NUR 504 Exam 3 Study Guide with
Questions and Correct Answers
Kidney Functions: AWETBED ✅o Acid-base balance
o Water removal
o Erythropoiesis
o Toxin removal
o BP control
o Electrolyte balance
o Vitamin D Activation
Renal System - · Diagnostics (4) ✅o Creatinine: 0.6-1.2
o BUN: 10-20
o GFR: >90
o Imaging: CT, KUB x-ray, bladder scans
Chronic Kidney Disease (CKD) - def ✅· Abnormalities in kidney structure or function
that alter health and are present for 3+ months
Stage 1 of CKD: def and r/f ✅o GFR >90: At risk for kidney disease
Risk factors: uncontrolled hypertension, diabetes, congenital renal abnormalities, family
hx, exposure to nephrotoxic substances (CT contrast, NSAIDs, antibiotics, diuretics,
etc.)
Stage 2 of CKD: def & tx ✅o Stage 2: GFR 60-89: Mild CKD
Focus on reduction of risk factors
Stage 3 of CKD: def & tx ✅o GFR 30-59: Moderate CKD
Implement renal diet, drug therapy and fluid restriction
Stage 4 of CKD: def & tx ✅o GFR 15-29: Severe CKD
Prepare for renal replacement therapy (hemodialysis, peritoneal dialysis)
Stage 5 of CKD: def & tx ✅o GFR <15: End Stage Kidney Disease (ESKD)
Patient requires extensive replacement therapy or kidney transplant
CKD Complications (4) ✅o Fluid overload: edema, crackles, SOB, decreased breath
sounds
, § Risk for pulmonary edema, CHF
o Oliguria anuria
o Increased BUN/Creatinine
o Electrolyte abnormalities: hypernatremia, hyperkalemia, hyperphosphatemia,
hypermagnesemia, hypocalcemia
CKD Complications - Acid/base ✅o : metabolic acidosis—inability to secrete H+ ions
§ Monitor for Kussmaul's respirations
CKD Complications - HTN ✅o due to fluid overload, hypernatremia, and dysfunction of
RAAS system
CKD Complications - anemia & risk ✅o kidneys unable to secrete erythropoietin and
stimulate RBC production
§ Risk for platelet dysfunction and immunosuppression
CKD Complications - Cognitive changes & risk ✅o headache, migraines, anxiety,
depression, lethargy, fatigue,
§ Risk for seizures, coma
CKD Complications - Skeletal ✅weak brittle bones
CKD Complications - skin ✅dry skin, poor wound healing, pruritis, uremic frost, urine
odor in sweat
Renal Diet - restrictions (6)vs supplements (4) ✅o Restrictions: fluid, sodium,
magnesium, potassium, protein, and phosphorous
o Supplements: phosphate binders (renogels), calcium, vitamin D, iron supplements
CKD interventions ✅o Strict I&Os, daily weights, balance activity with rest, good head-
to-toe assessments, monitor for s/s of infection, attend to psychosocial needs, provide
community resources, monitor labs, VS
CKD interventions - meds ✅diuretics, antihypertensives, epoetin alfa
Kidney Replacement Therapies - stages & GFR ✅CKD stages 4, 5 (GFR <30)
Hemodialysis (HD) - def ✅Blood passed through an external artificial kidney (dialyzer),
removes fluid &/or waste and returns the blood to the
