What is a consequence of prolonged fluid overload and hypertension?
left ventricular hypertrophy
What is pericarditis?
inflammation of the membrane (pericardial sac) surrounding the heart
What is the treatment of pericarditis? (2)
Decrease or stop heparin, more frequent dialysis
What is a common cause of hypertension of dialysis in patients?
fluid overload
What does left ventricular hypertrophy lead to? (4)
- ischemic heart disease
- arrhythmia
- myocardial infarction
- sudden death
What is the primary cause of dialysis patients being anemia?
lack of the hormone erythropoietin used to produce RBC
What is the secondary cause of dialysis patients being anemia? (4)
- inadequate iron stores
- inadequate dialysis
- malnutrition
- blood loss during treatment
What is the life span of a RBC for someone in end stage kidney disease?
60 days instead of 120 days.
What can you do to avoid contributing to lower hemoglobin and blood loss in dialysis patients? (3)
- verify correct Erythropoietin Stimulating Agent (ESA) dose is administered
- rinse back until venous line is pink tinged
- avoid repeat lab draws
What are the 4 key elements contributing to CKD Mineral Bone Disorder?
- calcium
- phosphorous
- PTH
- Vitamin D (calcitriol)
all lead to the disorder when in abnormal levels
What are the symptoms of CKD-MBD in addition to bone disease? (8)
- soft tissue calcification
- itching
- muscle weakness
- pathological fractures
- tendon ruptures
- compression of vertebrae
- atherosclerosis
- heart disease
What is a PCT role in CKD-MBD management? (3)
- Report symptoms
- urge patients to take medications
- report problems related to nonadherence
What is acute kidney injury (AKI)?
A term that incorporates a wide spectrum of kidney issues
includes acute kidney failure as well as other less catastrophic kidney function changes
What can a dialysis patient with AKI do?
May dialyze in an out-patient facility until kidney function recovers
What are some examples of pre-renal causes of AKI? (3)
- obstruction
- volume depletion
- impaired cardiac function (decreases cardiac output)
What are some examples of intra-renal causes of AKI? (10)
- Ischemic ATN
- sepsis
- acute interstitial nephritis
- septic shock
- anaphylaxis
- drugs
- goodpasture syndrome
- acute glomerulonephritis
- taruma
- open heart surgery
What are some examples of post-renal causes of AKI? (3)
- obstruction
- bladder rupture
- pregnancy
What is the difference between AKI and CKD?
Eliminating the causes of AKI will eventually help return normal kidney function
can eliminate causes of CKD
List the outline of the treatment foals for a patient with AKI dialyzing in the out-patient facility? (3)
- find the root/causes of AKI
- Patients with AKI will usually have a catheter, so avoid all catheter related infections
- Avoid substances that are toxic to the kidney such as contract, low dose aspirin, NSAIDS, etc)
What is important when monitoring weight and BP for AKI patients?
Keep a little extra fluid on the patient, so it is available to the kidneys when they start filtering/ultra-filtering on their own
AKI patients are at increased risk for which complications? (2)
- Hypovolemia (decreased volume of blood in body)
- hypotension
What is the difference between OSHA and CMS infection control requirements?
OSHA: requires employers to provide works with a safe work environment
CMS: concerned with patient care and patient safety
What are V-tags and why are they important?
- State specific regulations that has to be met within a condition such as infection control, interpretive guidance for each regulation and citing deficiencies by tag number.
Explain the acceptable hand hygiene technique when caring for a patient with C. Diff.
Only acceptable hand hygiene is handwashing with soap and water per policy.
