CNeph(C) Nephrology Nursing flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Glomerular filtration rate

Volume of plasma filtered by the glomeruli per unit time; normal ~125 mL/min/1.73 m²; estimated from serum creatinine using CKD-EPI equation.

Juxtaglomerular apparatus

Structure at the vascular pole of the glomerulus containing macula densa and granular cells; regulates renin release in response to sodium delivery and perfusion pressure.

Erythropoietin

Glycoprotein hormone produced by peritubular interstitial cells of the kidney; stimulates red blood cell production in bone marrow; deficient in chronic kidney disease.

CKD staging

Classification by glomerular filtration rate (G1–G5) and albuminuria (A1–A3); CKD requires kidney damage or GFR <60 mL/min/1.73 m² for >3 months.

Albuminuria categories

A1: <30 mg/g; A2: 30–300 mg/g; A3: >300 mg/g albumin-to-creatinine ratio; higher category predicts faster CKD progression and cardiovascular risk.

SGLT2 inhibitors

Drugs blocking sodium-glucose cotransporter 2 in proximal tubule; reduce glucose reabsorption and intraglomerular pressure; slow CKD progression in albuminuric kidney disease.

KDIGO AKI criteria

AKI defined by serum creatinine rise ≥0.3 mg/dL within 48 hours, or ≥1.5 times baseline within 7 days, or urine output <0.5 mL/kg/h for 6 hours.

Fractional excretion of sodium

FENa = (urine Na × plasma Cr) / (plasma Na × urine Cr) × 100; <1% suggests prerenal AKI; >2% suggests intrinsic renal injury.

Continuous renal replacement therapy

Slow, continuous extracorporeal dialysis used in hemodynamically unstable ICU patients; modalities include CVVH, CVVHD, and CVVHDF with effluent rates 20–25 mL/kg/h.

AV fistula rule of 6s

Mature arteriovenous fistula has blood flow >600 mL/min, diameter >6 mm, and depth <6 mm from skin; assessed by ultrasound before cannulation.

Kt/V

Dimensionless measure of dialysis adequacy: K = clearance, t = time, V = urea distribution volume; target spKt/V ≥1.2 per hemodialysis session.

Disequilibrium syndrome

Cerebral edema from rapid urea removal during hemodialysis; presents with headache, nausea, confusion, seizures; prevented by slower blood flow and shorter initial sessions.

Peritoneal equilibration test

Standardized test using 2.5% dextrose dwell to classify peritoneal transport status (high, high-average, low-average, low); guides dialysis prescription.

Peritonitis in PD

Cloudy effluent with abdominal pain and fever; peritoneal fluid WBC >100/mm³ with >50% neutrophils; treat with intraperitoneal antibiotics; remove catheter if refractory.

Peritoneal ultrafiltration

Fluid removal across peritoneal membrane driven by osmotic gradient from dextrose; higher dextrose concentration increases ultrafiltration but also glucose absorption.

Hyperacute rejection

Rapid graft rejection within minutes to hours due to preformed antibodies against donor antigens; prevented by crossmatching; graft must be removed.

Calcineurin inhibitors

Tacrolimus and cyclosporine; inhibit T-cell activation; require therapeutic drug monitoring; nephrotoxic and cause hypertension, hyperkalemia, and tremor.

BK virus nephropathy

Viral infection of renal allograft causing tubulointerstitial nephritis; diagnosed by urine/serum BK PCR and biopsy; treated by reducing immunosuppression.

Cockcroft-Gault equation

Estimates creatinine clearance: ((140 − age) × weight) / (72 × SCr) × 0.85 if female; used for renal drug dosing adjustment.

Sick-day rules

Guidance to temporarily hold ACE inhibitors, ARBs, diuretics, NSAIDs, and metformin during acute illness with dehydration to prevent AKI.

Phosphate binders

Medications taken with meals to reduce intestinal phosphate absorption; calcium-based (carbonate, acetate) or non-calcium (sevelamer, lanthanum); prevent CKD-MBD.

Protein intake in dialysis

Hemodialysis: 1.0–1.2 g/kg/day; peritoneal dialysis: 1.0–1.2 g/kg/day; non-dialysis CKD: 0.6–0.8 g/kg/day; higher dialysis losses require more protein.

Interdialytic weight gain

Weight gain between hemodialysis sessions reflecting fluid intake; target <2 kg/day or <4–5 kg total; excess increases hypotension and cardiovascular risk.

Hyperkalemia treatment

Calcium gluconate for cardiac membrane stabilization; insulin with glucose and beta-agonists shift K+ intracellularly; binders or dialysis remove potassium.

Hand hygiene

Most effective infection prevention measure; use alcohol-based hand rub or soap and water before and after patient contact and after glove removal.

Catheter-related bloodstream infection

Bloodstream infection attributed to dialysis catheter; suspect with fever, chills, hypotension; obtain cultures and treat with antibiotics; remove catheter if severe.

Hepatitis B vaccination

Recommended for all dialysis patients; gives protection against hepatitis B virus; monitor anti-HBs titers and revaccinate if inadequate response.

Teach-back method

Educational technique where patient explains information in own words; confirms understanding and identifies gaps; improves self-management and safety.

Advance care planning

Process of discussing and documenting patient goals, values, and preferences for future medical care, including dialysis withdrawal and palliative care.

Depression screening in CKD

Use PHQ-9 or similar tool; depression common in dialysis patients; treat with psychotherapy, medication, and social support; improves quality of life and adherence.

Informed consent

Ethical and legal requirement to disclose benefits, risks, alternatives, and consequences before procedures or research; document patient agreement.

Patient identifiers

Two identifiers (name and date of birth or medical record number) verified before medication administration, procedures, and blood transfusions to prevent errors.