Learning Guide for CKD/Transplant cmj & lc
1.
What are the causes of CKD (chronic kidney disease)?
Lewis p. 1205
What are the 2 main causes or risk factors leading to ESRD?
2.
3.
What are the gerontologic considerations with regard to renal failure? Lewis p.
1204
Differentiate between CKD and ESRD:
CKD:
ESRD:
Once the GFR is < or equal to 15ml/min, the stage of renal failure is termed
__________________________.
4.
What is the definition of uremia versus azotemia?
5.
What is the effect of chronic uremia on each body system (Lewis p 12061209-Figure 47.5)
6.
What is the reason that each of the following conditions/electrolyte problems
exist in CKD?



Waste Product Accumulation
Altered Carbohydrate Metabolism
Electrolyte and Acid-Base Imbalances

Potassium excess:

Sodium deficit or normal:


Calcium deficit and Phosphate excess:
Metabolic Acidosis:

Hematologic System

Anemia

Bleeding Tendencies
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
Infection
7. How does uremia effect the Cardiovasular System? (Lewis p. 1207)
8.

Hypertension:

Left Ventricular Hypertrophy:

Cardiac Dysrhythmias:

Uremic Pericarditis:
What are the effects of uremia on the Respiratory System? (Lewis p. 1208)



Kussmaul breathing
Uremic Lung
Pleuritis/Pleural effusion
9. What are the effects of uremia on the GI, Neurological, Musculoskeletal
systems? (Lewis p. 1208)
 Uremic fetor
 GI bleeding
 Restless leg syndrome
 Lethargy
 Seizures and Coma
 Osteomalacia

10. What are the effects of uremia on Integumentary, Reproductive, and
endocrine system, psychological system?
11. What “type” of antacids can safely be used to treat GI distress and renal
osteodystrophy?
12. Phosphate binders are given to the client with renal failure. Name several
medications that act as phosphate binders. When should these medications be
administered?
13. Why is drug toxicity a problem with renal failure clients?
14. What are the most commonly used antihypertensive medications used in clients
with CKD and ESRD?
15. Why is protein limited in conservative therapy and hemodialysis and not limited
in peritoneal dialysis?
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16. Why are fluids limited with hemodialysis?
What is a typical fluid restriction for a client receiving hemodialysis? Why is a
client weighed before and after dialysis??
If the client has urine output, what effect will this have on his/her fluid
restrictions?
17. *How are fluids controlled with peritoneal dialysis? Is it a true statement that a
client who receives peritoneal dialysis has less limitations on the amount of fluid
intake? If this is true, why would this be so?
18. What are the “types” of peritoneal dialysis and the characteristics of each?
19. What are the complications of peritoneal dialysis? What is the most common
complication?
20. What is the care of a shunt (primary fistula and with graft)? How do you assess
patency?
21. What are the complications of hemodialysis and why? (include disequilibrium
syndrome)
22. Compare Hemodialysis and Peritoneal as to advantages and disadvantages:
Peritoneal Dialysis
Advantages
Disadvantages
Hemodialysis
Advantages
Disadvantages
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23. Compare the types of rejection. (
Type of rejection
:
Cause/when it occurs
Management
Hyperacute
Acute
Chronic
24. What are the major postoperative nursing actions for a renal transplant client?
25. What are the major drugs used for immunosuppressive therapy? What are
complications of these drugs?
26. What are the major post-operative complications for renal transplant clients?
From Real time video and/or handout on Organ Donation
27. What is the criteria for organ donation?
28. What is the role of the nurse/MD in the event of a potential organ donation?
29. What determines whether or not organs/tissues can be donated?
30. What are some of the ethical dilemmas discussed in this chapter? (Lewis pp.
1225, 1226, & 1230)
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