Term
There is an inverse/direct relationship between Sodium and Potassium. Therefore, when when pt experiences fluid overload/dehydration, Na levels decrease, so K levels will increase/decrease?
If the GFR is __ ml/min, restrict/supplement K in diet. |
|
Definition
inverse
increase
< 10 mL/min, Restrict |
|
|
Term
Renal Osteodystrophy (now called Chronic Kidney Disease Mineral and Bone Disorder = CKMBD):
Damaged Kidneys fail to excrete _____ (yielding ______) and to convert Vitamin __ to its active form (yielding _____). This leads to hyper_____ in attempt to absorb _____ from the bones and GI Tract, in addition to converting Vit __ to its active form.
S/S are: |
|
Definition
Phosphate, hyperphosphatemia
Vitamin D, hypocalciemia
Hyperparathyroidism
Calcium
Bone pain, joint pain, bone degradation/deformities, fractures |
|
|
Term
| Decreased/Increased erythropoietin from damaged kidneys yields _____. |
|
Definition
| Chronic, iron-deficient anemia |
|
|
Term
| Bone marrow is suppressed because of _____ (toxins that build up due to damaged kidneys). |
|
Definition
|
|
Term
| An irritating and potential problem in which uric acid is deposited in the pericardial sack is called _____. |
|
Definition
|
|
Term
Damaged kidneys leads to a metallic taste when eating; this can decrease the pt's appetite and result in anorexia.
T/F? |
|
Definition
|
|
Term
| A common motor and sensory problem with damaged kidneys characterized by the sensation of "burning" in the feel |
|
Definition
|
|
Term
| S/S of _____ include: decreased alertness, decreased attention, loss of recent memory, and perceptual errors. |
|
Definition
|
|
Term
| Asterixis is characterized by: _____. It's caused by _____. |
|
Definition
Brief, rapid relaxation of wrist
high uremic levels |
|
|
Term
| Immune function is decreased due to: |
|
Definition
- decreased granulocytes (basophils, eosinophils, neutrophils
- imparied humoral and cell-mediated immunity
- phagocytic malfunction |
|
|
Term
| Renal disorders usually yield pale skin due to the _____. Urea also causes _____ to deposit on the skin and cause what clinical manifestation? |
|
Definition
anemia
uremic frost; pruritis |
|
|
Term
| Tubulointestinal Fibrosis occurs when there is _____. |
|
Definition
| an obstruction in the bladder. |
|
|
Term
| Hydronephrosis is when there is _____ in the kidney. |
|
Definition
|
|
Term
| Problems with uric acid metabolism leads to _____. |
|
Definition
|
|
Term
| Gout can cause what kind of stones? |
|
Definition
| Calcium phophate with urate in the middle |
|
|
Term
| Struvite/staghorn stones are composed of: |
|
Definition
| Magnesium ammonium phosphate |
|
|
Term
| Proteus, Klebsiella, and Pseudomonas are often responsbile for forming _____ |
|
Definition
|
|
Term
Men are more at risk for UTI's because they are typically less hygenic.
T/F? |
|
Definition
| FALSE; women are more at risk because they have a shorter urethra. |
|
|
Term
| People with GOUT have an increased risk for forming _____. |
|
Definition
|
|
Term
| Clinical manifestations of stones include: |
|
Definition
- Severe Pain (starting in flank and radiating to groin)
- Incredible N/V
- Blood in the urine
- PAIN |
|
|
Term
|
Definition
| breaking down kidney stones via laser/ultrasound to help them pass |
|
|
Term
| Pus and inflammation of the nephron, affecting the renal tubules, connective tissues, and pelvis, is called: |
|
Definition
|
|
Term
| People who have frequency and urgency, suprapubic pain, dysuria, and may be confused if elderly, most likely have...? |
|
Definition
| Cystitis (a bladder infection!) |
|
|
Term
Vesicoureteral Reflux is characterized by _____
and is usually a clinical manifestation of...? |
|
Definition
a one-way valve in the ureter between the bladder and the kidney that no longer closes and urine and bacteria can travel up to the kidneys
Chronic Pyelonephritis |
|
|
Term
| Chills, fever, headache, pain at the costovertebral angle, infection, frequency, urgency, and dysuria are most likely clinical manifestations of...? |
|
Definition
|
|
Term
| Risks for acute pyelonephritis include: |
|
Definition
o Obstruction
o Intrumentation, anything that gets inserted
o Vesicoureteral reflux
o Pregnancy: 20-40% develop UTI with 4-5% getting pyelonephritis
o Gender: females from 1-40 y.o.a., > 40 men more at risk with prostate problems
o Age
o DM
o Renal lesions
o Immune compromise
o Sexual trauma
|
|
|
Term
| White blood cell casts are clinical manifestations of: |
|
Definition
|
|
Term
10-20% of cases of Chronic Pyelonephritis are in cases of end stage renal failure.
T/F? |
|
Definition
TRUE
Also common in children due to bilateral/unilateral obstruction and with urinary tract influx |
|
|
Term
| Focal Segmental Glomerulosclerosis can be found in _____. |
|
Definition
|
|
Term
| In drug induced kidney damage, the damage typically is better after _____ days. |
|
Definition
|
|
Term
| Acetaminophen damages the kidneys due to the _____. |
|
Definition
| Increased production of free radicals. |
|
|
Term
| Aspirin damages the kidneys because it: |
|
Definition
| inhibits prostaglandin synthesis which doesn't allow the nessary vasodilation in the glomerular capillaries. |
|
|
Term
| Treatment for analgesic-induced kidney damage is to: |
|
Definition
|
|
Term
| NSAIDs can damage the kidney because they are _____ that _____. |
|
Definition
non-selective cycloxygenase inhibitors
decrease prostaglandin synthesis |
|
|
Term
| Inflammation of the glomeruli is known as: |
|
Definition
|
|
Term
| An increase in the basement membrane permeability is known as: |
|
Definition
|
|
Term
| What are 5 differences between Nephtitic and Nephrotic Syndrome? |
|
Definition
|
Nephritic Syndrome
|
Nephrotic Syndrome
|
|
Inflammation (remember “itis"
|
basement membrane permeability
|
|
Variable proteinuriea
> 3 gm/day
|
Profound proteinuria
> 3.5 gm/day
|
|
Heamturia
RBC casts
|
Hypoalbuminemia
|
|
Edema
|
Huge amounts of Edema
|
|
Hypertension
|
Hyperlipidemia
|
|
serum creatinine
|
Lipiduria
|
|
Oliguria (400 mL/day)
|
|
|
|
|
Term
What is the purpose of protein metabolism?
Describe the process
|
|
Definition
· REMOVE NITROGENOUS WASTE
o Proteins are deaminated for use
§ Amino group is transferred to some substance
§ This produces ammonia – NH3
§ Ammonia is converted to urea
§ Urea is excreted by kidneys
|
|
|
Term
What does BUN measure?
What's a normal range?
Filtered at _____; reabsorbed at _____.
If elevated, what does it mean? |
|
Definition
The amount of urea in the blood
10-20 mg/dl
Glomerulus; Tubules
There's a problem with filtration of the kidneys
|
|
|
Term
Inrcreased nitrogenous wastes in the blood is known as:
Clinical manifestations include: |
|
Definition
Uremia
· INC BUN
· INC creatinine
· Fatigue
· Anorexia
· Nausea
· Vomiting
· Pruritis
· Neurological changes
· AZOTEMIA
o BUN and creatinine is elevated
|
|
|
Term
Normal serum levels of creatinine are:
_____ is released when muscle is damaged and you will see elevated creatinine in blood. |
|
Definition
|
|
Term
| If GFR decreases, the plasma creatinine in the blood _____. |
|
Definition
|
|
Term
| What is the normal BUN:Creatinine Ratio? |
|
Definition
|
|
Term
| What are some causes of a HIGH BUN:Creatinine Ratio? |
|
Definition
o Kidney failure
o Severe dehydration
o Urinary tract blockage
o Respiratory tract bleeding
§ More protein being broken down
o High protein diet
§ More protein being broken down
o Steroid medications
§ More protein being broken down
|
|
|
Term
| What are some causes of a LOW BUN:Creatinine Ratio? |
|
Definition
o Low protein diet
o Muscle injury
o Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH)
o Pregnancy
o Cirrhosis: liver disease
|
|
|
Term
| A sudden, severe drop in BP (shock) or interruption of blood flow to the kidneys from severe injury or illness is due to: |
|
Definition
|
|
Term
| A sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury is: |
|
Definition
|
|
Term
| Direct damage to the kidneys by inflammation, toxins, drugs, infection, or decreased blood supply is: |
|
Definition
|
|
Term
| The most common cause of AKI is: |
|
Definition
| PRE-renal problems (dec renal blood flow, volume, perfusion, or alterations in electrolyte balances). |
|
|
Term
| An obstruction or a neurogenic bladder (neuro problem with motor impulses going TO the kidneys or sensory problem going FROM the kidneys) can lead to a ____-renal AKI. |
|
Definition
|
|
Term
| Glomerular problems or Acute Tubular Necrosis can lead to a _____-renal AKI. |
|
Definition
|
|
Term
|
Definition
Risk
Injury
Failure
Loss
ESKD |
|
|
Term
| Decrease in urine production to < 400 ml/day (due to ischemia, direct toxic injury, obstruction) is called _____ and is the most common cause of ____. |
|
Definition
Acute Tubular Necrosis
AKI |
|
|
Term
| Ototoxicity is due primarily to a nephrotoxic antibiotic known as: |
|
Definition
|
|
Term
| Heavy metals (lead), poisons, hemoglobinurea, etc, can all cause _____. |
|
Definition
|
|
Term
What are the 3 stages of AKI?
Describe them
|
|
Definition
Initiation
o Increased UO
o Diuresis
§ Levels may vary due to decreased fluid
§ Lose lots of electrolytes… monitor them closely
o Decreased serum creatinine
o Persistent damage to kidneys
|
|
|
Term
| Decreased UO and Increased BUN at anout 36 hours since renal damage defines which stage of AKI? |
|
Definition
|
|
Term
| When the UO is between 40-400 ml/day, the pt is acidotic, and there is an increase in Na, fluid volume, BUN, and K+, what stage of AKI is the pt in? |
|
Definition
|
|
Term
| Extreme UO with dec fluid volume, Na+, and K+ describes which phase of AKI? |
|
Definition
|
|
Term
| Describe the treatment for pt with AKI... |
|
Definition
o Treat cause
o Keeping appropriate Fluid balance
o Low protein
o Hemodialysis
o Continuous Renal Replacement Therapy (CRRT)
§ Hemodialysis
ú More modern version
ú Constant dialysis
ú Occurs when person can’t tolerate dialysis
|
|
|
Term
| What are the four stages in CRI? |
|
Definition
Diminished Reserve (mild renal injury)
Renal insufficiency
Chronic Renal Failure
End-Stage Renal Disease |
|
|
Term
| When the GFR is 50% (60-89 ml/min) but the BUN is WNL, what stage of CRI is the pt in? |
|
Definition
|
|
Term
| When the GFR is 20-50% (30-59 ml/min) and the BUN and creatinine have increased (azotemia) and the pt is experiencing anemia, HTN, polyuria, and nocturia, they are most likely in what stage of CRI? |
|
Definition
|
|
Term
| When the GFR is 20-25% and the pt is experiencing metabolic acidosis, hyperkalemia, severe uremia, and edema, they are most likely in what stage of CRI? |
|
Definition
|
|
Term
| When the GFR is < 5% and the pt is experiencing terminal uremia, they are in what stage of CRI? |
|
Definition
|
|
Term
What is the best treatment for CRI?
What are other, more common treatments?
What is a good diet plan for those experiencing CRI? |
|
Definition
Kidney Transplant
Hemodialysis, Peritoneal dialysis
Low protein and low Na diet |
|
|
Term
What's the most common clinical manifestation for Bladder Neoplasms?
Best treatment? |
|
Definition
Hematuria; usually painless
Surgery to remove tumor; will also inject stuff into bladder (intravesicular therapy) |
|
|
Term
Wilm's Tumor is a type of _____ seen most commonly in _____, __ - __ yoa. It's often _____. One of the most obvious clinical symptoms is _____ because this is rarely seen in this age bracket.
The best treatment is with _____ and _____ with and ___% survival. |
|
Definition
Wilm's Tumor is a type of bladder cancer seen most commonly in children, 3 - 5 yoa. It's often genetic. One of the most obvious clinical symptoms is HTN because this is rarely seen in this age bracket.
The best treatment is with chemo and surgery with an > 80% survival. |
|
|
Term
| 80-85% of renal cancers are _____ and due to _____, _____, and _____. |
|
Definition
| 80-85% of renal cancers are renal cell carcinoma and due to smoking, obesity, and petroleum products. |
|
|
Term
| Someone who is relativley asymptomatic but may have hematuria, dysuria, and a fever may have...? |
|
Definition
|
|
Term
| The best treatment for renal cancer is: |
|
Definition
|
|
Term
| Renal cancers often metastasize to the: |
|
Definition
| lymph, liver, bones, and lungs |
|
|
