Learning Guide for CKD/Transplant
1.
“RIFLE” classification of Acute Kidney Injury as listed in your book lists the GFR
for each stage. Discuss when you think a patient might realize something is
wrong and why. (This is just to get you thinking – there is no “right” answer).
2.
Differentiate between CKD and ESRD and give presenting factors to help
identify when they present to the hospital:
CKD:
ESRD
3.
What is the effect of chronic uremia on the body systems?
Respiratory, Circulatory. Cardiac, Neuro & Musculoskeletal systems?
4.
What is the reason that each of the following conditions/electrolyte problems
exist in CKD?
5.



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

Infection
What “type” of antacids can safely be used to treat GI distress and renal
osteodystrophy?
6. Phosphate binders are given to the client with renal failure. Name several
medications that act as phosphate binders. When should these medications be
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administered?
7.
Why is drug toxicity a problem with renal failure clients?
8.
What are the most commonly used antihypertensive medications used in
clients with CKD and ESRD?
9.
Why is protein limited in conservative therapy and hemodialysis and not
limited in peritoneal dialysis?
10.
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?
11.
*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?
12.
What are the complications of peritoneal dialysis? What is the most common
complication?
13.
What is the care of a shunt (primary fistula and with graft)? How do you
assess patency?
14.
What are the complications of hemodialysis and why? (include disequilibrium
syndrome)
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15.
Compare the types of rejection. (
Type of rejection
:
Cause/when it occurs
Management
Hyperacute
Acute
Chronic
16.
17.
18.
What are the major postoperative nursing actions for a renal transplant client?
What are the major drugs used for immunosuppressive therapy? What are
complications of these drugs?
What are the major post-operative complications for renal transplant clients?
From Real time video and/or handout on Organ Donation
19.
What is the criteria for organ donation?
20.
What is the role of the nurse/MD in the event of a potential organ donation?
21.
What determines whether or not organs/tissues can be donated?
22.
What are some of the ethical dilemmas discussed in this chapter?
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