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Kidney Failure and DialysisMedical-Surgical Nursing-7th edition

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_______ is the type of kidney damage caused by hypertension. Damage occurs to both the glomeruli and arteriolar walls.
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Hypertensive nephrosclerosis
What causes fluid to shift from the intravascular space to the interstitial space in response to the decreased oncotic pressure caused by kidney disease?
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Loss of albumin in the urine
What type of renal failure is caused by spinal cord disease, neuromuscular disorders and back trauma? Prerenal, Intrarenal or Postrenal?
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Postrenal
The _______ phase of acute renal failure is from the time of insult until the signs and symptoms become apparent.
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Initiating
How is sepsis prevented in dialysis patients?
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Strict aseptic technique
_______ results from rapid changes in extracellular fluid composition from dialysis. It can cause cerebral edema.
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Disequilibrium syndrome
What are signs of clotting for a patient on CRRT?
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Decreased ultrafiltrate, increased venous resistance, dark strands in the hemofilter, and/or increased circuit pressure.
Why is digitalis a medication that needs to be monitored closely in patients with chronic kidney disease?
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Decreased potassium (a common problem with kidney disease) can potentiate digitalis toxicity.
Decreased glomerular filtration rate results in a release of ________, causing the kidneys to reabsorb sodium and water.
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Aldosterone from the adrenal cortex
Why does metabolic acidosis develop from chronic kidney disease?
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The tubules can't excrete hydrogen ions which uses up the bicarbonate. In addition, ammonium excretion is decreased.
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The _______ can be used to determine the cause of metabolic acidosis. A widening indicates the cause is kidney failure.
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Anion gap. The normal anion gap is 12 mmol
Fluid intake for a patient with chronic kidney disease should be adjusted so weight gains are no more than ________ between dialysis sessions.
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1 to 3 kilo grams or 6.6 lbs.
Which type of renal insult (pre, intra or post renal) is characterized by oliguria with a high specific gravity and low sodium concentration?
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Prerenal. The urine specific gravity is typically greater than 1.025 and the sodium is less than 10.
Why does prerenal failure result in a high urine specific gravity?
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The kidneys aren't perfused enough to allow them to perform their excretion function.
Which type of renal insult (pre, intra or post renal) is characterized by oliguria with a fixed specific gravity 0f 1.0101 and a high sodium concentration?
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Intrarenal. The sodium level is typically greater than 40 (normal is 10 to 20).
Why does intrarenal failure result in a fixed urine specific gravity?
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The kidneys cannot function enough to concentrate urine.
________ electrolyte levels may be normal until late end stage renal disease develops.
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Potassium
What intervention is commonly successful in correcting a peritoneal dialysis outflow problem?
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Evacuating the bowels
________ is a renal osteodystrophy that occurs due to inadequate calcium absorption from the GI tract.
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Osteomalacia
During dialysis, the total amount of blood outside the body at any time is approximately _______.
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200 to 300 mL
When using a central venous catheter, what is the preferred insertion site?
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The right internal jugular vein. However, the femoral or subclavian vein can be used as well.
  
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