NURS 460_Renal

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Author:
GerberTri
ID:
23267
Filename:
NURS 460_Renal
Updated:
2010-06-12 21:28:31
Tags:
Critical care renal
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Description:
Test III Renal
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  1. Erythropoeitin
    Stimulates RBC production
  2. Lasix (furosemide)
    • Loop diuretic, prevents body from absorbing too much salt, allowing salt to be passed in yoru urine.
    • Treats fluid retention (edema) in people with liver disease/kidney disorder (nephrotic syndrome)
  3. Calcium
    • 8.2-10.2
    • Inverse relationship with phosphate
  4. Phosphorus
    • 2.5-4.5
    • Inverse relationship with calcium
  5. BUN
    • 8-25
    • Kidney function status
  6. Creatinine
    • 0.8-1.4
    • Kidney function status
  7. BUN/Creat ratios
    • 20:1 prerenal
    • 15:1 intrarenal/postrenal
  8. MAP
    65-70
  9. GFR
    nomral
    definition
    influenced by...
    • 125 mL/minute; 80% reabsorbed, 20% urine
    • rate at which the filtrate (urine) is formed
    • influenced by blood hydrostatic pressure & the filtrate osmotic pressure
  10. GFR: i/c BP= afferent arteriole ____
    • i/c BP = afferent arteriole vasoconstriction
    • MAP 90-250, GFR is proportional to perfusion pressure; if MAP falls greatly (shock) GFR will fall to near zero reulting in anuria
  11. GFR: d/c BP= afferent arteriole ____
    • D/c BP= afferent arteriole dilation
    • increasing perfusion of glomeruli
  12. 3 phases of acute renal failure
    • Prerenal
    • Intrarenal
    • Postrenal
  13. Prerenal failure
    cause, BUN, tx
    • Causes: renal vasoconstriction, hypotension, hypovolemia, hemorrhage, inadequate CO, massive vasodilation, obstruction of renal artery
    • BUN: CR ratio 20:1
    • Presenation: see notes
    • Tx: goal is to restore perfusion & revent tubular damage
    • volume depletion: crystalloids, colloids
    • impaired cardiac function: positive inotropes
    • Vasodilation: vasopressors & fluids
  14. Intrarenal failure
    • Cause: glomerular injury, vascular injury, ATN
    • BUN: Cr ratio 10:1 to 15:1
  15. Postrenal Failure
    • Causes: obtruciton of urine flow from the kidney to the urethra (prostate problems)
    • BUN: CR ratio 10:1 to 15:1
    • Tx. aimed @ removing the blockage
  16. ATN phases
    • 1. Onset
    • 2. Oliguric/nonoliguric phase
    • 3. Diuretic phase
    • 4. Recovery
  17. ATN clinical presentation
    voluem overload, metabolic acidosis, hyperkalemia, hypocalcemia/hyperphosphatemia, hematologic (anemia, d/c platelet function), uremia
  18. ADH
    • changes permability of collecting tubes to water
    • I/C levels: high permeability (highly concentrated urine in small amounts--dehydration)
    • D/C: low permeability (larger volume of urine with elss concentration--large intake of water)
  19. RAA
    Renin is stimulated when GFR falls due to dehydration or blood loss (can also be stimualted when sodium levels are low in the filtrate)
  20. Aldosterone
    • stimulated by Angiotensin II
    • Promotes reabsorption of Na and H2O to correct fluid defiicts, i/c BP, i/c Na & d/c K levels
  21. Hemodialysis
    Principle of osmosis & diffusion to remove water products & excess fluid from the blood

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