Podcast
Questions and Answers
What is a common nursing diagnosis related to chronic renal failure (CRF)?
What is a common nursing diagnosis related to chronic renal failure (CRF)?
- Risk for impaired mobility due to muscle weakness
- High Risk for Injury related to osteoclast activity (correct)
- Ineffective Thermoregulation due to kidney dysfunction
- Fluid Volume Deficit related to dehydration
What dietary adjustment is recommended for patients with chronic renal failure?
What dietary adjustment is recommended for patients with chronic renal failure?
- Elimination of all fats
- Increase protein and sodium intake
- Protein restriction and increased carbohydrate intake (correct)
- Low carbohydrate diet
Which laboratory finding indicates the need for increased dialysis frequency?
Which laboratory finding indicates the need for increased dialysis frequency?
- Decreased BUN levels
- Elevated serum electrolytes (correct)
- Normal CBC values
- Normal serum creatinine levels
What is the purpose of administering synthetic erythropoietin (Epogen) in chronic renal failure?
What is the purpose of administering synthetic erythropoietin (Epogen) in chronic renal failure?
Which statement about kidney transplant recipients is correct?
Which statement about kidney transplant recipients is correct?
What is a common complication of hemodialysis that nurses should monitor for?
What is a common complication of hemodialysis that nurses should monitor for?
What is a nursing intervention for managing electrolyte imbalance in acute renal failure (ARF)?
What is a nursing intervention for managing electrolyte imbalance in acute renal failure (ARF)?
Which type of dialysis involves the use of a catheter placed in the abdomen?
Which type of dialysis involves the use of a catheter placed in the abdomen?
What is a characteristic of Acute Renal Failure (ARF) during its clinical course?
What is a characteristic of Acute Renal Failure (ARF) during its clinical course?
Which of the following is a key difference between Chronic Renal Failure (CRF) and ARF?
Which of the following is a key difference between Chronic Renal Failure (CRF) and ARF?
What is a common physiological effect during the recovery period of ARF?
What is a common physiological effect during the recovery period of ARF?
Which electrolyte imbalance is commonly seen in Chronic Renal Failure?
Which electrolyte imbalance is commonly seen in Chronic Renal Failure?
What does a GFR of 20-40 indicate in the context of renal function?
What does a GFR of 20-40 indicate in the context of renal function?
Which symptom is NOT typically associated with Chronic Renal Failure?
Which symptom is NOT typically associated with Chronic Renal Failure?
Which of the following conditions arises due to fluid overload in CRF?
Which of the following conditions arises due to fluid overload in CRF?
What occurs at the end stage of renal disease concerning renal function?
What occurs at the end stage of renal disease concerning renal function?
What is the mechanism by which Thiazide diuretics help in the management of calculi formation?
What is the mechanism by which Thiazide diuretics help in the management of calculi formation?
Which condition is most commonly associated with decreased renal tissue perfusion?
Which condition is most commonly associated with decreased renal tissue perfusion?
What is a common symptom of acute glomerulonephritis (AGN)?
What is a common symptom of acute glomerulonephritis (AGN)?
Which intervention is considered non-invasive for the treatment of kidney stones?
Which intervention is considered non-invasive for the treatment of kidney stones?
Chronic glomerulonephritis can lead to which notable symptom?
Chronic glomerulonephritis can lead to which notable symptom?
What is the primary goal of using cholestyramine in the context of nephrolithiasis?
What is the primary goal of using cholestyramine in the context of nephrolithiasis?
What is a common complication associated with post-renal acute renal failure?
What is a common complication associated with post-renal acute renal failure?
Which of the following is NOT a management strategy for nephrotic syndrome?
Which of the following is NOT a management strategy for nephrotic syndrome?
Which factor may lead to acute renal failure by causing decreased renal blood flow?
Which factor may lead to acute renal failure by causing decreased renal blood flow?
What is the primary function of narcotics in managing acute conditions related to nephrolithiasis?
What is the primary function of narcotics in managing acute conditions related to nephrolithiasis?
What is a key symptom of cystitis?
What is a key symptom of cystitis?
Which of the following factors contributes to the formation of kidney stones?
Which of the following factors contributes to the formation of kidney stones?
Which condition would most likely cause pain localized to the groin area?
Which condition would most likely cause pain localized to the groin area?
What is a recommended management strategy for patients with struvite stones?
What is a recommended management strategy for patients with struvite stones?
Which of the following is NOT a contributing factor to urinary tract infections (UTIs)?
Which of the following is NOT a contributing factor to urinary tract infections (UTIs)?
What is a primary method to manage urinary stasis?
What is a primary method to manage urinary stasis?
What dietary recommendation would be beneficial for patients with calcium stones?
What dietary recommendation would be beneficial for patients with calcium stones?
What is an indication for urine acidification?
What is an indication for urine acidification?
Which type of pain is usually associated with pyelonephritis?
Which type of pain is usually associated with pyelonephritis?
Which of the following treatments is associated with the management of hypercalcemia?
Which of the following treatments is associated with the management of hypercalcemia?
What is the primary function of the renal tubules with respect to regeneration?
What is the primary function of the renal tubules with respect to regeneration?
Which condition results in increased hydrogen secretion and HCO3 reabsorption in the kidneys?
Which condition results in increased hydrogen secretion and HCO3 reabsorption in the kidneys?
What symptom is most closely associated with urinary obstruction?
What symptom is most closely associated with urinary obstruction?
Which of the following statements about serum creatinine is true?
Which of the following statements about serum creatinine is true?
What effect do loop diuretics have on electrolyte balance?
What effect do loop diuretics have on electrolyte balance?
In renal failure, which of the following electrolytes is usually not elevated?
In renal failure, which of the following electrolytes is usually not elevated?
Which type of diuretic blocks sodium reabsorption in the distal convoluted tubule?
Which type of diuretic blocks sodium reabsorption in the distal convoluted tubule?
What is a common side effect of thiazide diuretics?
What is a common side effect of thiazide diuretics?
Which imaging technique is best for visualizing urinary tract obstructions?
Which imaging technique is best for visualizing urinary tract obstructions?
What is the main therapeutic effect of carbonic anhydrase inhibitors in the kidneys?
What is the main therapeutic effect of carbonic anhydrase inhibitors in the kidneys?
Which of the following conditions is indicated by terminal dribbling?
Which of the following conditions is indicated by terminal dribbling?
What electrolyte imbalance commonly occurs with the use of loop diuretics?
What electrolyte imbalance commonly occurs with the use of loop diuretics?
In patients with chronic renal failure, which blood study value indicates a normal range for BUN?
In patients with chronic renal failure, which blood study value indicates a normal range for BUN?
Which of the following is NOT a symptom of incontinence?
Which of the following is NOT a symptom of incontinence?
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Study Notes
Anatomy and Physiology of the Kidneys
- Aldosterone plays a significant role in regulating sodium and potassium balance.
- Nephrons are the functional units of the kidneys, consisting of glomerulus, vasa recta, and kidney tubules.
- Tubules have regenerative capacities, while glomeruli do not.
Acid-Base Regulation
- Acidosis leads to increased hydrogen secretion in kidney tubules, elevating HCO3 reabsorption.
- Alkalosis results in decreased hydrogen secretion, reducing HCO3 reabsorption.
Kidney Function Assessment
- Evaluates excretory and tubular reabsorption of water, electrolytes, and wastes.
- Secretory functions include active Vitamin D, renin, and erythropoietin production.
Assessment Symptoms
- Dysuria, frequency, urgency, and nocturia indicate potential irritation or obstruction.
- Painless hematuria is notable; incontinence can manifest in various forms such as stress, urge, or overflow.
Blood Studies
- Blood Urea Nitrogen (BUN) normal range is 20-30 mg/dL; useful for kidney disease assessment.
- Serum creatinine is a crucial measure for renal function, with a normal range of 0.5-1.5 mg/dL.
- Serum electrolytes in chronic renal failure (CRF) show elevated levels except for calcium and bicarbonate.
Diagnostic Imaging
- Utilizes intravenous pyelography (IVP), MRI, and renal angiography for assessing kidney structure and function.
Diuretic Classification
- Loop Diuretics (e.g., Furosemide) inhibit sodium, chloride, and potassium reabsorption leading to hypokalemia.
- Potassium-sparing diuretics (e.g., Spironolactone) promote sodium and water excretion while retaining potassium.
- Thiazide diuretics block sodium reabsorption in distal convoluted tubule, causing hypokalemia and hyponatremia.
Urinary Tract Infections (UTIs)
- Commonly caused by E.coli; symptoms include fever/chills and pain assessment during urination.
- Factors contributing to UTIs: female anatomy, poor hygiene, urinary stasis, and safe sexual practices.
- Management includes increasing fluids, hygiene practices, and possibly antibiotics.
Kidney Stones (Lithiasis)
- Nephrolithiasis refers to kidney stones; often composed of calcium phosphate/oxalate or uric acid.
- Risk factors include hyperuricemia, hypercalcemia, dehydration, and prolonged immobility.
- Management involves increasing fluid intake, identifying stone type, and possible dietary adjustments.
Renal Failure
- Acute Renal Failure (ARF) is a sudden decline in kidney function, often reversible.
- Clinical stages include oliguric-anuric phase, diuresis phase, and recovery period.
- Chronic Renal Failure (CRF) is a progressive, irreversible deterioration leading to the need for dialysis or transplantation.
Nursing Diagnoses in Renal Failure
- Fluid volume excess related to decreased GFR and sodium retention.
- Risk for infection due to compromised immunity.
- Altered nutrition and electrolyte imbalances require careful management.
Management Strategies
- For CRF: restrict water and sodium, monitor ABGs, and provide supplements (vitamin D, calcium).
- For ARF: maintain I&O balance, monitor weight, and provide dietary management.
- Kidney transplant candidates undergo extensive testing (HLA, ABO) and preparation to avoid rejection and infection.
Surgical Interventions
- Procedures such as nephrolithotomy, ureterolithotomy, and cystolithotomy are performed for stone removal.
- Post-operative monitoring includes increased hydration, ambulation encouragement, and complication observation.
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