Pathophysiology
The kidneys will no longer produce the active form of this hormone which helps with calcium absorption.
What is active vitamin D?
These levels will LOW because the kidneys no longer produce erythropoietin.
What is normal RBC count, hemoglobin and hematocrit count?
Normal RBC Count: 4.7-6.1 (male)/ 4.2-5.4(Female)
Normal hemoglobin: 14-18 (Male) / 12-16 (Female)
Normal hematocrit: 42-52 (male) / 37-47 (female)
Medication to treat hyperkalemia.
What is sodium polystyrene?
Kayexalate
Teach the client to avoid these foods containing potassium.
What is salt substitutes? What are citrus fruits?
A healthy dialysate will appear like this.
What is straw colored, clear, odorless?
The kidney will no longer produce this hormone which is necessary for red blood cell production.
What is erythropoietin (EPO)?
Note: Patients will be required to take epoetin alfa / darbepoetin since there kidneys no longer produce this hormone.
These levels will be HIGH because the kidneys are no longer able to excrete these waste products.
What are BUN and Creatinine levels?
Normal levels:
BUN: 10-20
Creatinine: 0.6-1.2 (male)/ 0.5-1.1 (female)
Medication to treat high phosphate levels.
calcium acetate (PhosLo)
Teach your client to avoid these foods containing phosphorus.
What are colas, dairy, peas, beans, nuts?
Too rapid of an infusion will lead to this complication with a patient on hemodialysis.
What is disequilibrium syndrom?
The overproduction of this hormone will lead to hypertension in a client with renal failure.
What is Renin?
These levels will be high in renal failure because the kidneys are unable to excrete this mineral and will cause hypocalcemia and pathological fractures.
What are phosphate levels?
Normal is 2.5 to 4.5
Remember: Patients must take calcium acetate (Phoslo) to correct this!
Medication to help stimulate red blood cell production.
Nurses is should do this before and after dialysis to assess the fluid status of the client.
What is weight the patient?
Cloudy dialysate, fever purulent drainage are signs of this complication.
What is peritonitis?
The kidneys inability to excrete or eliminate this electrolyte can lead to cardiac dysrhythmias /EKG changes.
What is potassium? (Hyperkalemia)
Remember normal K+ levels are 3.5 - 5.0
This determines the extent of renal failure and will classify the client in renal failure. It determines how well the functional unit of the kidney is working.
What is GFR?
Remember a GFR less than 15 a patient is in kidney failure and will require dialysis or transplant.
Examples of medications that are nephrotoxic.
What is NSAIDS...aspirin, ibuprofen, naproxen
What are antibiotics....aminoglycosides (gentamicin),
vancomycin, cephalosporins
Nurses should do this to assess the AV Fistula or Graft.
What is palpate a thrill and auscultate a bruit?
A nurse should do this if peritoneal dialysis drainage is less than the amount inserted.
What is turn the patient on their side? What is elevate the head of bed? What is check for kinks?
The kidney's inability to excrete hydrogen and to reabsorb bicarbonate leads to this complication of end stage renal disease.
What is metabolic acidosis?
Rember: Normal blood PH is: 7.35-7.45
Normal Carbon Dioxide (CO2) levels are 35-45
Normal Bicarbonate levels (HCO3): 22-26
Avoid this laxative because it will raise magnesium levels.
What is milk of magnesia?
This supplement will help with anemia along with epoetin alfa.
What is iron supplement? What is ferrous sulfate?
This sight is at risk for infection in peritoneal dialysis patients.
What is the peritoneum? What is peritonitis?
Nursing interventions for a chronic renal patient.
What is...
Daily weights especially dialysis days?
What is fluid restriction?
What is assessing for fluid volume overload?
*How would a nurse assess for fluid volume overload or hypervolemia?*