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Kidney Failure and DialysisMedical-Surgical Nursing-7th edition

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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.
_______ may be present in urine if the cause of renal failure is related to glomerular membrane dysfunction.
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Proteinuria
What are EKG signs a patient has hyperkalemia secondary to renal failure?
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A peaked T wave, wide QRS complex, and an ST depression.
How is hypotension from hemodialysis treated?
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Decrease the volume of fluid being removed, infuse 0.9% saline at 100 to 300 mL, and hold all blood pressure medications before dialysis.
Why is the subclavian vein the last resort site for a central venous catheter?
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It is prone to venous stenosis and thrombosis, both of which prevent future access for fistulas or grafts.
_______ is a complication of chronic kidney disease caused by increased levels of parathyroid hormone, resulting in bone decalcification.
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Osteitis fibrosa cystica
What are the signs and symptoms of disequilibrium syndrome?
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Nausea, vomiting, headache, confusion, restlessness, twitching, jerking and/or seizures.
What should you do if the CRRT alarm sounds?
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Check the patient, inspect the catheter site for kinking, monitor flow pressures and check for clotting in the hemofilter.
What finding is usually the first indication of kidney damage?
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Persistent proteinuria, a positive urine dip 2 or more times in 3 months.
How is disequilibrium syndrome treated?
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Slowing or stopping dialysis and then infusing hypertonic saline, albumin or mannitol to prevent cerebral edema.
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What are expected assessment findings post-dialysis?
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Decreased blood pressure, decreased weight, and decreased serum lab levels of BUN, creatinine, and electrolytes.
Effluent drained after the first few days of exchanges is usually _______ in color.
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Pink or slightly bloody
Why are potassium levels elevated in patients with chronic kidney disease?
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Due to the inability of the kidneys to excrete potassium as a result of a decreased glomerular filtration rate.
What interventions can decrease the pulmonary complications of peritoneal dialysis caused by diaphragm displacement?
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Repositioning, deep breathing, and increasing the head of the bed to 35 to 45 degrees.
_______ failure results from conditions that decrease blood flow to the kidneys.
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Prerenal (examples include hypovolemia, hypotension, inadequate cardiac output, and extreme vasoconstriction).
______ failure results from damage to the filtering structures of the kidneys, usually from acute tubular necrosis.
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Intrarenal failure
________ failure results from bilateral obstruction of urine outflow.
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Postrenal
________ is a fistula created for dialysis using synthetic materials to form a bridge between the arterial and venous blood supplies.
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Arteriovenous Graft (AVG)
An _______ is a fistula created for dialysis using a patient's own vessels.
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Arteriovenous fistula (AVF)
How long does it take for an arteriovenous fistula to mature enough to use for dialysis?
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At least 4 to 6 weeks, although 3 months is the recommendation
What procedures should be avoided in an extremity with an arteriovenous fistula or an arteriovenous graft?
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Blood pressure measurements, IV insertion, and/or venipuncture
  
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