Chronic kidney disease, dialysis, and urinary tract disorder nursing assessment priorities and interventions.
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- What is the normal range for glomerular filtration rate (GFR) in a healthy adult?
- About 90-120 mL/min/1.73m2
- At what GFR is chronic kidney disease classified as stage 5 (kidney failure)?
- Less than 15 mL/min/1.73m2
- What is the leading cause of chronic kidney disease?
- Diabetes mellitus
- What is the second most common cause of chronic kidney disease?
- Hypertension
- Which electrolyte imbalance is the most life-threatening complication of CKD?
- Hyperkalemia
- What ECG change is an early sign of hyperkalemia?
- Peaked, tall T waves
- What IV medication is given emergently to stabilize the heart during severe hyperkalemia?
- Calcium gluconate
- Why does CKD commonly cause anemia?
- Failing kidneys produce less erythropoietin, reducing red blood cell production
- Why does CKD lead to renal osteodystrophy (bone disease)?
- The kidneys retain phosphorus and cannot activate vitamin D, triggering secondary hyperparathyroidism
- Why is dietary protein often restricted in CKD?
- To reduce the buildup of nitrogenous waste products such as BUN
- Name two potassium-rich foods a CKD patient is taught to limit.
- Bananas and oranges (also potatoes and tomatoes)
- When should phosphate binders be taken?
- With meals
- How is daily fluid allowance typically calculated for a dialysis patient?
- Previous day's urine output plus about 500-600 mL for insensible losses
- What late sign of untreated uremia appears as crystallized urea deposits on the skin?
- Uremic frost
- How does a nurse assess patency of an AV fistula?
- Palpate for a thrill and auscultate for a bruit