CDN flashcards

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

Stage G3a CKD

Glomerular filtration rate of 45–59 mL/min/1.73 m². This moderate decrease warrants monitoring for anemia, mineral bone disease, hypertension, and medication dosing adjustments.

Erythropoietin in CKD

Failing kidneys produce insufficient erythropoietin, causing normocytic normochromic anemia. Iron stores are evaluated first, because iron deficiency blunts the response to erythropoiesis-stimulating agents.

Secondary hyperparathyroidism mechanism

Phosphate retention and reduced calcitriol lower ionized calcium, stimulating parathyroid hormone release. The result is renal osteodystrophy, bone pain, and vascular calcification.

Nephrotic syndrome criteria

Proteinuria greater than 3.5 g per day, hypoalbuminemia, edema, and hyperlipidemia. Loss of urinary immunoglobulins and antithrombin raises infection and thrombosis risk.

KDIGO AKI stage 1

Creatinine rise of 0.3 mg/dL or more within 48 hours, or urine output below 0.5 mL/kg/h for 6 to 12 hours.

Hyperkalemia emergency sequence

Calcium gluconate stabilizes the myocardium first; insulin with glucose and beta-agonists shift potassium intracellularly; dialysis or potassium binders then remove total body potassium. Continuous ECG monitoring is required.

ACE inhibitor renal protection

Angiotensin blockade lowers intraglomerular pressure and slows CKD progression. Potassium and creatinine are monitored, and a creatinine rise up to about 30 percent may be acceptable.

Uremic platelet dysfunction

Retained toxins impair platelet adhesion and aggregation despite a normal platelet count, prolonging bleeding time. Desmopressin or dialysis temporarily improves hemostasis before procedures.

Kt/V adequacy target

Delivered Kt/V should be at least 1.2 per session with three treatments weekly, and urea reduction ratio should reach at least 65 percent.

Fistula rule of sixes

A mature arteriovenous fistula has blood flow above 600 mL/min, diameter above 0.6 cm, depth below 0.6 cm, and at least six weeks of maturation.

Access steal syndrome

Hand ischemia distal to the vascular access, marked by pain, pallor, paresthesia, paralysis, and pulselessness. Options include flow reduction, the DRIL procedure, or access ligation.

Air embolism response

Stop the blood pump, clamp the lines, position the patient in left lateral Trendelenburg, and administer 100 percent oxygen while summoning emergency assistance.

Dialysis disequilibrium syndrome

Rapid urea removal creates an osmotic gradient that draws water into the brain, causing headache, nausea, confusion, and seizures. Slower blood flow and shorter initial sessions prevent it.

Ultrafiltration rate limit

Keeping ultrafiltration below roughly 13 mL/kg/hour reduces intradialytic hypotension and myocardial stress. The rate equals target fluid removal divided by treatment time and body weight.

Catheter-related bloodstream infection

Fever, chills, and exit-site drainage in a patient with a central venous catheter suggest bloodstream infection. Blood cultures are drawn and antibiotic lock or catheter removal follows protocol.

Hemolysis during dialysis

Suspect with cherry-red extracorporeal blood, back or chest pain, dyspnea, and hypotension. Stop the pump, do not return the blood, and check dialysate conductivity and water treatment.

Peritonitis in peritoneal dialysis

Cloudy effluent, abdominal pain, and fever, with effluent white count above 100/µL and more than 50 percent neutrophils. Effluent is cultured and intraperitoneal antibiotics started promptly.

Peritoneal equilibration test

Classifies membrane transport as high, high-average, low-average, or low. High transporters lose ultrafiltration during long dwells; low transporters need longer dwells for adequate clearance.

Dextrose strength and ultrafiltration

Solutions of 1.5, 2.5, and 4.25 percent dextrose produce increasing osmotic ultrafiltration, but stronger solutions also increase glucose absorption, hypertriglyceridemia, and hyperglycemia.

Peritoneal dialysis contraindications

Recent major abdominal surgery, uncorrected hernia, severe respiratory compromise, peritoneal membrane failure, and encapsulating peritoneal sclerosis limit peritoneal dialysis because of leak, mechanical, or clearance failure.

Net ultrafiltration calculation

Subtract the instilled dialysate volume from the drained volume. A negative value indicates fluid absorption and prompts review of membrane transport status and dwell time.

Exit-site infection prevention

Daily cleansing, catheter immobilization, and nasal mupirocin for Staphylococcus aureus carriers reduce exit-site infection rates and subsequent peritonitis episodes.

Intradialytic hypotension management

Place the patient supine or in Trendelenburg, reduce or stop ultrafiltration, and give a saline bolus. Then reassess estimated dry weight and interdialytic fluid gain.

Estimated dry weight

The weight at which the patient is normotensive without edema or pulmonary congestion. It is reassessed periodically using blood pressure, lung sounds, and symptoms.

Dialysis muscle cramps

Give a small saline bolus, slow the ultrafiltration rate, and consider sodium modeling. Cramps usually reflect rapid fluid removal or electrolyte and osmolality shifts.

Predialysis nursing assessment

Obtain weight, blood pressure, temperature, access thrill and bruit, lung sounds, edema assessment, symptom review, and medication review before starting the treatment.

Pyrogenic reaction signs

Fever, chills, and hypotension arising during treatment suggest contaminated dialysate or reprocessed dialyzers. The treatment is stopped, the team notified, and cultures obtained.

Teach-back method

Patients restate instructions in their own words so the nurse can confirm understanding. It reveals comprehension gaps better than asking whether the patient understood.

Interdialytic fluid gain limits

Weight gain should stay below 2 kg per day and generally below 5 kg between treatments, since larger gains require higher ultrafiltration rates and provoke hypotension.

Depression screening in dialysis

Depression affects roughly 20–25 percent of dialysis patients and is linked to missed treatments and higher mortality. A validated tool such as the PHQ-9 supports screening and referral.

Hepatitis B vaccination in dialysis

Patients with kidney failure respond poorly to standard vaccine doses, so higher-dose or additional hepatitis B series are given, with antibody titers checked and revaccination when unprotected.

Dialysis infection control core actions

Hand hygiene, catheter hub disinfection, chlorhexidine skin antisepsis, no sharing of supplies between stations, staff vaccination, and bloodstream infection surveillance reduce dialysis-associated infection.