Chapter 32

A child under the age of 5 is diagnosed with chronic kidney disease (CKD). what treatment plan would the provider implement?

Children between birth and 5 years of age often are managed with peritoneal dialysis.

what test would the nurse conduct that can determine kidney failure?

serum creatinine

explain hydrostatic pressure

the high pressure arterioles creates the pressure to force fluid to go through the Bowman's capsule which will generate filtrate

wha tests are used to determine kidney function?

, glomerular filtration rate (GFR), urinalysis, serum creatinine, and blood urea nitrogen

what is the average urine output?

1200 mL in 24 hours

the specific gravity of urine should be

1.005-1.025

consider the patient with a blood pressure of 80/50, what is the MAP?

60

What is an ideal MAP range?

65-70

with sympathetic stimulation, what will occur with glomerular filtration?

Blood will be redistributed away from the cortex, glomerular filtration will be reduced but urine output will remain the same

Manifestations of childhood renal disease are varied and may differ from adult-onset renal failure. A school-aged child with chronic kidney disease may exhibit which manifestation?

Developmental delays such as uncoordinated gait and minimal fine motor skills

The nurse is instructing a client with advanced kidney disease (AKD) about a dietary regimen. Which restriction should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?

Dietary protein

A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is:

Dorsiflexion of hands and feet

For renal failure in young children, what treatment would be best?

Early transplantation in young children is the best choice to promote physical growth, improve cognitive function, and foster psychosocial development.

A client is being treated for chronic kidney disease (CKD). One of the nurse's responsibilities is to explain to the client the need to keep her blood pressure under control. Why is blood pressure control so important in CKD clients?

Elevated blood pressure will exacerbate nephron loss and accelerate renal failure.

The health care provider is reviewing laboratory results of a client. Select the diagnostic test that is considered the best measurement of overall kidney function.

Glomerular filtration rate (GFR) and is estimated using serum creatine concentration

A client diagnosed with CKD has begun to experience periods of epistaxis and has developed bruising of the skin and subcutaneous tissues. The nurse recognizes these manifestations as

Impaired platelet function

A client sustained acute tubular injury approximately 2 hours ago. Which cause of acute kidney injury (AKI) would the nurse suspect the client is experiencing?

Intrarenal

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which statement regarding vitamin D is correct?

Kidneys convert inactive vitamin D to its active form, calcitriol.

Excess exercise and muscle trauma can contribute to the formation of which condition?

Myoglobinuria

what can cause acute tubular necrosis?

Myoglobinuria

How do you find MAP?

[(2x diastolic)+systolic]/ 3

when evaluating a patient, you notice they have low blood pressure, what other assessment will you find in this patient?

a high heart rate, low blood pressure, and altered mental status

The intrarenal AKI is caused by and characterized by:

acute tubular necrosis/acute renal injury, destruction of tubular epithelial cells with acute suppression of renal function.

blood pressure hyper perfusion will result in what occurring in the body?

blood pressure will be too low

The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney injury?

client with prostatic hyperplasia

what causes hemogluria?

from hemolysis following a reaction to a blood transfusion

what is the function of the kidneys?

regulate the composition of fluid, pH and substances

Kidneys use antidiuretic hormone to

regulate the osmolarity of the ECF

A child over the age of 12 is diagnosed with chronic kidney disease (CKD). what treatment plan would the provider implement?

hemodialysis

what is required for the nephron to produce filtrate?

hydrostatic pressure is needed to push the fluid through to be filtered

what is an early manifestation of chronic kidney disease?

hypertension

what causes hypertension in early CKD?

increased vascular volume, increased peripheral vascular resistance, decreased levels of renal vasodilator prostaglandins, and increased activity of the renin-angiotensin-aldosterone system.

nephron destruction would be an example of which condition?

intrarenal failure

if a patient was lying on the kitchen floor for days, what would their specific gravity urine look like and why?

it would be higher than 1.005-1.025 because the person would be more dehydrated which will lead to a higher concentration

Prerenal AKI is characterized by

marked decrease in renal blood flow.

what are reasons that can lead to low blood pressure?

medication, bleeding

what should there be little to none of in urine?

plasma proteins, blood cells or glucose molecules

the obstruction of urine is an example of which condition?

postrenal failure

dehydration, and decreased renal perfusion are examples of which condition?

prerenal failure