Chronic Kidney Disease (CKD) Complications and Management
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Questions and Answers

What is the primary cause of metabolic acidosis in chronic kidney disease?

  • Defective reabsorption and regeneration of bicarbonate (correct)
  • Increased acid production
  • Decreased potassium levels
  • Impaired vitamin D synthesis

    • A patient with chronic kidney disease is experiencing dyspnea and Kussmaul respirations. What is the likely cause of these symptoms?

  • Hyperkalemia
  • Severe metabolic acidosis (correct)
  • Diabetes
  • Hypocalcemia

    • A patient with chronic kidney disease is experiencing nausea and vomiting. What is the likely cause of these symptoms?

  • Uremic breath
  • Electrolyte imbalance
  • Metabolic acidosis
  • Gastrointestinal symptoms of uremia (correct)

    • What is the term for the bone disorder associated with chronic kidney disease?

    <p>Renal osteodystrophy</p> Signup and view all the answers

    A patient with chronic kidney disease has a potassium level of 6.5 mEq/L. What is the most likely cause of this electrolyte imbalance?

    <p>Decreased potassium excretion</p> Signup and view all the answers

    What is the cardiovascular complication associated with chronic kidney disease?

    <p>All of the above</p> Signup and view all the answers

    What is the daily limit of sodium intake recommended for patients with CKD?

    <p>2-4 g/day</p> Signup and view all the answers

    What is the primary goal of administering phosphate binders in CKD patients?

    <p>To limit dietary phosphorus absorption</p> Signup and view all the answers

    Which of the following electrolyte imbalances is a concern in CKD patients?

    <p>Hyperkalemia</p> Signup and view all the answers

    What is the primary complication of mineral bone disorder in CKD patients?

    <p>Secondary hyperparathyroidism</p> Signup and view all the answers

    What is the purpose of subtotal parathyroidectomy in CKD patients?

    <p>To control secondary hyperparathyroidism</p> Signup and view all the answers

    What is the primary focus of nursing management in CKD patients with fluid overload?

    <p>Daily weight measurement and fluid status assessment</p> Signup and view all the answers

    What is a key diagnostic indicator of kidney disease?

    <p>Consistently elevated serum creatinine</p> Signup and view all the answers

    What is the target blood pressure for patients with kidney disease?

    <p>130/80 mm Hg</p> Signup and view all the answers

    Which medication is used to treat hyperkalemia in patients with kidney disease?

    <p>Sodium polystyrene sulfonate (Kayexalate)</p> Signup and view all the answers

    What is a potential complication of medication use in patients with kidney disease?

    <p>Accumulation of toxins due to reduced excretion</p> Signup and view all the answers

    What is the purpose of nutritional therapy in patients with kidney disease?

    <p>To restrict protein, fluid, sodium, and potassium intake</p> Signup and view all the answers

    Which of the following is a diagnostic test used to detect kidney disease?

    <p>Renal ultrasound</p> Signup and view all the answers

    What is the preferred treatment for acute hyperkalemia?

    <p>IV glucose and insulin</p> Signup and view all the answers

    A patient with chronic kidney disease has a blood pressure of 140/90 mmHg. What is the next step in hypertension management?

    <p>Initiate a diuretic and an ACE inhibitor</p> Signup and view all the answers

    A patient with chronic kidney disease has a hemoglobin level of 9 g/dL. What is the most likely medication to be prescribed?

    <p>Epoetin alfa</p> Signup and view all the answers

    A patient with chronic kidney disease has a low-density lipoprotein (LDL) level of 120 mg/dL. What is the most likely medication to be prescribed?

    <p>Statins</p> Signup and view all the answers

    What is the primary focus of nursing management in patients with chronic kidney disease?

    <p>All of the above</p> Signup and view all the answers

    What is a critical component of nursing assessment in patients with chronic kidney disease?

    <p>All of the above</p> Signup and view all the answers

    What is the primary mechanism by which the kidneys contribute to the development of metabolic acidosis in chronic kidney disease?

    <p>Defective reabsorption and regeneration of bicarbonate</p> Signup and view all the answers

    What is the primary reason for restricting sodium intake to 2g/day in patients with chronic kidney disease?

    <p>To reduce the risk of hypertension and heart failure</p> Signup and view all the answers

    What is the primary hematologic consequence of chronic kidney disease?

    <p>Anemia</p> Signup and view all the answers

    What is the primary goal of nutritional therapy in patients with chronic kidney disease?

    <p>To slow disease progression</p> Signup and view all the answers

    What is the primary nursing assessment focus for patients with chronic kidney disease?

    <p>Assessing for hypertension and heart failure</p> Signup and view all the answers

    What is the primary risk associated with chronic kidney disease?

    <p>Progression to end-stage renal disease</p> Signup and view all the answers

    What is the primary goal of restricting potassium intake in patients with CKD?

    <p>To prevent cardiac arrhythmias</p> Signup and view all the answers

    Which of the following medications is used to treat secondary hyperparathyroidism in CKD patients?

    <p>Cinacalcet</p> Signup and view all the answers

    What is the primary focus of nursing management in CKD patients with hypertension?

    <p>Monitoring daily BP</p> Signup and view all the answers

    Which of the following is a potential risk associated with CKD patients?

    <p>All of the above</p> Signup and view all the answers

    What is the primary goal of nursing assessment in CKD patients?

    <p>To identify signs of fluid overload</p> Signup and view all the answers

    Which of the following is a nursing intervention for CKD patients with anemia?

    <p>Providing iron supplements</p> Signup and view all the answers

    Study Notes

    Chronic Kidney Disease (CKD)

    • CKD occurs most often at night, requiring diuretics, and worsens as CKD progresses, eventually requiring dialysis in End-Stage Renal Disease (ESRD).

    Metabolic Disturbances

    • Waste production accumulation leads to decreased Glomerular Filtration Rate (GFR) and increased Blood Urea Nitrogen (BUN) and serum creatinine levels.
    • Altered carbohydrate metabolism and impaired glucose metabolism occur.
    • Electrolyte and acid-base imbalance can lead to hyperkalemia, hyponatremia, and metabolic acidosis.

    Cardiovascular System

    • Hypertension and diabetes contribute to Cardiovascular Disease (CVD) and heart failure (HF).
    • Dyslipidemia or hyperlipidemia increases the risk of Coronary Artery Disease (CAD).

    Musculoskeletal System

    • CKD Mineral Bone Disorder (MBD) is characterized by altered bone metabolism and bone disease (renal osteodystrophy).

    Integumentary System

    • Pruritus is a common symptom in CKD patients.

    Reproductive System

    • Infertility and decreased libido are common in CKD patients.

    Psychologic System

    • Behavioral changes, emotional changes, withdrawal, and depression are common in CKD patients.

    Respiratory System

    • Severe acidosis leads to dyspnea and Kussmaul respirations.

    Gastrointestinal System

    • Stomatitis, metallic taste, uremic breath, nausea, vomiting, anorexia, and constipation are common gastrointestinal symptoms in CKD patients.

    Neurologic System

    • Neurologic changes occur as CKD progresses, including lethargy, fatigue, confusion, irritability, peripheral neuropathy, asterixis, nocturnal leg cramping, and seizures.

    Hematologic System

    • Anemia, bleeding tendencies, and infection are common in CKD patients.

    Diagnostic Tests

    • Diagnostic tests include:
      • Glomerular Filtration Rate (GFR)
      • Urinalysis for albuminuria, red blood cells, and white blood cells
      • Renal ultrasound to detect obstruction and kidney size
      • Renal biopsy

    Interprofessional Care

    • Goals include preserving kidney function, reducing cardiovascular disease risk, preventing complications, and ensuring patient comfort.
    • Drug therapy includes:
      • Hyperkalemia treatment with potassium-binding agents, sodium polystyrene sulfonate, patiromer, and sodium zirconium cyclosilicate
      • Hypertension treatment with diuretics, antihypertensive drugs, ACE inhibitors, and angiotensin receptor blockers
      • Anemia treatment with erythropoiesis-stimulating agents (ESAs) and iron supplements
      • Dyslipidemia treatment with statins

    Nutritional Therapy

    • Protein restriction, fluid restriction, and sodium and potassium restriction are essential in CKD patients.

    CKD Mineral Bone Disorder

    • Limit dietary phosphorus to less than 1000mg/day if patient requires Renal Replacement Therapy (RRT)
    • Administer phosphate binders with meals, such as calcium carbonate, lanthanum carbonate, sevelamer carbonate, sucroferric oxyhydroxide, and ferric citrate
    • Supplement Vitamin D and calcitriol to control secondary hyperparathyroidism
    • Use calcimimetic agents, such as cinacalcet, and consider subtotal parathyroidectomy

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    Description

    This quiz covers the complications and management of chronic kidney disease, including the effects on diuretics, electrolyte and acid-base balance, and metabolic disturbances. It also discusses the importance of dietary restrictions and medication management in CKD patients. Test your knowledge of CKD and its implications on patient care.

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