Renal Failure

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Author:
alyn217
ID:
200091
Filename:
Renal Failure
Updated:
2013-02-14 12:16:04
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AMS2T1
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Description:
Adult MedSurg 2
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  1. General info about acute renal failure (ARF)?
    • Rapid decrease in renal function = accumulation of metabolic waste
    • Caused by inadequate kidney perfusion
    • Prerenal failure: something happened that had nothing to do with the kidney to cause it to fail, ie trauma or toxins introduced to body. 
    • Intrarenal failure: Stuff happening inside the kidney. 
    • Postrenal failure: Stuff happening below (after) the kidney to cause it to fail. 
    • Prognosis
    • End-stage renal disease (ESRD)
    • Reversible/pre-ARF level of renal function 
  2. What is acute tubular necrosis? (ATN)
    • THE one form of recoverable renal failure. 
    • Causes: 
    • poisons (NSAIDs)
    • hypoperfusion (kidney shock)

    • Early SnSs:
    • oliguriea (3-7 days), hyperkalemia danger
    • later:
    • diuresis (up to 2 wks, 4Lt/day), potassium wasting
    • Throughout: isosthenuria
  3. What are some complications associated with end stage renal disease (esrd)
    • Progressive, irreversible kidney injury
    • Azotemia:^BUN, Crt
    • Uremia
    • Uremic syndrome: Uremic "frost." Pasty flower on skin. 
    • Stages?
    • Diminished renal reserve
    • Renal insufficiency
    • End-stage renal disease 
    • Decreased adrenal fxn-->^cortisol levels-->^BP.
    • Good idea to know this.
    • Potassium = acid-->upset acid/base balance. 
  4. What is the biggest problem with peritoneal dialysis?
    • Infection. Pt education, education, education. 
    • Also, speed of infusion can effect pain/cramping. 
  5. SnSs of peritonitis?
    • pain, distention, and loss of bowel sounds.
    • progressively sicker
    • hurts to breath
    • symptoms of shock
    • pt preferes to lay on back with knees bent. 
  6. Management of peritonitis?
    • NPO
    • I/O
    • TPN fluids
    • antibiotics
    • NG suctioning
    • Pain Rx
    • semifowlers
    • drains
  7. Major complications of peritonitis?
    • hypovolemic shock
    • sepsis
    • abscess
    • paralytic ileus
    • multiple organ failure
  8. What are the dietary restrictions associated with chronic renal failure?
    • Protein restriction
    • Sodium restriction
    • Potassium restriction
    • Phosphorus restriction
    • Vitamin supplementation
    • Individualization of diet
  9. What kinds of Rx are used for kidney failure?
    • Typical Crt. 28---> give erythropoetin-->^RBC count. 
    • Iron-->^RBCs (and constipation and black stools). 
    • Calcium + vit D to avoid demineralizing bones along with parathyroid hormones. Will draw vit D levels. 
    • Phos and phos binding agents, ie 6 tums with meals.
    • Vit replacements, ie NephroVit to help skel muscle cramping. 
    • Benadryl (secreting toxins through skin)-->depressed personality. 
    • Antihypertensives. 
    • Folic acid to correct homocystine levels. 
    • Statins to correct cholesterol/triglycerides.
  10. What is EKD and AKI
    • ESKD: End Stage Kidney Disease. Same as ESRD. 
    • AKI: Acute Kidney Injury. Early onset of kidney damage. May precede ATN.  

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