Nephrology Lecture: Kidney Disease Seminar
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Questions and Answers

What is the normal glomerular filtration rate (GFR) in mL/min?

  • 100 mL/min
  • 125 mL/min (correct)
  • 150 mL/min
  • 175 mL/min

    • Which of the following are primary causes of renal failure?

  • Alcohol abuse
  • Hypertension (correct)
  • Diabetes mellitus (correct)
  • High cholesterol

    • What might fluid retention in chronic kidney disease manifest as?

  • Increased urination
  • Dehydration
  • Weight loss
  • Peripheral edema (correct)

    • Which cardiovascular manifestation is associated with chronic kidney disease?

    <p>Dysrhythmias / ECG changes</p> Signup and view all the answers

    What is indicated by a pericardial friction rub in a patient with chronic kidney disease?

    <p>Fluid overload</p> Signup and view all the answers

    Which nursing assessment is most appropriate for evaluating respiratory function?

    <p>Inspection of thorax for symmetrical movement</p> Signup and view all the answers

    What laboratory value would indicate a potential renal issue if there is an increase?

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

    Which manifestation is a common sign of renal impairment?

    <p>Decreased urinary output</p> Signup and view all the answers

    What type of skin finding is associated with liver dysfunction?

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

    What is one of the primary assessments for monitoring renal function?

    <p>Testing urine for protein</p> Signup and view all the answers

    Which of the following is NOT a manifestation of the integumentary system?

    <p>Shortness of breath</p> Signup and view all the answers

    What is the significance of monitoring uric acid levels in relation to renal function?

    <p>Indicates possible azotemia</p> Signup and view all the answers

    What type of respiration pattern is characterized by deep, rapid breathing?

    <p>Kussmaul respirations</p> Signup and view all the answers

    What is a key manifestation that must be monitored for individuals at risk of malnutrition?

    <p>Daily weight changes</p> Signup and view all the answers

    Which assessment is necessary to check for peripheral neuropathy?

    <p>Assess for the 3 spheres of orientation</p> Signup and view all the answers

    What assessment should be performed to evaluate postural instability in neurologically impaired patients?

    <p>Motor strength comparison bilaterally</p> Signup and view all the answers

    Which symptom is associated with increased risk of infection?

    <p>Local swelling and heat in wounds</p> Signup and view all the answers

    What is a common cause of confusion in a clinical setting?

    <p>Severe dehydration</p> Signup and view all the answers

    Which of the following should be monitored to assess hematological health?

    <p>Complete blood count (CBC)</p> Signup and view all the answers

    What nursing assessment is critical to evaluate muscle function?

    <p>Motor strength testing</p> Signup and view all the answers

    In cases of GI bleeding, which finding should be closely monitored?

    <p>Emesis appearance</p> Signup and view all the answers

    What is an important aspect of assessing a patient's neurological status?

    <p>Changes in LOC</p> Signup and view all the answers

    Which of these factors is significant in monitoring a patient with renal osteodystrophy?

    <p>Calcium and phosphate levels</p> Signup and view all the answers

    What is the maximum urine output defined as oliguria?

    <p>Less than 400-500 ml in 24 hours</p> Signup and view all the answers

    Which of the following statements about creatinine is true?

    <p>It is used to estimate kidney function.</p> Signup and view all the answers

    Which risk factor is associated with an increased likelihood of developing acute kidney injury (AKI)?

    <p>Advanced age</p> Signup and view all the answers

    Which of the following correctly defines chronic kidney disease (CKD)?

    <p>Irreversible loss of kidney function lasting more than 3 months</p> Signup and view all the answers

    Which of the following is NOT a common cause of acute kidney injury?

    <p>Regular exercise</p> Signup and view all the answers

    During which phase of acute kidney injury should 'risks' be considered?

    <p>Oliguric phase and Diuretic phase</p> Signup and view all the answers

    What laboratory finding suggests a decreased glomerular filtration rate (GFR)?

    <p>High creatinine levels</p> Signup and view all the answers

    Which medication can lead to an increase in blood urea nitrogen (BUN) levels without affecting kidney function?

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

    What happens to the nephrons in chronic kidney disease?

    <p>They experience progressive loss of function.</p> Signup and view all the answers

    What condition is characterized by having less than 100 ml of urine output in 24 hours?

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

    Study Notes

    Nephrology Lecture: Acute and Chronic Illness Theory

    • Objectives:
      • Describe pathophysiology, manifestations, and lab abnormalities of chronic and end-stage kidney disease.
      • Explain nursing assessments needed for patients with chronic and end-stage kidney disease.
      • Develop understanding of renal replacement therapies and how they work.
      • Discuss important assessments and ongoing monitoring for patients with renal disease undergoing dialysis and what to report.
      • Explain care necessary to promote health and prevent illness in patients with renal disease.

    Terms to Consider

    • Creatinine:
      • Breakdown product of creatinine phosphate in muscle.
      • Filtered by the kidney.
      • Used to estimate kidney function.
      • Higher creatinine = lower filtration (GFR).
    • BUN (Blood Urea Nitrogen):
      • Urea formed from protein breakdown by the liver.
      • Filtered by the kidney and used to measure function.
      • High BUN reflects low filtration.
      • Some medications (steroids, antibiotics) can cause BUN to rise without affecting kidney function.
    • Oliguria: 400-500 ml of urine in 24 hours.
    • Anuria: < 100 ml of urine in 24 hours.

    Acute Kidney Injury (AKI)

    • AKI is a sudden episode of kidney failure or damage within a few hours or days.
    • Causes build-up of waste products in the blood, difficult for kidneys to keep the right fluid balance in the body.
    • Approximately 5-7% of hospitalized and critically ill patients develop AKI (often due to medication).

    Risk Factors for AKI

    • Advanced age
    • Diabetes
    • Hypotension
    • Cardiovascular disease (CAD)

    Causes of AKI

    • Infection/sepsis
    • Low cardiac output (kidneys receive 25% of total CO)
    • Reduced blood flow to renal tubules
    • Nephrotoxic drugs (aminoglycoside antibiotics, contrast dyes, ethylene glycol, diuretics, NSAIDs)

    AKI Types and Phases

    • AKI has 3 types (pre-renal, renal, post-renal) and 4 phases (onset, oliguric, diuretic, recovery). Specific details from the provided text.

    Chronic Kidney Disease (CKD)

    • Defined as abnormalities of kidney function or structure present for more than 3 months, with health implications.
    • Includes people with markers of kidney damage and those with a glomerular filtration rate (GFR) of less than 60 ml/min/1.73 m² on at least 2 occasions separated by 90 days (with or without markers of kidney damage).
    • Progressive, irreversible loss of kidney function.
    • Nephron loss leads to decreased GFR and waste product accumulation in blood (azotemia).
    • Common causes of renal failure: diabetes mellitus, hypertension.

    GFR Categories (Glomerular Filtration Rate)

    • This table provides categories of GFR levels and their corresponding descriptions in relation to levels relative to other adults:

    Chronic Kidney Disease (CKD) Manifestations

    • The text provides a comprehensive list of manifestations across various body systems (integumentary, cardiovascular, respiratory, renal, gastrointestinal, neurological, musculoskeletal & Hematological).

    Nursing Assessments For Various Systems

    • The text provides specific assessment strategies for each system affected by CKD These assessments vary based on the specific system and include inspection, palpation, auscultation, and laboratory monitoring for parameters such as blood pressure, heart rate, respiratory rate, and renal function tests.

    Renal Replacement Therapies

    • Used when kidneys can no longer function adequately (GFR < 15 mL/min).

    • Peritoneal dialysis: Uses the abdominal peritoneum as a membrane to filter fluids. The dialysis fluid (dialysate) is introduced into the abdominal cavity. Fluid moves via osmosis and solutes move through diffusion to filter waste from the blood.

    • Hemodialysis: Employs a dialysis machine to clean the blood. Approximately 2 liters of fluid is removed during each hemodialysis treatment. Venous access is required, such as an arteriovenous fistula (AVF).

    • The document includes information on AVF creation, maturation, and care considerations. Includes assessment details.

    Additional Topics

    • Frequency of Treatment: Hemodialysis schedule and frequency (example: 3 times a week).
    • Assessment and Care After Hemodialysis: Various assessments (e.g., dry weight, volume status, blood pressure, electrolytes, anemia, malnutrition, infections, medications, and diet). Specific details of dry weight determination and its significance.
    • Acid-base and Electrolyte Imbalances: Pre and post dialysis; imbalances associated with CKD. Detailed descriptions from both pre and post-dialysis; explanation of assessments for such issues.
    • Mineral and Bone Disorder (MBD): Includes the loss of calcium vitamin D, High phosphorus and parathyroid hormone.
    • Anemia: Involves erythropoietin synthesis, RBC production, and clinical manifestations from decreased red blood cell production in the bone marrow.
    • Infections: The increased susceptibility and potential complications of chronic wounds and infection.
    • Renal Management: Dietary restrictions, medication management, and blood pressure control. Detailed guidance on medications and their use.
    • Fluid Restrictions: The fluid allowances calculated using urine levels for dialysis patients; important considerations during treatment. Important information about fluid restriction needs.

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    Nephrology Lecture - Acute & Chronic Illness Theory PDF

    Description

    This quiz covers key concepts in nephrology, focusing on acute and chronic kidney disease. Participants will explore the pathophysiology, nursing assessments, and renal replacement therapies, as well as important monitoring practices for renal patients. Test your knowledge of lab abnormalities and health promotion strategies in renal care.

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