what is CKD
slow, progressive, irreversible loss of kidney function
kidney function and waste elimination are to poor to sustain life
Fluid overload
due to the body's inability to maintain fluid balance
also may cause pulmonary edema
What happens in stage 1 of CKD?
This is normal kidney function but at risk: early kidney disease may or may not be present
Stage 1 Interventions
screen for risk factors and manage care to reduce risk
which body systems should be assessed with CKD?
Neurological
cardiovascular
Respiratory
hematological
gastrointestinal
urinary
integumentary
muscoskeletal
reproductive
what is the GFR for CKD?
less than or equal to 60mL per minute for 3 months or longer
Decreased Cardiac Function
due to reduced stroke volume, dysrhythmias, fluid overload, and increased vascular resistance
What happens in Stage 2 of CKD
There is slightly reduced kidney function
the GFR is 60-89mL/min
Stage 2 Interventions include...
focusing on reduction of risk factors
What psychological changes would we assess?
emotional liablity
withdrawal/depression
anxiety
denial
changes in body image
suicidal behaviors
why does hypovolemia occur in CKD?
Infections
What happens in stage 3 of CKD?
there is modertely reduced kidney function.
GFR is 30-59mL/min
Stage 3 interventions include
implementing strategies to slow down progression
What will your telemetry look like with hyperkalemia?
Tall peaked T-waves and ST Elevation
What is the normal GFR for kidney function?
90-120mL/min
Risk of Injury
due to effects of kidney disease on bone density, blood clotting and drug elimination
What happens in Stage 4 of CKD
Kidney function is severely reduced,
there is noticeable jaundice around the eyes
GFR is 15-29ml/min
Stage 4 interventions include...
managing complications
education about options and preparing them for renal replacement therapy
discuss patient preferences and values
Why do we see weight loss in CKD?
inability to ingest and digest
inability to absorb food and nutrients because of physiological factors
there is also a vitamin D deficiency
Why should a patient with Kidney disease be on continuous telemetry?
they can develop hyperkalemia resulting in dysrhythmias
Fatigue
due to anemia, and reduced energy production
What happens in stage 5 of CKD?
This is ESKD (end stage kidney disease)
the GFR is less than 15mL/min
Stage 5 interventions include...
implementing renal replacement therapy or kidney transplant
Causes of CKD
may occur following an Acute Kidney Inury
DM and other metabolic disorders
Hypertension
chronic urinary obstruction
recurrent infections
renal artery occlusion
autoimmune disorders