NUR 265 Exam 1

NUR 265 Exam 1 - What is nephrotic syndrome? A condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted. - What are key features of nephrotic syndrome? - Massive proteinuria -Hypoalbuminemia -Edema (facial and periorbital) -Lipiduria -Hyperlipidemia -Increased coagulation -Reduced kidney function - In nephrotic syndrome, severe protein loss in the urine is greater than what? 3.5g in 24 hours - What is nephrotic syndrome treated with? -immunosuppressant agents (if immunity based). -ACE inhibitors (decreased protein loss in urine) -statins (improve blood lipid levels). -Heparin (used to treat vascular effects and improve kidney function) - Describe Prerenal AKI. Give examples. Decreased perfusion to kidneys. -NSAIDs -Severe dehydration -Renal artery stenosis -MI or HF resulting in low ejection fraction and low cardiac output -Blood/ fluid loss - Describe Intrarenal AKI. Give examples. Tissue damage to the actual kidneys. -Glomerulonephritis or inflammation of the glomeruli -Sepsis -Intrarenal bleeding -Pyelonephritis - Describe Postrenal AKI. Give examples. Obstruction that occurs after the kidney. -Enlarged prostate (BPH) -Bladder Cancer -Kidney stones - How do you determine the mean arterial pressure (MAP)? Systolic + (Diastolic*2) /3 - What is the MAP needed to perfuse the kidneys? 65 mmHg - What are examples of nephrotoxic drugs? -NSAIDS -Metformin -Diuretics -Antibiotics (especially -mycin) -Contrast dye - During the diuretic phase of AKI, what needs to be monitored? Watch for dehydration and make sure output is greater than input - What are the dietary restrictions for an AKI patient? -Low protein -Low sodium -Fluid restriction: 1000 -1500mL day (for anything except perfusion problem) - What are the 2 most common causes of CKD? -HTN -Uncontrolled diabetes - What is azotemia? Nitrogenous waste build up - What are manifestations of uremia? •Metallic taste in mouth •Anorexia •Nausea/vomiting •Muscle cramps •Uremic frost on skin •Itching •Fatigue and lethargy •Hiccups •Edema •Dyspnea •Paresthesia's - What effects can CKD have on the cardiac system -HTN -Heart failure (major problem. Call the doctor) -Pericarditis - What effects can CKD have on the Integumentary system -Uremic frost - What are the dietary restrictions on CKD? -Protein (restrict early in disease process to preserve kidney function) -Potassium -Fluid -Sodium - Describe hemodialysis -3x a week - 4-5 hours -At risk for bleeding do to heparin -Extremely fatigued post. -Vitals and weight before and after -Slight fever post is normal. Monitor. - Describe peritoneal dialysis -Sterile procedure at home where catheter is placed into the abdomen -Wear a mask -Solution may be warmed using a heating bag or blanket, not microwave! -Make sure patient turns and repositions to mix solution in the cavity - Describe nursing care for an AV fistula.