Hurst Q cards - Renal

steroids

(causes sodium retention and potassium depletion and inhibit insulin leading to increased glucose)

Hemodyalysis

-3-4 x week for treatment -hooked up to machine that acts like your kidneys -BP and blood levels checked continually -need vascular access p not recommended for heart patients

signs and symptoms of renal failure

-Creatinine and BUN increase -FVE -Anemia (not enough erythropoietin)-draw -Htn, HF (retaining fluid) -Anorexia, N/V (retaining toxins) -Itching frost (uremic frost) -Acid/Base and fluid/electrolyte imbalances

peritoneal dyalisis

-vascular access will be placed in your abdomen -peritoneal membrane will act like kidneys - exchanges will be q4h during the day -or through the night while you sleep not recommended for pt w/ abdominal surgery or back surgery

care of vascular access in forearm

do not carry anything on that side no bp in arm no needle sticks no constrictive clothing - not even a purse

anemia in renal failure -- why?

erythopoietin is secreted by the kidneys and needed for red bloods to mature mature rbcs carry O2

BUN/ Creatinine in pt with renal failure

increase - elevated with renal damage / failure

serum sodium

increase- serum sodium up - blood very concentrated just like

glomerulonephritis

inflammation of the glomeruli of the kidney main cause: strep s/s: sediment PRO blood in urine facial edema

things that nephrotic syndrome and glomerulonephritis have in common

inflammatory reaction malaise decreased urinary output increased blood pressure can lead to renal failure

nephrotic syndrome

inflammatory response---> big holes from so protein starts leaking out in the urine causes: multiple proteinuria- you never see protein in the urine unless there is a problem in the kidneys hypoalbuminemia- body tries to produce enough albumin but it cant do it anasarca- total body edema due to loss of so much protein- no enough protein to keep fluid in vascular space hyperlipidemia- due to hypoalbuminemia stimulated synthesis of lipoproteins replace the protein in the diet

FVE in renal failure -- why?

kidneys aren't working so fluid in the vascular space will continue to increase

protein problem with nephrotic syndrome and glomerulonephritis

limit protein in diet why- protein breaks down to urea in the liver urea(toxin) is removed from the body in the urine kidneys not filtering toxins out correctly

HTN in renal failure --why?

retaining fluid leading to increased workload of the heart

urine specific gravity concentrated makes numbers go up diluted makes numbers go down

up- due to small amount of concentrated fluid in vascular failure

itchy frost in renal failure -- why?

urea excess is surfacing to the skin

peritoneal dialysis order

warm dialysate assess tenckhoff catheter begin dwell time remove effluent- complete exchange assess effluent for COCA- should look just like urine

what assessment data is the priority nursing concern in a client receiving prednisolone for the treatment of nephrotic syndrome?

weight gain of 2lbs in 24 hrs--edema is more significant --correct answer temp of 99.6 F-- normal blood glucose 116 mg/dl-- elevated but its expected with steroid use serum sodium 142 mEq/L-- normal

a nurse is caring for pt following abdominal surgery. pt NPO w/ NG tube to low wall suction. nurse notes copious amounts of dark brown fluid in drainage container. BP 88/58 Pulse 110 urine output 26 ml in last hour

worry about renal failure and shock-- kidneys not perfusing minimum uo per hr = 30mls/hr decreased perfusion --> renal failure and shock decreased fluid in vascular space leads to decrease cardiac output