- What is nephrotic syndrome?
A condition of increased glomerular permeability that allows larger
molecules to pass through the membrane into the urine
... [Show More] and then be excreted.
- What are key features of nephrotic syndrome?
-
Massive proteinuria
-Hypoalbuminemia
-Edema (facial and periorbital)
-Lipiduria
-Hyperlipidemia
-Increased coagulation
-Reduced kidney function
- In nephrotic syndrome, severe protein loss in the urine is greater than what?
3.5g in 24 hours
- What is nephrotic syndrome treated with?
-immunosuppressant agents (if immunity based).
-ACE inhibitors (decreased protein loss in urine)
-statins (improve blood lipid levels).
-Heparin (used to treat vascular effects and improve kidney function)
- Describe Prerenal AKI. Give examples.
Decreased perfusion to kidneys.
-NSAIDs
-Severe dehydration
-Renal artery stenosis
-MI or HF resulting in low ejection fraction and low cardiac output
-Blood/ fluid loss
- Describe Intrarenal AKI. Give examples.
Tissue damage to the actual kidneys.
-Glomerulonephritis or inflammation of the glomeruli
-Sepsis-Intrarenal bleeding
-Pyelonephritis
- Describe Postrenal AKI. Give examples.
Obstruction that occurs after the kidney.
-Enlarged prostate (BPH)
-Bladder Cancer
-Kidney stones
- How do you determine the mean arterial pressure (MAP)?
Systolic + (Diastolic*2) /3
- What is the MAP needed to perfuse the kidneys?
65 mmHg
- What are examples of nephrotoxic drugs?
-NSAIDS
-Metformin
-Diuretics
-Antibiotics (especially -mycin)
-Contrast dye
- During the diuretic phase of AKI, what needs to be monitored?
Watch for dehydration and make sure output is greater than input
- What are the dietary restrictions for an AKI patient?
-Low protein
-Low sodium
-Fluid restriction: 1000-1500mL day (for anything except perfusion
problem)
- What are the 2 most common causes of CKD?
-HTN
-Uncontrolled diabetes
- What is azotemia?
Nitrogenous waste build up
- What are manifestations of uremia?•Metallic taste in mouth
•Anorexia
•Nausea/vomiting
•Muscle cramps
•Uremic frost on skin
•Itching
•Fatigue and lethargy
•Hiccups
•Edema
•Dyspnea
•Paresthesia's
- What effects can CKD have on the cardiac system
-HTN
-Heart failure (major problem. Call the doctor)
-Pericarditis
- What effects can CKD have on the Integumentary system
-Uremic frost
- What are the dietary restrictions on CKD?
-Protein (restrict early in disease process to preserve kidney function)
-Potassium
-Fluid
-Sodium
- Describe hemodialysis
-3x a week- 4-5 hours
-At risk for bleeding do to heparin
-Extremely fatigued post.
-Vitals and weight before and after
-Slight fever post is normal. Monitor.
- Describe peritoneal dialysis
-Sterile procedure at home where catheter is placed into the abdomen
-Wear a mask
-Solution may be warmed using a heating bag or blanket, not microwave!
-Make sure patient turns and repositions to mix solution in the cavity [Show Less]