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Kidney Failure and DialysisMedical-Surgical Nursing-7th edition

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Question Answer
In relation to cardiac output, what percentage of blood is filtered through the nephrons per minute normally?
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20 to 25 %
Normally, the kidneys excrete ________ mmol daily of potassium.
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40 to 60
When is the use of CRRT indicated?
Show Answer
When the patient cannot tolerate the fluid and electrolyte shifts caused by normal hemodialysis.
What are the three major life-sustaining tasks performed by the kidneys?
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Solute and water balance, excreting wastes while conserving nutrients, and regulating acid base balance.
End Stage Renal Disease results when ______ percent of nephrons are lost, resulting in significantly impaired renal function.
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90%
What are the four factors used to calculate glomerular filtration rate?
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Creatinine, age, gender (higher rate for women), and race (higher rate for African Americans).
Why is fluid volume altered when the kidneys are damaged?
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Damaged nephrons lose the ability to excrete water and albumin is lost in urine. The albumin loss results in a decreased oncotic pressure and the formation of edema. Aldosterone is then released from the adrenal cortex which causes sodium and water retention.
What causes proteinuria in kidney disease?
Show Answer
Damage to the glomeruli
What are the two leading causes of end stage renal disease?
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Diabetes mellitus and hypertension
Sodium intake for patients with chronic kidney disease is generally restricted to ______ g a day.
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2 grams
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What type of deficiency can lead to megaloblastic anemia in patients with chronic kidney disease and what causes it?
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Folic acid deficiency, triggered by dialysis.
What type of problems and complications are the leading causes of death in patients with end stage renal disease?
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Cardiovascular problems like myocardial infarctions, stroke, and left ventricular hypertrophy that leads to heart failure.
What medications are used to treat anemia in patients with chronic kidney disease?
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Epoetin alfa (Epogen or Procrit typically) which raises hemoglobin and hematocrit within 2 to 3 weeks. Aranesp is a longer acting medication that works the same way.
How are muscle cramps that occur during hemodialysis treated?
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Decrease the ultrafiltration rate, or administer a hypertonic saline or normal saline bolus.
How does an increase in parathyroid hormone impact the gastrointestinal system?
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It increases gastric acid secretion which leads to nausea, vomiting and anorexia.
What is a major side effect of exogenous erythropoietin?
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Acceleration of hypertension (it also can causes iron deficiency). Examples of expogenous erythropoietin include Procrit, Epogen and Aranesp.
_________ is a complication of chronic kidney disease that is most often the signal that dialysis must be started.
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Altered mental status
What are the three general types of renal osteodystrophies?
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Osteomalacia, osteitis fossa, and osteosclerosis.
________ is a renal osteodystrophy that results from increased parathyroid hormone causing bone demineralization.
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Osteitis fibrosa
__________ is a renal osteodystrophy characterized by bands of increased and decreased bone density in the vertebrae.
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Osteosclerosis
_______ is the type of kidney damage caused by hypertension. Damage occurs to both the glomeruli and arteriolar walls.
Show Answer
Hypertensive nephrosclerosis
  
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