One recent research project looked at how genes affect the causes of kidney disease. Utilization of the peritoneum as the semi-permeable membrane, How is the dialysis delivered in pts receiving peritoneal dialysis, Peritoneal access is supplied by an implanted catheter in abdomen. Heart disease 4. The nurse would suggest which diagnostic determinations to confirm this diagnosis? Which condition does the nurse suspect is common with this stage of kidney disease? "The kidney is rich in blood supply and can concentrate toxins in high levels in the medullary portion of the kidney.". How is a transplant patient prepared for transplants? Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD? Heart disease can cause kidney disease, but kidney disease can also cause heart disease. Dietary and lifestyle What is Uremic Pericarditis secondary too in ESRD pts? Kidney failure is the last (most severe) stage of chronic kidney disease. According to the National Institutes for Health, one of the most common causes of renal failure among children is genetic predisposition. What does later progression of diabetic neuropathy result in? "an abrupt decrease in both glomerular and tubular function, resulting in the failure of the kidneys to excrete nitrogen and waste products & a corresponding failure to maintain F & E & acid-base balance. What is done to control a pt with a glomerular inflammation infection? The third leading cau… No, probably a combination of poor glucose control and hypertension, How long do diabetics have renal deterioration till they experience diabetic neuropathy symptoms, 5-10 yrs prior to symptoms manifesting themselves. What is the most common indicator of acute renal failure? A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Are pts with recent cancer eligible for a kindey transplant? Heart disease is the most common cause of death among people on dialysis. Hyponatremia (Early phases of failure because of loss of ability to reabsorb Na+ by nephrons), What happens to K levels in pts with ESRD, What happens to acid/base balance in pts with ESRD, Metabolic acidosis: Kidneys not able to excrete ammonia and reabsorb bicarb. autoimmune disorders (SLE, Goodpasture's, vasculitis), Strep infections. Other common causes of kidney disease include high blood pressure, polycystic kidney disease, interstitial nephritis, and … What are the symptoms of ESRD secondary too? What needs to be tested regarding a nephrotic syndrome pt urine, What needs to be taught to a pt with nephrotic syndrome, Genetics: can cause liver as well as kidney cysts, Antihypertensive low protein, low Na+ diet. This stimulates PTH to further pull calcium from storage areas in the bone (> serum Ca+). What does the simulation of PTH result in? What are early symptoms of autosomal dominant PKD? How does AKI manifest itself regarding renal labs? Learn vocabulary, terms, and more with flashcards, games, and other study tools. - Urinary sediment of red and white cells. Usually preceded by dialysis and blood transfusion to prepare recipient, What is done with the diseased kidney during a transplant. The world's disease profile is changing, and chronic diseases now account for the majority of global morbidity and mortality, rather than infectious diseases. Cautious use of NSAIDs-avoid ASA because of bleeding potential. The nurse anticipates the client's blood urea nitrogen (BUN) and serum creatinine laboratory results will be in which range? As part of an interrelated system, the kidneys are prone to damage if any disease alters the flow and/or chemistry of blood entering the kidneys or causes direct injury to the kidneys themselves. is there a age limitation on organ donors? Select all that apply. increases in creatinine and BUN & creatinine decreases in GFR, > in BUN and Creatinine: Referencing GFR during the acute phase is not considered valid, What can cause prerenal AKI (think vascular flow), Hypoperfusion (decreased blood flow to kidneys) with azotemia, > BUN and Creatinine, Obstruction of outflow of urinary system (bilateral ureteral stones, tumors, strictures, blood clots, BPH) Result is reflux to the kidneys, What things that pts cna be exposed to that can cause a higher risk for AKI. Which dermatologic problem most often accompanies chronic kidney disease (CKD)? Any damage done to the kidneys will cause harm to other organs as waste, acids, and fluids accumulate to dangerous levels. The nurse is providing dietary instruction for a client with chronic kidney disease (CKD) who is on hemodialysis. Is obesity a major cause of chronic kidney disease? The disease can progress to complete kidney failure, also called end-stage renal/kidney disease. Autosomal dominant genetic inherited(90% of cases) Onset age 30-40. proteinuria and worsening kidney function reflected in decreasing GFR and increasing BUN & creatinin. Chronic can develop from unresolved acute infections. 34 Acute Kidney Injury and Chronic Kidney Disease. A daily fluid intake of 500 to 800 mL/day to maintain hydration. Diabetes is the most common cause of ESRD. An 80-year-old client with diabetes has a GFR of 41 mL/min/1.73 m2. Fluids and solutes are moved from the blood through a semipermeable membrane into a dialysate (dialysis solution) for the purpose of correcting fluid and electrolyte imbalances in the renal failure client. Chronic kidney disease impacts many systems in the body. The care team has established that the client's glomerular filtration rate (GFR) remains at a low, but stable, level. What is the most common cause of pyelonephritis? As people age, so do their kidneys. Adds more daytime freedom but some do not like being tied to machine. What is the most common hematologic disorder caused by CKD? Acute physical, chemical, hypoxic or immunological damage to kidney tissue: yes, ny drugs are nephrotoxic particularly if the patient is not well hydrated. What does the nurse have to monitor for a pt receiving CRRT, What does the nurse have to assess for a pt receiving CRRT, Assessment of pre and post findings (weight, vitals (especially hypotension during and after treatment), cardiac rhythm). A client is beginning to recover from acute tubular necrosis. The epidemiology of chronic kidney disease. The following are the ten major causes of kidney disease. Chronic kidney disease and risk of incident myocardial infarction and all-cause and cardiovascular disease mortality in middle-aged men and women from the general population. What interventions are done to treat anemia in ESRD pts? control protein, phosphorus, Na+, and K+ and perhaps fluids, Complications are we monitoring when treating pts with AKI, What needs to be known about duration of time it takes for a AKI pt to recovery, recovery may take months so monitoring will be periodic during this period, Progressive, irreversible destruction of nephrons and deterioration of renal function, Up to 80% of function may be lost before there are overt symptoms (may take years to develop). This is why kidney failure is also called end-stage renal disease, or ESRD for short. What F/E control interventions do we have to do regarding the CV system? Elevated BUN/Creatinin (nitrogeneous by-products), Anemia because of decreased production of hormone erythropoetin/iron deficiency + < survival of RBCs, Why does the risk of bleeding in pts with ESRD, Bleeding tendencies because of impaired platelet aggregation (watch for bruising, ecchymosis, blood in urine and feces). The client's admitting laboratory results are suggestive of prerenal failure. Eur Heart J . Infection because of altered immune response-decreased production of neutrophils and monocytes, How can stomatitis occur in pts with ESRD, ammonia produced by bacterial breakdown of urea. - Nephron destruction takes place over many months. Treatment involves the introduction into the peritoneum of a sterile dialyzing solution, which is drained after a specified time. bone depletion and subsequent renal osteodystrophy. > BUN, Creatinin, What issues regarding blood are present with AKI, altered sensorium, lethargy, seizures and coma, What are conventional markers to diagnose AKI, Urine output, creatinine and BUN (a BUN-Creatinin ratio equal to or greater than 25-1 is usually indicative of dehydration), What are other biomarkers are used to diagnose AKI, Cystatin C (marker of glomerular filtration rate), Clinical Manifestations: Acute Kidney Injury (prerenal), Clinical Manifestations: Acute Kidney Injury (Intra & Postrenal), To prevent further injury and to facilitate recovery, Can F/E issues in AKI pts be hypo or hypervolemia, Can cardiac involment in AKI pts impact F/E, yes, Complicated by cardiac involvement: heart failure or valve issues. Baseline urine output of 50 mL/hr that is now 10 mL/hr. What F/E control interventions do we have to do regarding electrolytes? What should you maintain for trying to prevent AKI? Gastroparesis: syndrome N & V and anorexia secondary to delayed gastric emptying, What can occur with ESRD pts bowel habits, Constipation because of iron and calcium containing phosphate binders/slowed GI transit time, What are resp clinical manifestations of pts with ESRD, What are Neurological/Muskuloskeletal clinical manifestations of pts with ESRD, How does renal osteodystrophy occur in pts with ESRD, Decreased Ca absorption stimulates release of PTH which stimulates release of calcium from bone creating weakened bones, What are Integumentary clinical manifestations, pruritis secondary to uremia (may be secondary to uremic frost), What is pruitis secondary too in pts with ESRD, What are Reproductive clinical manifestations in pts with ESRD, What are endocrine clinical manifestations in pts with ESRD, What are urinary tendencies clinical manifestations in pts with ESRD, Variable production of urine (amount/composition of urine will change with degree of dysfunction), Are pts with ESRD at a higher risk for drug toxicity, yes, Delayed and/or decreased elimination of some mediations, What meds are ESRD pts at risk for regarding drug toxicity. 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