
b) No Mrs. Dash(contains a lot of K+)
c) Avoid milk & shrimp(high in phosphorus)
C. Hemodialysis:
1. Monitor for low BP post dialysis
2. Check cap refill, distal pulses to fistula/graft site
3. “Feel the thrill, hear the bruit”
4. Cramping in legs, thirsty are normal after
5. If patient has a temp post dialysis, this is OK d/t warmed fluid during dialysis
6. If BP goes up accompanied by headache/n/v: dialysis disequilibrium syndrome
D. Peritoneal Dialysis:
1. Infection risk, STERILE dressing change
2. Notify provider if output is anything other than CLEAR
3. Admin enema/stool softener before
4. NOT ON A PROTEIN RESTRICTED DIET
5. Warm dialysate prior to admin., NO MICROWAVES
6. If not draining, reposition patient(3 parts: instill, dwell, drain)
7. Assess for crackles, temp, tachycardia, dyspnea(fluid overload)
8. May not be a candidate if prior hx of and surgery/presence of adhesions d/t dialysate not being able to flow
past scar tissue
II. LIVER
A. Cirrhosis(scarrosis)
1. If patient develops hematemesis d/t esophageal varicose, notify MD for poss. Endoscopy, may have Upper
GI bleed
a) If + for esophageal varicose, NO NGT
I. KIDNEYS
• functions(filter, make urine, regulate BP, process meds, erythropoietin, electrolytes, ABG balance specifically
metabolic acidosis)
What do we want the kidneys to keep vs. toss?
KEEP TOSS
• Protein • Urea
• Glucose • Ammonia
• RBC’s • K+
• WBC’s
A. Acute Kidney Injury
1. GFR >90
2. Creatinine 1.0
3. BUN 10-20(Cr is PRIORITY for ACUTE)
3 Causes
Pre-renal Intra-Renal Post-renal
• Heart failure(any heart issue) • NSAIDs • Tumors
• Dehydration(vomitting/diarrhea) • Metformin • Enlarged prostate
• Hypovolemia • Contrast dye • Stones
• Hemorrhage/burns • Tylenol
• NG suctioning • Aminoglycosides
• Sepsis • Myoglobinuria
• Asthma • Acute polynephritis
• Diabetes
• Head injury
• Smoking
B. Chronic Kidney Injury
1. look at GFR for CHRONIC
a) the BUN or Cr will typically always be off because it’s CHRONIC
b) Muscle cramping, uremic frost on skin
2. Dietary Guidlines for CKD
a) Limit Na, K+, protein, fluids
, Fall 2025 NUR 265 Exam 1 Review 2 of 5
b) No Mrs. Dash(contains a lot of K+)
c) Avoid milk & shrimp(high in phosphorus)
C. Hemodialysis:
1. Monitor for low BP post dialysis
2. Check cap refill, distal pulses to fistula/graft site
3. “Feel the thrill, hear the bruit”
4. Cramping in legs, thirsty are normal after
5. If patient has a temp post dialysis, this is OK d/t warmed fluid during dialysis
6. If BP goes up accompanied by headache/n/v: dialysis disequilibrium syndrome
D. Peritoneal Dialysis:
1. Infection risk, STERILE dressing change
2. Notify provider if output is anything other than CLEAR
3. Admin enema/stool softener before
4. NOT ON A PROTEIN RESTRICTED DIET
5. Warm dialysate prior to admin., NO MICROWAVES
6. If not draining, reposition patient(3 parts: instill, dwell, drain)
7. Assess for crackles, temp, tachycardia, dyspnea(fluid overload)
8. May not be a candidate if prior hx of and surgery/presence of adhesions d/t dialysate not being able to flow
past scar tissue
II. LIVER
A. Cirrhosis(scarrosis)
1. If patient develops hematemesis d/t esophageal varicose, notify MD for poss. Endoscopy, may have Upper
GI bleed
a) If + for esophageal varicose, NO NGT
