CHA 2 EXAM 1 REVIEW (RENAL, GI, LIVER, PANCREAS/APPENDIX) Questions And Answers
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Course
CHA 2
Institution
CHA 2
Pre-renal failure causes - ANS hypovolemia
hemorrhage
shock
cardiac tamponade
renal artery stenosis
What is pre-renal failure - ANS Blood can't get to the kidneys due too:
->Hypotension
->Decrease HR occurs (arrhythmias)
->Hypovolemic
->Any form of shock
...
What is pre-renal failure - ANS Blood can't get to the kidneys due too:
->Hypotension
->Decrease HR occurs (arrhythmias)
->Hypovolemic
->Any form of shock
pre renal failure treatment - ANS Vasopressin
IV fluids
Diuretics
hemodialysis
initiating phase of renal failure - ANS initial insult to the kidneys; patient is hypotensive
what can lead to the initiating phase of renal failure - ANS hemorrhage
nephrotoxic drugs
contrast media
acute obstruction
electrolyte imbalances during the oliguric phase - ANS increased K+
increased Na+
decreased Ca+
increased PO4-
creatine and BUN levels - ANS 0.96-1.16
9-20
What happens when aldosterone is released - ANS increased Na+ retention leads to H2O
retention, resulting in urine conservation and decreased UO to increase the BP
urine may appear orange and have a high specific gravity with scant Na+ in urine
high levels of Na+ in the circulating blood
what happens when the RAAS is activated - ANS vasoconstriction
urine conservation
aldosterone is released
metabolic acidosis
what happens during the oliguric phase - ANS RAAS activated
electrolyte imbalances
hematologic
decreased Ca+
increased PO4-
acetemia
acetemia - ANS increase in nitrogenous waste
increased BUN>20
increased creat>1.16
during this phase of renal failure, your patient has over 100 mL of urine per hour, and their lab
values indicate hypokalemia and hyponatremia. what phase of renal failure are they in? - ANS
diuretic
What is the priority intervention during the diuretic phase of renal failure - ANS replenish
fluids and closely monitor electrolytes
, what are the electrolyte imbalances during the diuretic phase - ANS decreased Na+
decreased K+
Diet/nutrition for patient with acute renal failure - ANS High calorie
low Na+
limit K+
low PO4- (monitor dairy intake)
NO/limited K, PO4, Na+, Protein!
tight fluid control
what medications should you monitor for a patient with acute renal failure - ANS ACE
inhibitors
ARB's
Digoxin (dig toxicity**)
heparin (can decrease doseage)
analgesic
NSAIDs
opioids
signs of dig toxicity - ANS --n/v
--anorexia
--visual problems
--restlessness
--H/A
--cardiac dysrhythmias
--pulse < 60 bpm
peds: rubbing eyes; looking at lights
why do you want to restrict/limit the amount of protein in a patient with acute renal failure - ANS
increased protein breakdown leads to increased ammonia, increased BUN/creat levels and
proteinuria
what diagnostic studies would you expect for a patient in acute renal failure - ANS
urinalysis
renal ultrasound
CT/MRI
H/H
electrolytes/metabolic panel
range for specific gravity - ANS 1.002-1.03
is this value high/normal/low for specific gravity:
1.045 - ANS high
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