ACE Inhibitors/ARBs
These medications help control hypertension and may slow CKD progression by reducing protein loss in the urine.
What are ACE inhibitors and ARBs?
CKD patients may need this medication because diseased kidneys produce less erythropoietin.
What is an ESA?
This supplement may be given with an ESA to provide the material needed to make hemoglobin.
What is iron?
These medications lower phosphorus by binding it in the gastrointestinal tract.
What are phosphate binders?
Diseased kidneys lose the ability to activate this vitamin.
What is vitamin D?
These medications help remove excess potassium from the body.
What is potassium-lowering therapy?
Lisinopril belongs to this medication class.
What is an ACE inhibitor?
Epoetin alfa stimulates this location to produce additional red blood cells.
What is the bone marrow?
These two gastrointestinal effects commonly occur with oral iron therapy.
What are nausea and constipation?
Phosphate binders should be taken at this time to bind phosphorus from food.
What is with meals?
Active vitamin D helps increase absorption of this mineral from the gastrointestinal tract.
What is calcium?
This assessment should be performed because severe hyperkalemia can cause life-threatening cardiac changes.
What is cardiac or ECG monitoring?
The nurse should closely monitor this electrolyte because ACE inhibitors and ARBs can cause it to become dangerously elevated.
What is potassium?
The nurse monitors these two laboratory values to evaluate the patient’s response to an ESA.
What are hemoglobin and hematocrit?
The nurse should teach the patient that this harmless stool change may occur with oral iron.
What are dark or black stools?
The nurse monitors this laboratory value to evaluate whether a phosphate binder is effective.
What is serum phosphorus?
Calcitriol is an example of this type of medication used in CKD.
What is active vitamin D?
The nurse should monitor this laboratory value before and after potassium-lowering treatment.
What is serum potassium?
This common ACE-inhibitor adverse effect may require changing the patient to an ARB.
What is a persistent dry cough?
This cardiovascular finding should be monitored because ESAs can cause or worsen it.
What is hypertension?
Patients receiving this form of iron must be monitored for hypersensitivity or infusion reactions.
What is intravenous iron?
Depending on the specific binder, the patient may experience these common gastrointestinal adverse effects.
What are constipation, nausea, or diarrhea?
The nurse monitors calcium and phosphorus because excessive vitamin D activity may cause these levels to become elevated.
What are hypercalcemia and hyperphosphatemia?
Potassium-binding medications may cause these gastrointestinal adverse effects.
What are constipation, diarrhea, nausea, or abdominal discomfort?
A patient taking lisinopril develops facial swelling and difficulty breathing. This serious adverse effect requires immediate action.
What is angioedema?
ESAs may be ineffective when the patient does not have enough of this mineral available for red blood cell production.
What is iron?
The nurse monitors hemoglobin and these laboratory measurements to determine whether the patient has adequate stored and available iron.
What are iron studies, including ferritin and transferrin saturation?
A patient takes the phosphate binder two hours after eating. What important teaching should the nurse provide?
Take the phosphate binder with the meal.
Vitamin D therapy helps manage CKD-mineral and bone disorder partly by suppressing excess production of this hormone.
What is parathyroid hormone?
A patient has potassium of 6.8 mEq/L, muscle weakness, and ECG changes. Why should the nurse not rely only on an oral potassium binder?
The patient has severe, symptomatic hyperkalemia requiring immediate emergency treatment.