Kidney function/F&E
Normal GFR
125 mL/min (180 Litres per day) (Iggy p. 1324)
Candidate selection criteria for receiving a kidney transplant
Potential qualifier: 2-70 years
Potential disqualifier: advanced uncorrectable cardiac disease, alcohol/chemical dependency,
(Iggy p 1421)
Normal functions of the liver
Detoxing, produces clotting factors, gluconeogenesis, assist with digesting of fats,
Percentage of nephron involvement in AKI
50%-95% (Iggy p. 1391)
Hemodialysis Nursing care
wt before, V/S and LOC, assess for headache, N/V, assess for bleeding at the vascular access site, electrolyte labs, also discuss with PCP which medications should be held until after dialysis as many can be removed from the body during dialysis. (Iggy p. 1416)
Post-op treatment for kidney transplant
BUN, serum creatinine, creatinine clearance, CBC, electrolytes, V/S with spectial attention to BP, chest pain, dyspnea, edema, JVD, etc (Iggy p 1425 Chart 68-10)
Usual cause of chronic hepatitis
Hepatitis B or C (Iggy p1182)
Causes of AKI
reduced perfusion to the kidneys, damage to the kidney tissue, obstruction of urine outflow. (Iggy p.1391)
Most sodium, calcium, phosphate, bicarbonate, chloride, glucose, and water reabsorption occurs here.
Proximal convoluted tubule (PCT) (Iggy p. 1325)
signs/symptoms of hyperacute rejection (<48 hours post-op)
increased temperature, increased BP, Pain at transplant site,
Complications of chronic hepatitis
Cirrhosis and cancer (Iggy p 1182)
GFR for the 5 stages of CKD
Stage 1: >90 mL/min
Stage 2: 60-89 mL/min
Stage 3: 30-59 mL/min
Stage 4: 15-29 mL/min
Stage 5: <15 mL/min (Iggy p. 1399)
Hormones produced by the kidneys
Renin, prostaglandins, bradykinins, erythropoietin, activated vitamin D (Iggy p 1326 table 65-2)
Patient teaching
immunosuppressive therapy, signs of infection and what to report, renal diet, dialysis teaching if applicable, adequate hydration, etc. (Iggy p 1424)
Abnormal labs in liver disease
elevated AST, ALT, LDH, serum alkaline phosphatase, GGT, serum total bilirubin, serum amonia, serum total protein (acute liver disease)
decreased fecal urobilinogen, serum total protein (chronic liver disease), serum albumin (severe liver disease),
prolonged PT/INR (Iggy p1174)
Risk factors for CKD
Uncontrolled hypertension, DM with poor glycemic control, family history of genetic kidney diseases, exposure to nephrotoxic substances. (Iggy p. 1399)
Hormones that affect kidney function
Vasopressin (ADH), aldosterone, natriuretic hormones, (Iggy p 1326 table 65-2)
Signs of acute rejection
Oliguria or anuria, temp >100F, increased BP, tender & enlarged kidney, lethargy, ^serum creatinine, ^BUN, ^K+, and fluid retention (Iggy p 1423 Table 68-13)
Hepatitis vaccinations available
Type A and B (Iggy p 1182)
Unexpected complications from AKI
Hiccups! :) (Iggy p. 1392 table 68-3) <- Look here for more expected complications. I found this one under "Other"