DKA
ONLY insulin type given IV route
Regular Insulin
Name some complications of Dialysis
Hypotension, dialysis disequilibrium syndrome, and cardiac events
What is Oliguria ?
Urine output less than 400mL/ day
What is Signs and Symptoms of Fluid Overload?
Lung crackles, edema, distended neck veins (JVD)
Oral glycemic management drug given to DM2 patients with a side effect of diarrhea. (HINT: also can be nephrotoxic)
Metformin
Explain DKA pathophysiology
Hyperglycemia
Fatty Acids Metabolized
Ketone Formation
Decreased serum pH
Name some nursing considerations when caring for a patient with AV dialysis site
Do not take blood pressures using the extremity where vascular access is placed. Palpate thrills and auscultate buits. Do not perform venipunctures on affected site. Check for bleeding.
What are nephrotoxins ?
NSAIDS, Chemotherapy agents, Radiographic contrast dye, Metformin, Vancomycin, and some antibiotics.
What is the most effective drug class to treat hypertension in CKD?
Ace Inhibitors
What is Classic Symptoms of Diabetes mellitus ?
Polyuria, Polydipsia, and Polyphagia
What is the pH level (high or low) in DKA?
LOW
What is an AV fistula ?
Surgically connecting an artery to a vein (radial or brachial) to allow increased venous blood flow during dialysis
What are risk factors for AKI ?
Shock, cardiac surgery, hypotension, prolonged mechanical ventilations, hypovolemia, nephrotoxic agents, obstruction, and sepsis
What is a drug class given to manage volume overload in patients with CKD?
Loop Diuretics
What is Diabetic Peripheral Neuropathy ?
Progressive deterioration of nerve function resulting in a loss of sensory perception.
The goal for treatment with insulin gtt is to slowly lower the glucose level no more than 30-90 mg/dL each hour to prevent: _____.
Cerebral edema, seizures, and coma
What is Dialysate ?
Fluid that helps remove unwanted particles and waste from the blood and contains electrolytes, glucose, and minerals that is prescribed by the nephrologist
What is Serum Creatinine ?
Kidney Lab value. Product of skeletal muscle breakdown. Normal levels are 0.5-1.2 mg/dL and are 3x elevated in AKI.
What are some Dietary Considerations for CKD patients ?
Limiting excess protein, sodium, potassium, and phosphorus. Adding calcium supplements. Possible fluid restrictions
What is Metabolic Syndrome ?
A presence of all of these: Abdominal obesity, Hyperglycemia, Hypertension, Hyperlipidemia
Name DKA risk factors
New-onset DM, acute illnesses, stress, and pregnancy, infection
What is AV graft ?
Looped plastic tubing tunneled beneath the skin that connects an artery and vein.
How does the MAP (mean arterial pressure) influence the kidneys?
Goal is to keep MAP 65-70 mm Hg to perfuse the kidneys. Hypoperfusion leads to kidney injury
Symptom of CKD caused by vitamin deficiency, anemia, and build up or urea?
Fatigue, malaise, lethargy
What are Symptoms of Hypoglycemia?
Weakness, confusion, diaphoresis, tachycardia, seizures, tremors