Exam (elaborations)
NUR 265 EXAM ONE STUDY GUIDE.
- Course
- Institution
NUR 265 EXAM ONE STUDY GUIDE/NUR 265 EXAM ONE STUDY GUIDE/NUR 265 EXAM ONE STUDY GUIDE.
[Show more]
Seller
Follow
Toppnurse
Reviews received
Content preview
NUR 265 EXAM ONE STUDY GUIDE Nephrotic Syndrome:
o NS is a condition of increased glomerular permeability that
allows larger molecules to pass through the membrane into the
urine and then be excreted.
o Immunological Kidney disorder
o This causes massive loss of protein in the urine, edema
formation, and decreased plasma albumin levels.
Proteinuria- severe protein loss more than 3.5 g in 24-
hour urine sample.
o Key features:
Massive proteinuria >3.5g / 24hrs
Hypoalbuminemia <3g/dL
Edema (facial and periorbital)
Lipiduria
Hyperlipidemia
Increased coagulation (renal vein thrombosis)
Reduced kidney function (↑ BUN, ↑ Cr, ↓ GFR)
o Treatment- immunosuppressant agents (if immunity based).
ACE inhibitors (to decreased protein loss in urine & ↓BP)
Statins (improve blood lipid levels).
Heparin (↑ coagulation / risk of thrombosis → treat
vascular effects and improve kidney function)
o Diet:
If GFR is normal- dietary intake of complete proteins is
needed
If GFR is decreased- dietary protein is decreased, diuretics
and sodium restriction.
Acute Kidney Injury:
o AKI is rapid reduction in kidney function resulting in a failure to
maintain fluid and electrolyte balance, and acid-base balance.
Can occur over a few hours or days
o Severity of AKI is based on serum creatinine increase, and
decreased urine output- an increase in specific gravity (meaning
urine is more concentrated or the patient is dehydrated).
o GFR isn’t used to measure acute injury or illness—only chronic
kidney disease.
o 3 types of AKI
prerenal - conditions that reduce blood flow / oxygen to
the kidney → decreased perfusion to kidneys
azotemia- nitrogenous waste/toxin build up
o effects LOC, mood, change in personality
, o related directly to reduced perfusion to the
kidneys
examples of perfusion reduction:
o blood/fluid loss- (surgery, sepsis, hypovolemic
shock)
o blood pressure drugs resulting in hypotension
o MI or HF → low ejection fraction → low cardiac
output
o NSAIDs, ASA
o Anaphylaxis
o Severe burns
o Severe dehydration
o Renal artery stenosis
o Bleeding or clotting in kidney blood vessels
o Atherosclerosis (cholesterol deposits
obstructing blood flow to the kidneys)
Intra-renal failure- tissue damage to the actual kidneys
Intra-renal- reflects injury to the glomeruli, nephrons,
or tubules
Examples of intra-renal failure:
o Bleeding in the kidney
o Glomerulonephritis or inflammation of the
glomeruli
o Pyelonephritis
o Thrombi or emboli in the kidney blood vessels
o TTP → platelet disorder ↑ clotting
o Sepsis or local infection
o Lupus
o Multiple myeloma
o Scleroderma
o Chemo/ ABTs / nephrotoxic drugs
o Ischemia in kidney failure, including hypoxemia
from respiratory and cardiac arrest
Post-renal failure- Urine flow obstruction
Post-renal failure examples:
o Bladder cancer
o Colon cancer
o Prostate cancer
o Cervical cancer
o Enlarged prostate
o Kidney stones
o Blood clots in urinary tract
, o Neurogenic bladder →Nerve damage
o Mean atrial pressure is important in determining adequate kidney
perfusion!!!
MAP= (systolic+ 2[diastolic])/3
Mean atrial pressure of 65 is needed to perfuse the kidney!!
Manifestations (s/s) of AKI
o Oliguria
o Fluid Volume Overload
Crackles
Edema
Anasarca (generalized edema)
↓ 02 sats
↑ RR
o LOC changes
o Labs (↑BUN, ↑Cr, urine specific gravity >1.030)
o Nursing considerations / Interventions for AKI:
Prevention is key! - urge patients to drink 2-3 L of water
daily.
Monitor Fluid status (I&O, weight, ↑ hydration,
characteristic of urine)
Report Output <0.5mL/kg/hr if persists >2hr
<30mL/hr
Monitor for kidney functions
o Labs (BUN, Cr, GFR, electrolytes, osmolarity)
o I&Os
You want output to be more than input
Sodium, potassium, and specific gravity
determine hydration status.
o Contrast dyes
o MAP > 65 mmHg
Diuretic therapy- happens after AKI is starting to be
resolved! (Releasing extra fluid through the urine -
This is a good sign!!! - Watch for dehydration! - Its
normal to have fluids hanging during the diuretic
phase! - Titrate fluids!)
Nutrition during AKI:
o Low protein
Because protein molecules are huge and
put on the strain to process
o Low sodium
Since the body has high sodium
concentration due to AKI
Fluid restriction
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Toppnurse. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $12.49. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
75759 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now