AHN 447 Exam 1 (Renal)- Questions &
Answers
What can azotemia cause? Correct Ans-change in mental status
What is the treatment for acute renal failure? Correct Ans-- optimize blood pressure
- manage fluid status
- support other body systems ( ex. ventilation)
How much should GFR be for normal people? Correct Ans-90+ is good, under 90 is a little
bad, under 60 is really bad
What are the clinical manifestations of ESRD/CRF? Correct Ans-- HTN
- edema
- HF
- anemia
- hematuria/oliguria
- dry skin/pruritis
What nutrition therapy is used to treat CRF? Correct Ans-- low protein early on, then high
protein if on dialysis
- sodium/potassium/phosphorus restriction
- vitamin supplementation
What is considered a temporary hemodialysis access? Correct Ans-vascath
Where is a vascath placed? Correct Ans-chest or groin area
, What is important to know about a vascath Correct Ans-- can be used immediately after
insertion
- CANNOT be used for blood sampling
- must be instilled with heparin so that it doesn't clot off
What are considered long term hemodialysis acesses? Correct Ans-native fistula and goretex
graft
What is the difference in placement for a fistula and graft? Correct Ans-- fistula: forearm or
upper arm
- graft: forearm, upper arm, or inner thigh
How long does it take fistula to be able to use vs a graft? Correct Ans-- fistula: 2-4 months
- graft: 1-2 weeks
What should you assess for with a graft or fistula to ensure patency? Correct Ans-palpate for
thrill (purring cat vibration) or auscultate for bruit (swishing sound)
What can you not use with a graft or a fistula? Why not? Correct Ans-no BP cuff or
tourniquet; huge risk for bleeding
What kind of patient would be chosen to do peritoneal dialysis? Correct Ans-- those who
can't tolerate anticoagulation
- older adults
- poor vascular access
- NO prior abdominal adhesions
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