Med-surg Exam 3 part 3

Module 10

100

If the BUN is elevated but creatinine is normal what might the problem be?

Prerenal ARF

(dehydration)

200

If both BUN and creatinine are high what might the problem be?

Intrarenal ARF

300

Normal BUN level?

7-24

400

Normal creatinine level?

0.6-1.2

500

What are the signs of acute renal failure?

-Hyponatremia

-Hyperkalemia

-Hypocalcemia 

-Edema

-Metabolic acidosis

-N/V

-Mental status changes

-Anemia

Module 10

100

Symptoms of acute renal failure?

-Changes in urine output

-Electrolyte imbalances

-Fluid imbalances: edema; monitor for heart failure and pulmonary edema

-Acid-base balance: metabolic acidosis

-N/V, constipation, anorexia

-Mental status changes (due to ammonia levels): lethargy and memory impairment

-Anemia and platelet dysfunction: fatigue and bruising 

-Impaired wound healing and susceptibility to infection

200

Treatment of acute renal failure?

-Correct the underlying cause: rehydrate patient, increase profusion, treat trauma, etc.

-Symptomatic treatment: 

correct fluid/electrolyte imbalances

monitor for dysrhythmias; caused by hyperkalemia 

manage anemia

manage hypertension

hemodialysis/peritoneal dialysis

300

Nursing interventions for ARF?

-Monitor for signs of fluid imbalances

-Immediately report output of less than 30mL/hr to provider

-Monitor electrolytes

-Encourage ADL's

-Hand hygiene and infection prevention

400

What tests are done to show kidney function?

-UA

-CBC

-BUN

-Creatinine

500

What can cause an elevated BUN?

-Rhabdo

-Keto diet

-Dehydration

Module 10

100

What is the most common cause of chronic renal failure?

-Glomerulonephritis 

-Nephrosclerosis

200

What are the labs for chronic kidney disease?

-Increased phosphate

-Decreased calcium

-Increased mag

-Decreased H & H

-Decreased Bicarb

-Increased potassium

-Increased BUN

-Increased creatinine

300

What should the nurse assess for chronic renal failure?

-Fluid overload

-Pulmonary edema

-Decreased cardiac functioning

-Weight loss

-Fatigue

-Decreased bone density

400

What are the five functions of the kidneys?

1- Regulate blood pressure by secreting renin

2- Increase RBC production by secreting erythropoietin

3- Metabolize vitamin D into an active form

4- Maintains acid-base balance by secreting hydrogen ions into the urine

5- Also relates electrolytes and eliminates waste

500

What do you want to avoid with a dialysis fistula?

-No blood pressure

-No draws

-No IV

-Feel thrill

Module 10

100

Complications of peritoneal dialysis?

-Peritonitis

-Pain

-Tunnel infection

-Clot

-Leakage

200

What do you want to assess after dialysis?

Hypotension

300

What does the nurse want to do with the patient before dialysis?

-vitals

-weight

-labs

400

What does the nurse monitor during dialysis?

-Pain

-Respiratory effort

-Discomfort

-Dwell time

-Initiate outflow

500

What are the signs of glomerulonephritis?

-Puffiness of eyes

-Hypertension

-Visual disturbances

-Fever

-Chills

-Skin lesions

-Flank pain

-Edema

Module 10

100

What tests should be reviewed for acute glomerulonephritis?

-UA

-Creatinine

-BUN

-CBC

200

What will the UA results contain if the patient has acute glomerulonephritis?

-Smokey orange color

-RBCs and proteins in the urine

-Increased specific gravity

300

What is the treatment for acute glomerulonephritis?

-Bed rest until hypertension, hematuria, and proteinuria subside

-Sodium restriction

-Antihypertensive (hypertension)

-Diuretics (edema)

-Plasmapheresis and steroids (inflammation)

-Low protein, high carb diet

400

What other therapies might help treat acute glomerulonephritis?

Plasmapheresis for autoimmune disorders

500

What does the nurse want to monitor with acute glomerulonephritis?

Mental status changes, they could be an indication of ICP