NUR 431 Exam 3 study guide with complete solutions.

NUR 431 Exam 3
10-15 - Answer normal BUN

0.8 - 1.5 - Answer normal creatinine

125 - Answer normal GFR

chronic kidney disease (CKD) - Answer presence of kidney damage for more than 3
months with or without a GFR < 60

CKD kidneys have inability to - Answer maintain acid-base balance
remove products of metabolism
maintain fluid and electrolyte balance

Stage 1 CKD - Answer kidney damage with normal or increased GFR

Stage 1 CKD GFER - Answer > 90

Stage 1 CKD symptoms - Answer asymptomatic

Stage 2 CKD - Answer kidney damage with mild decrease in GFR

Stage 2 CKD GFR - Answer 60-89

Stage 2 CKD symptoms - Answer asymptomatic
possible HTN

Stage 3 CKD - Answer moderate decrease in GFR

Stage 3 CKD GFR - Answer 30 - 59

Stage 3 CKD symptoms - Answer HTN

Stage 4 CKD - Answer severe decrease in GFR

Stage 4 CKD GFR - Answer 15 - 29

Stage 4 CKD symptoms - Answer manifestations become apparent (azotemia)

Stage 4 - Answer CKD stage that diagnosis usually occurs in

Stage 5 CKD - Answer end-stage renal disease (ESRD)
require renal replacement therapy

,Stage 5 CKD GFR - Answer < 15

Stage 5 CKD symptoms - Answer uremia (azotemia)
may or may not produce urine

CKD causes - Answer DM (poorly controlled)
HTN

CKD risk factors - Answer family history
increased age (> 60)
male
African American
HTN, DM, smoking
overweight/ obesity

CKD pathogenesis - Answer glomerulosclerosis (cannot filter blood)
interstitial fibrosis
interstitial inflammation (damage causes loss of function over time)

uremia - Answer increased blood levels of ureas and nitrogenous wastes that are
normally eliminated by the kidneys

CKD symptoms - Answer anxiety
depression
HTN
HF
CAD
pericarditis
anorexia
N/V
gastritis
GI bleed
fatigue
headache
uremic pleuritis
pulmonary edema
increased risk of infection
hyperlipidemia
anemia
increased bleeding risk
pruritus, dry skin
ecchymoses
paresthesia
osteomalacia

, CKD symptoms related to kidney no longer able to maintain fluid and electrolyte
hemmostasis - Answer edema
hyperkalemia
hyperphosphatemia
metabolic acidosis
hypermagensemia

CKD symptoms related to kidney no longer able to rid body of wastes via urine - Answer
anorexia
malnutrition
itching
CNS changes

CKD symptoms related to decrease in production of erythropoietin - Answer anemia

CKD symptoms related to decrease in activation of vitamin D - Answer renal
osteodystrophy

CKD drug uses - Answer slow rate of progression
treat complications

CKD complications - Answer volume overload
hyperkalemia
metabolic acidosis
hyperphosphatemia
renal osteodystrophy
anemia

BP control of systolic BP between 110 - 140 - Answer ACE and ARBs use with CKD

CKD volume overload drug therapy - Answer loop diuretic with los salt diet

CKD hyperkalemia drug therapy - Answer diuretics
hemodialysis
avoid foods high in potassium

CKD metabolic acidosis drug therapy - Answer sodium bicarbonate

CKD hyperphosphatemia drug therapy - Answer calcium carbonate

CKD renal osteodystrophy drug therapy - Answer calcitriol (activated Vit. D)

CKD anemia drug therapy - Answer erythropoietin

sodium bicarbonate therapy goals - Answer slow CKD progression
prevent bone loss