Chapter 34

Question 1

a condition in which the kidneys fail to remove metabolic end products from the blood and regulate the fluid, electrolyte, and pH of the extracellular fluids

Answer 1

renal failure

Question 2

when the kidneys fail…

Answer 2

less waste is removed, more waste remains in the blood, nitrogenous build up in the blood

Question 3

bun normal value:

Answer 3

5-25

Question 4

bun rise reflects

Answer 4

a decrease in renal function (sometimes)

Question 5

creatinine normal value

Answer 5

.5-1.5

Question 6

with creatinine, high is a problem… but low is

Answer 6

NOT

Question 7

creatinine is a reflection of

Answer 7

GFR and is a better indicator of renal function

Question 8

sudden, rapid onset. often reversible. abrupt reduction on renal function

Answer 8

acute

Question 9

chronic, slow progressing to end-stage renal failure. over months or years. not reversible.

Answer 9

chronic

Question 10

three types of acute kidney injury

Answer 10

1. prerenal
2. intrinsic
3. postrenal

Question 11

usually progressive, generally not reversible. detoriation of kidney function.

Answer 11

chronic renal failure

Question 12

chronic renal failure involves

Answer 12

tissue destruction, loss of kidney function, and eventual end stage renal disease

Question 13

possible causes of CKD

Answer 13

chronic glomerular disease, chronic UTIs, obstructions, cancers, autoimmune functions, diabetes, vascular disases

Question 14

development of CRF:

Answer 14

• diminished renal reserve
• renal insufficency
• renal failure
• end-stage renal disease

Question 15

nephrons are working as hard as they can. losing numbers

Answer 15

diminished renal reserve

Question 16

nephrons can no longer regulate urine density, electrolytes are wack, starting to notice problem, work until they can’t.

Answer 16

renal insufficency

Question 17

renal failure starts when

Answer 17

nephrons can no longer keep blood composition normal. RAAS kicks in, high blood pressure. leading to sclerosis.

Question 18

cardiovascular consquences of CRF

Answer 18

• decrease viscosity
• increased blood pressure
• decreased oxygen supply

Question 19

process of cardiovascular consquences of CRF:

Answer 19

less erythropoietin –> anemia –> lower blood viscoity –>blood flows though vessels more swiftly –> heart rate increases—> increased workload on left heart –> left ventricle dilation and hypertrophy –> not enough 02 to support LV function —> angina ischemia/LHF!!!!!!

Question 20

CKD: what would occur?

Answer 20

• HTN and CV: hypervolemia (too much fluid)
• Peripheral edema: fluid and protein issues
• ALT in H20, electrolyte, acid-base balance (hyperkalemia)
• anemia: no erythropoetin
• mineral and skeletal disorders: hyperphosphatemia (not eliminating, can cause weak by pulling calicum)
• accumulation of nitrogenous waste products
• fluid and electrolyte balance: Na and H20 balance, K+ balance, acid base balance (metabolic acidosis when GRF is 30-40%), calicum/phosphate/bone
• problems with proteins, carbohydrates, fat metabolism
• anemia

Question 21

CKD affects all system. List how it affects each system:

Answer 21

• Renal: fatigue, decreased urine.
• cardiovascular: HTN, heart failure, life threatening arrhythmias
• Gi: nausea, gum sores, abnormal pain
• skin: pallid, yellowish-brown color, dry/itchy/scaly skin
• impaired platelet function: bruising
• neurologic: LOC, muscle cramps, pain, itching and burning
• endocrine
• musculoskeletal: bone fractures and muscle pain

Question 22

CKD and its treatment can interfere with

Answer 22

absorption, distribution and elimination of drugs

Question 23

altered metabolism results of

Answer 23

less protein bound drugs and increased intermediates of drug metabolism