AKI/Renal Transplant
Postrenal causes of AKI?
What is BPH, prostate cancer, stones, trauma, external tumors. There is a mechanical obstruction in the outflow of urine.
What does CVP measure? What does CVP tell us about our patient?
What is preload and overall fluid status of our patients.
Classification of Shock
What is
Cardiogenic
Hypovolemic
Distributive (Anaphylactic, Septic, Neurogenic)
Obstructive
Clinical manifestations of Circulatory Overload Reaction?
What is Hypertension, JVD, tachycardia, crackles.
What is the purpose of the "push pause technique"?
What is to remove debris and keep catheter patent.
Clinical manifestations of the Oliguric Phase?
What is Hyperkalemia and Hyponatremia, Fatigue and Malaise, fluid volume excess, metabolic acidosis, elevated BUN and Creatine, less than 400 ml/day of urine.
What is the CVP goal for septic shock?
What is CVP of 8-12 mmHg.
Drug therapy for anaphylactic shock?
What is epinephrine, corticosteroids, antihistamines, bronchodilators and histamine receptor blockers.
A client develops chills, fever, anxiety and vomiting during a blood transfusion. What type of reaction is the client experiencing?
What is: febrile, nonhemolytic reaction.
What is 2-8
Indications for Renal Replacement Therapy (RRT)?
Volume overload, Elevated potassium level, metabolic acidosis, BUN greater than 120 mg/dL, significant change in mental status, pericarditis, pericardial effusion, cardiac tamponade.
What is the formula to calculate Mean Arterial Pressure (MAP)?
The mathematical equation is: MAP = SBP + (2 x DBP)
The Normal range is 70 – 105.
Absolute vs Relative Hypovolemia?
What is absolute is actual blood or body fluids externally and relative is when fluids shift out of the vascular space.
Mild S/S: flushing, itching, pruritus, urticaria.
Increased creatine X2 or GFR decrease >50% OR Urine output <0.5 ml kh X12 hours
What is INJURY
PPT slide 4 RIFLE Classification.
What is the treatment for Hyperkalemia?
Nursing management for Central Venous Access Device (CVAD)?
What is: assess insertion site every shift, use transparent semi-permeable dressing, use 10ml syringe or larger, push-pause technique, have pt turn head t opposite side when changing caps. PPT slide 5.
Which medication will increase the contractility of the heart to improve cardiac output?
What is dobutamine.
How to treat a febrile nonhemolytic blood transfusion reaction?
What is: stop the transfusion and symptomoatic treatment with antipyretics such as acetaminophen.
Interventions when caring for an arterial line.
What is keep pressure bag inflated to 300 mmHg, fluids bags of normal saline are changed every 96 hours, PRN, or per policy, all lines must be rigid non-compliant tubing, immobilize site, keep site visible.
What would indicate the client is in the Injury stage of RIFLE?
What is Increased creatine X 2 OR GRF decrease greater than 50% OR Urine output less than 0.5 ml kg X12 hours.
What is the CVP goal for Hypovolemic shock?
What is CVP of 15 mmHg.
Your patient is in septic shock and is hypotensive and lo longer fluid responsive after receiving isotonic crystalloid fluids. What is the first line vasopressor to add?
What is norepinephrine.
Fever, back/abdominal pain, chest/flank pain, dyspnea, elevated HR/RR with hypotension.
What is Acute Hemolytic blood transfusion reaction.
Clinical manifestations of obstructive shock.
What is confusion, urine output 20 ml/hr, 95/48, JVD, tachycardia, hypotension.