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Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid


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46 - Acute Kidney Injury and Chronic Kidney Disease
21 Picmonics to Learn | 39 mins

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Metabolic Acidosis Assessment
Characteristics
Decreased pH < 7.35
Decreased HCO3 < 22
Signs & Symptoms
Abdominal Pain
CNS Depression
Coma
Hypotension
Arrhythmias
Increased Respirations
Kussmaul Respirations
Flushed, Warm, Dry Skin
Muscle Weakness
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2 mins
Hyperkalemia
Assessment
> 5.0 mEq/L K+
Abdominal Cramps
Muscle Weakness
Diarrhea
Arrhythmia
Tall, Peaked T Waves
Interventions
IV Calcium
Infusion of Glucose and Insulin
Loop or Thiazide Diuretics
Kayexalate
Dialysis
Prevention Education
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2 mins
Insulin
Rapid Acting
Insulin Lispro (Humalog)
Insulin Aspart (Novolog)
Insulin Glulisine (Apidra)
Short Acting
Regular Insulin (Humulin R)
Intermediate Acting
Isophane NPH (Humulin N)
Long Acting
Detemir (Levemir)
Glargine (Lantus)
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2 mins
Chronic Kidney Disease Early Symptoms Assessment
GFR < 60mL/min
Accumulation of Waste Products
General Malaise
Hypertension
Proteinuria
Hyperkalemia
Mineral and Bone Disorders
Neuropathy
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2 mins
Chronic Kidney Disease Late Symptoms Assessment
Metabolic Acidosis
Severe Uremia
Arrhythmias
Edema
CNS Depression
Anemia
Oliguria
Pruritus
Considerations
End Stage Renal Disease (ESRD)
GFR < 15mL/min
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2 mins
Erythropoietin
Mechanism
Stimulates RBC Production
Indications
Chronic Renal Failure
Anemia
Side Effects
Increased Risk of Thrombosis
Pelvic and Limb Pain
Hypertension
Considerations
Do Not Shake
Monitor Hemoglobin (Hgb) Weekly
May Accelerate Tumor Progression
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2 mins
Hyponatremia
Assessment
< 135 mEq Na+
Nausea and Vomiting
Decreased LOC
Confusion / Lethargy
Seizures
Priority Interventions
Assess Airway
Reduce Diuretic Dosage
Fluid Excess Hyponatremia
Mannitol (Osmitrol)
Fluid Restriction
Fluid Deficit Hyponatremia
Hypertonic Solution (3% or 5% NaCl)
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2 mins
Hypocalcemia
Assessment
< 8.5 mg/dL Ca2+
Decreased Bone Density
Muscle Spasms
Tetany
Chvostek's Sign
Trousseau's Sign
Increased DTR
ECG Changes
QT Prolongation
Considerations
Oral and IV Replacement of Ca2+
Seizure Precautions
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2 mins
Parathyroid Gland
Characteristics
Blood Calcium Sensor
Parathyroid Hormone
Bone Resorption
Blood Calcium Increases
Vitamin D Activation
Calcium Absorption From The Small Intestine
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1 min
Chronic Kidney Disease Interventions
Interventions
Daily Weights
Strict I/O
Renal Diet
Strict Medication Regimen
Erythropoietin
Manage Hyperkalemia
Manage CKD-MBD
Dialysis
Kidney Transplant
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2 mins
Hemoglobin
Hemoglobin Has Four Iron Hemes
Lots Of Hemoglobin In Red Blood Cells
High O2 Levels Increase O2 Binding
High Temperature Reduces O2 Binding
High CO2 Levels Reduce O2 Binding
Low pH Reduces O2 Binding
Myoglobin Binds Oxygen in Muscle
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2 mins
Primary Hyperparathyroidism
Assessment
Hypercalcemia
Kidney Stones
Osteoporosis
Arrhythmias
Diagnostic Tests
Increased Calcium and Decreased Phosphorus
Considerations
Prevent Injury
Medication Education
Surgery
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1 min
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
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2 mins
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of PDA
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
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1 min
Dialysis
Hemodialysis
Rapid Shifts of Fluid and Electrolytes
Disequilibrium Syndrome
Hypotension
NO BP IN ARM with Shunt or Fistula
Assess for Thrill and Bruit
Peritoneal Dialysis
Slow Process
Peritonitis
Loss of Protein
Hyperglycemia
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3 mins
Low Blood Pressure Response
Characteristics
Posterior Pituitary Releases Vasopressin
Vasoconstriction
Adrenal Cortex Releases Aldosterone
Increased Na+ and H2O Reabsorption
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1 min
Kidney Transplant
Indications
End Stage Renal Disease (ESRD)
Considerations
Selective Candidacy
Close Compatibility
Immunosuppressants
Monitor for Rejection
Monitor for Infection
Monitor Urine Output
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2 mins
Prednisone (Glucocorticoids)
Mechanism
Glucocorticoid
Indications
Inflammatory Conditions
Organ Transplant Rejection
Side Effects
Cataracts and Glaucoma
Cushing's Syndrome
Osteoporosis
Immunosuppression
Hyperglycemia
Ulcers
Considerations
Adrenal Insufficiency
Taper Gradually
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2 mins
Varicella (Chickenpox)
Mechanism
Varicella Zoster Virus (VZV)
Signs and Symptoms
Red Maculopapular Rash
Vesicles Ooze and Crust
Pruritus
Centripetal
Considerations
Varicella Immunization
Skin Care to Minimize Itching
Isolate until Vesicles Crust
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2 mins
Cytomegalovirus (CMV) TORCH
Signs and Symptoms
Nonspecific TORCH symptoms
Intrauterine Growth Restriction (Retardation)
Deafness
Microcephaly
Seizures
Periventricular Calcifications
Petechial Rash
Blueberry Muffin Rash
Chorioretinitis
Diagnosis
Urine Viral Culture or PCR
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2 mins
Acyclovir (Zovirax)
Mechanism
Guanosine Analog
Inhibits Viral Replication
Thymidine Kinase Activation
Indications
Herpes Simplex Virus (HSV)
Varicella Zoster Virus (VZV)
Side Effects (Oral)
Headache
GI Distress
Side Effects (IV)
CNS Toxicity
Nephrotoxicity (Crystalline Nephropathy)
Considerations
Prevents Recurrent Episodes
Slow IV Infusion
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2 mins

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