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NURS 112- Unit Six (Part 3)

Terms in this set (62)

A GFR < 15 indicates ...
dialysis
The normal GFR range is...
120-125 mL/min
A patient is put on dialysis with...

(AKI/CKI)
Chronic Kidney Injury (CKI)
Most patients with CKD die from what disease?
Cardiovascular disease
What will the GFR of a CKI patient look like?
< 60 mL/minute
Oliguria is a indicator for (AKI/CKI).
AKI
What is CRUCIAL to control with CKI patients?
blood pressure
ESRD has a GFR of
< 15 mL/minute
_______ are hard to teach a patient to do, but are crucial after surgery/for incontinence.
Kegels
Caffeine increase the ...
urgency to urinate
What medication takes up to 6 months to work, and a female should not handle it?
Proscar (Finasteride)
True/False:

Flomax works immediately.
True
In what circumstance is a Coude Catheter mostly used?
for a male with an enlarged prostate (BPH)
What is the most common form of urinary diversion?
Suprapubic catheters
With suprapubic catheters, what is crucial to provide?
meticulous care
neurogenic bladder
damage to the nerve that controls the bladder

(due to reinsertion of catheter every 3-5 hours for residual urine; ensuring an empty bladder)
What should you ALWAYS check prior to a patient's progression of diet?
bowel sounds
After a nephrectomy, it is important to monitor for a ________________ ____________ , and check for bowel sounds (esp. prior to diet progression).
paralytic ileus
Urine output should be how many mL/kg/hr?
0.5
Tetracyclines are known to be ___________________ drugs.
nephrotoxic
With hyponatremia, monitor for what in your patient?
seizures, and cerebral edema
How do you treat hyperkalemia?
- *Sodium bicarbonate
- *Calcium Gluconate
- Kayexalate (Sodium Polystyrene Sulfonate)
- *Regular Insulin
Limit protein in patients with (AKI/CKI).
AKI
AKI patients should limit protein and sodium, but increase calories from ?
carbohydrates and fats
Hyperkalemia can cause fatal .....
cardiac arrhythmias
Dialysis inside of the body is called...
Peritoneal Dialysis (PD)
Dialysis outside of the body is called...
Hemodialysis (HD)
The biggest complication with peritoneal dialysis is ?
Peritonitis; exit site or tunnel infection
PD patients need (more/less) protein intake.
more
A dry weight tells the nurse...
if the patient is holding onto any fluid
PD is found where on a patient's body?
in the abdomen
Rapid flow access by the leg, arm, graph, or fistula is known as (PD/HD).
HD (hemodialysis)
The vein and artery becoming one in order for HD to occur is called a...
fistula
What is CRUCIAL to not do with a fistula/graph?
DO NOT put pressure on the site.
Always feel a _____ first before you can insert anything for hemodialysis.
bruit
What is added to prevent clotting ONLY with HD?
Heparin
Main complication of HD is ?
hypotension
True/False

When inserting a graph for HD, you can access it as soon as it is positioned properly.
False; adequate wound healing must be present before the site can be accessed for HD.
Renagel is a ________________ ___________ used to prevent ___________________ in CKI patients.
phosphate binder; hypocalcemia
What things should the nurse monitor to determine if a patient is holding onto any fluid?
- Catheter patency
- Color/Consistency of urine
- Daily (dry) weights
What will labs of a AKI patient look like?
- > CREATININE
- > K
- > BUN
<. - Urine Output
Pre-Renal stage occur _______ injury gets to the kidneys.
before
Patients in the Pre-Renal stage show signs of...
hypovolemia (dehydration)

- decrease blood flow to the kidneys
- decreased renal perfusion
The Intrarenal stage is inside damaging the kidney and is caused by:
- Acute tubular necrosis
- Nephrotoxic drugs
(Tetras)
Post- Renal stage means an obstruction has occurred, stopping flow of the urine. This could be caused by:
kidney stones, BPH, and tumors
Pre-Renal stage affects the...
heart
Intrarenal stage affects the...
kidneys
Post-Renal stage affects the...
bladder, ureters
Monitor baseline vitals, looking for hypotension for what reason?
Hypotension is indicative of AKI.
Reasons why a cystoscopy is schedule:
- too big
- obstructing
- not getting comfortable (unrelieved pain)
What can be done besides a cystoscopy that uses electric currnets?
Lithotripsy
Complications for both cystoscopy and lithotripsy include:
- blood in the urine (hematuria)
- colic pain
What is the primary cause of CKD?
-Diabetes
Labs of a CKD patient looks like:
- > BUN
- > Creatinine
- > K
< - Hg
< - Hct
< - Ca
Azotemia is the...
buildup of urea or other nitrogenous wastes
With Metabolic acidosis (CKD), what will the patient's breathing look like?
Kussmaul's (rapid/deep breathing)

- trying to get CO2 out
If a patient has a K of 6.0 with signs of fluid retention and pitting edema, what would be administered via IV?
- Insulin (with Dextrose)
- Na Bicarb
- Calcium Gluconate
Metformin and
Lisinopril (ACE Inhibitor) is given to...
protects the kidneys but control hypertension
Conservative therapy/treatment includes:
- BP control (ACE & ARB, Diuretics)
- Blood sugar control
- < Na, K, Protein (red meats), Calcium supplements
- Watch fluid retention, urine output.
- Follow up appt. with HCP
Who can give the patient a kidney transplant?
- partner
- family member
- codiver kidney
Which dialysis is more flexible; can start ASAP?
PD
Priorities before, during, and after hemodialysis?
- Temporary access?
- Permanent (AV fistula/graph prolonged healing time)
- 6 P's, Bruit/Thrill?
- Cannot access if hot; infection is present
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