Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI): Symptoms, Interventions, and D, Exams of Nursing

Download Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI): Symptoms, Interventions, and D and more Exams Nursing in PDF only on Docsity!

NURS 309 Renal 3 Questions With Complete Solutions How does hemodialysis work? Correct Answers Concentrations are leaked from a higher concentration to a lower concentration. Dialysate fluid contains water and electrolytes that are used to pull waste from blood What are some cardiac conditions of CKD? Correct Answers HTN , due to increase of RAAS Hyperlipidemia Heart failure Pericarditis What are some cardiovascular changes related to CKD? Correct Answers HTN, HF, Edema and cardiac tamponade What are some causes of CKDs? Correct Answers DM Glomerulonephritis UTI Vascular and tubular disorders What are some causes of intra-renal failure? Correct Answers Glomerulonephritis Bleeding in kidney Lupus What are some causes of post-renal failure? Correct Answers Bladder cancer Prostate cancer Stones Nerve damage

What are some causes to pre-renal failure? Correct Answers Blood loss Blood pressure meds Liver failure Burns and dehydration What are some cognitive changes in a patient with CKD? Correct Answers Progressively gets worse with disease development What are some complications of hemodialysis? Correct Answers Assess dialysis site place heparin solution after treatment What are some drugs that can be toxic to the kidney? Correct Answers NSAIDs Anti-biotics Chemo drugs What are some GI changes of CKD? Correct Answers Uremia, which can be shown with hiccups, N/V, anorexia , and peptic ulceration What are some GI signs and symptoms of CKD? Correct Answers Anorexia N/V Constipation What are some health maintenance and promotion for acute kidney injuries? Correct Answers Maintaining fluid of 2-3 L

Evaluate patients fluid levels (I and O) Correct problems early What are some hematological changes of CKD? Correct Answers Anemia, WBC reduction due to uremia What are some hematological conditions of CKD? Correct Answers Anemia Abnormal bleeding Risk of infection What are some history assessments for acute kidney injury? Correct Answers Any changes in urine Recent surgeries or trauma Drug history Past or current medical history (infections) What are some history questions to ask a patient regarding CKD? Correct Answers Ask about drug history, kidney conditions, and urinary habits Assess dietary routine What are some imaging techniques for someone with acute kidney injury? Correct Answers Ultrasonography CT scans without contrast X-rays (KUB) Kidney biopsy What are some interventions for bleeding at a fistula? Correct Answers Apply pressure to the needle sites

What are some interventions to CKD? Correct Answers Providing fluids and preventing fluid overload complications. term- Monitoring patients weight daily Assess pulses Assess JVD and lung sounds Fluid restrictions if necessary What are some interventions to enhance diet for CKD? Correct Answers Changes include sodium, fluid intake, potassium, and phosphorus. Protein restriction is done for prevent further kidney damage What are some interventions to help with fatigue in patients with CKD? Correct Answers Avoid giving needed vitamins before dialysis Watch for blood pressure rises What are some interventions to increase cardiac function for a patient with CKD? Correct Answers Controlling HTN is vital Use of ace inhibitors and diuretics to control blood pressure What are some interventions to prevent infection in a patient with CKD? Correct Answers Assess vital signs for infection Take care of the open sites on the body What are some interventions to prevent injury in a patient with CKD? Correct Answers Take extra time moving them, and move carefully Assess joints for movement and bumps or lumps on bones

What are some interventions to prevent pulmonary edema? Correct Answers Assess O2 saturations, restlessness Assess for crackles, cyanosis and frothy sputum What are some medications used to help with acute kidney injury? Correct Answers Cardioglycides (HF and renal failure) Vitamins Synthetic ETP (due to failure) Phosphate binders What are some Muscle changes of CKD? Correct Answers Cramping, bone pain, fractures What are some neurological symptoms of CKD? Correct Answers Lethargy Seizures coma Ataxia Numbness and tingling What are some nutritional therapies for acute kidney injury? Correct Answers Working with dietitian Food is lowered in certain contents but maintains other calories are maintained What are some physical assessments for someone with acute kidney injury? Correct Answers Assess I and O, with characteristics Azotemia Fluid overload, JVD and Crackles in lungs Confusion

What are some post-dialysis symptoms? Correct Answers Dizziness, hypotension, headache, N/V What are some precautions for the use dialysis? Correct Answers Assess for infections Avoid BPs Avoid blood draws What are some psychosocial assessments to conduct with CKD patients? Correct Answers Assess patients understanding of condition Identify their coping styles Feelings of anxiety or fear What are some respiratory changes related to CKD? Correct Answers Tachypnea Kussmauls respirations Crackles What are some signs and symptoms of dialysis disquilibrium? Correct Answers N/V, headache, fatigue, restlessness What are some signs and symptoms of uremia? Correct Answers metallic taste in the mouth Nausea Muscle cramps Itching Bad breath What are some symptoms of CKD? Correct Answers Polyuria, oliguria, hematuria

What are some symptoms of skin changes in CKD? Correct Answers Decreased turgor dry skin Itching Uremic frost What are the sodium changes that can occur with CKD? Correct Answers In the early stages, the kidneys will not longer absorb sodium and leave dilute urine In later stages, the kidneys will reduce urine output and have more concentrated sodium within the body What are the two most common diseases contracted from long term dialysis? Correct Answers Hepatitis and HIV What can polyuria be a sign of in acute kidney injury? Correct Answers Recovery period What causes acute kidney injury? Correct Answers Reduction in blood supply to the kidney Obstruction or urine flow What does CKD eventually lead to? Correct Answers End stage renal disease What food type leads to increased BUN and creatinine? Correct Answers Protein

What is a dialyzable drug? Correct Answers This is a drug that can be removed from the system from dialysis and should not be given prior to dialysis What is acute kidney injury? Correct Answers Acute kidney injury is defined as the abrupt loss of kidney function over hours to days What is an AV fistula? Correct Answers Surgically connecting an artery and vein, in which after maturation, the fistula can be used as a normal artery and vein combo to hold pressure What is an outcome for patients undergoing a contrast dye therapy? Correct Answers Urine output of 150 ml within 6 hours of administration What is automated peritoneal dialysis? Correct Answers -uses a cycling machine for dialysate inflow, dwell and outflow according to preset times/volumes -typical prescription is 30-minute exchanges for 8-10 hours What is chronic kidney disease? Correct Answers progressive, irreversible loss of kidney function What is continuous ambulatory peritoneal dialysis? Correct Answers Done while patient is awake during the day, done manually by exchanging 1.5 to 3 L of peritoneal dialysate at least 4x a day What is continuous kidney replacement therapy? Correct Answers Hemofiltration

Used in patients that are not suitable for fluctuating conditions. Most commonly presented in ICU due to assessment of machines and electrolytes What is dialysis disequilibrium syndrome? Correct Answers A change in body systems due to rapid change in fluid and electrolytes what is disconnect the disconnect peritoneal dialysis? Correct Answers Allows the patient to disconnect after infusion to allow for drainage at a different time frame What is important regarding drug therapy to patients with CKD? Correct Answers Monitor the drug effects and if the patient will need to have the dose changed accordingly Avoid magnesium antacids Caution in opioid usage What is intermittent kidney replacement? Correct Answers Hemodialysis This is the mixture of dialysate fluid, which is used to help reduce the amount of waste in the blood What is intra-renal failure? Correct Answers Direct damage due to inflammation, toxins, drugs, or infection What is manifested by end stage renal disease? Correct Answers Azotemia (build up of waste) Uremia and uremic syndrome

What is peritoneal dialysis? Correct Answers Use the peritoneal membrane as a filter. Dialysate is warmed and infused into the peritoneal cavity by gravity via a Tenckhoff catheter. The fluid fills the peritoneal cavity and remains in the peritoneal cavity for a prescribed amount of time. This is called the swell time. Then the bag is lowered and the fluid, along with the toxins are drained. This is called the exchange. What is post-renal failure? Correct Answers Obstruction of urine flow by stones, bladder trauma, and BPH What is pre-renal failure? Correct Answers This is caused by a condition that may lead to the decreased perfusion of blood to the kidneys What is renal osteodystrophy? Correct Answers bone lesions due to secondary or tertiary hyperparathyroidism due in turn to renal disease What is renal replacement therapy? Correct Answers Dialysis that is used for patients that are no longer ale to filter their own blood, and is used to remove waste products What is stage 1 acute kidney injury? Correct Answers Increased creatinine by 1.5-1.9 baseline, 0.5 ml/kg What is stage 1 CKD? Correct Answers greater than 90 mls of output per minute At risk from HTN, DM and family history

What is stage 2 acute kidney injury? Correct Answers creatinine: increase of 2-fold from baseline urine output: <0.5ml/kg/h for 12 hours What is stage 2 CKD? Correct Answers 60-89 mls that is reduced kidney function What is stage 3 acute kidney injury? Correct Answers creatinine: increase of 3-fold from baseline or creatinine >4. with an acute rise of >0. urine output: <0.5ml/kg/h for 24 hours or anuria for 12 hours What is stage 3 CKD? Correct Answers Moderate decrease, interventions to slow progress 30-59 mls/min What is stage 4 CKD? Correct Answers Severe CKD, manage complications, educate on the dialysis GFR is 15-29 mls/min What is stage 5 CKD? Correct Answers ESRD Less than 15 mls/min Kidney transplant or dialysis What is the acid base change in CKD? Correct Answers The kidneys are not able to filter out hydrogen anymore, leading to retention of the hydrogen and reduction of bicarbonate

What is the difference between acute kidney injury and chronic kidney disease? Correct Answers Acute is fast, chronic is gradual Acute can be cured with return to baseline with no change Chronic kidney disease leads to permanent damage leading to renal failure What is the diuretic phase of kidney injury? Correct Answers Increase in GFR Hypo Na and K Gradual decline in BUN and creatinine What is the olguric phase of kidney injury? Correct Answers Decrease in GFR Hyperkalemia Fluid overload Elevated BUN and creatinine What is the potassium changes from CKD? Correct Answers Any boost in potassium can lead to a hyperkalemia What is the recovery phase of acute kidney injury marked by? Correct Answers Stable BUN and creatinine with kidney function What is the red and blue port used for in dialysis? Correct Answers One lumen is used for inflow, while the other is used for outflow What percent of nephrons are in use with acute kidney injury? Correct Answers 50-95%

What percent of nephrons are used in chronic kidney disease? Correct Answers Can vary usually 75%-90% loss of function requires dialysis What test is best to test kidney function, but not to diagnose acute/chronic kidney problems? Correct Answers Glomerular filtration rate Which labs are used to show acute kidney injury? Correct Answers There will be an increase of creatinine by 0.3 over 48 hours, less urine output Who is most likely to experience an acute kidney problem? Correct Answers Older adults, pre-existing conditions, and hypotension Who is suitable for hemodialysis? Correct Answers Severe acidosis Fluid overload not helped with diuretic Hyperkalemia with ecg changes Toxin ingestion Most commonly used for patients with uremic symptoms