44 de martino renal-failure

Renal Failure Wendy DeMartino, MD PGY-2

Objectives ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Anatomy ,[object Object],[object Object],[object Object],[object Object]

Kidney Function ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Classifications ,[object Object],[object Object],[object Object]

Acute Versus Chronic ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acute Renal Failure ,[object Object],[object Object],[object Object]

Causes of ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Symptoms of ARF ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Diagnosis of Renal Failure Not A Field Diagnosis

Acute Renal Failure Management ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

ARF: Life Threatening Conditions ,[object Object],[object Object],[object Object]

Hyperkalemia Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],EKG?

Hyperkalemia & EKG ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hyperkalemia Treatment ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Chronic Renal Failure ,[object Object],[object Object],[object Object]

Chronic Renal Failure Causes ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

CRF Symptoms ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Acute Problems in CRF ,[object Object],[object Object],[object Object]

Problems Related to ESRD ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Dialysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Hemodialysis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Types of Access ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

What This Means For You ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Access Problems ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

Peritoneal Dialysis ,[object Object],[object Object],[object Object],[object Object],[object Object]

EMS Considerations ,[object Object],[object Object],[object Object],[object Object],[object Object]

Dialysis Related Problems ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

1. The normal urinary system consists of: ,[object Object],[object Object],[object Object],[object Object],D

2. The basic, functional unit of the kidney that acts to mechanically filter fluids, wastes and electrolytes is called: ,[object Object],[object Object],[object Object],[object Object],C

3. You receive a 911 call to respond to a local residence for a report of an elderly male who is unconscious. Upon arrival you find a 68 year old female patient who is unconscious with snoring respirations. Your partner opens the airway and the patient begins breathing at a rate of 44 breaths per minute. Patients daughter states her mother has ESRD and has decided she wants to die. Patient has not had dialysis treatment for 3 weeks. After quick assessment of ABCs what is your first priority in treating this patient? ,[object Object],[object Object],[object Object],B

4. You are dispatched for “Man light headed and bleeding from a shunt.” Upon arrival you find a 38 year old male with a recent history of ARF and receives dialysis 3 times a week. Today he was changing his shirt. The Permcath in the right side of his chest became caught in a button hole and the red port of the catheter was sheared off. Which of the following treatments are appropriate? ,[object Object],[object Object],[object Object],C

5. 911 dispatch pages your department for a 72 year old female with high fever, needs to be transported to emergency room for evaluation. Upon arrival you find an elderly female who is confused with hot dry skin and a respiratory rate of 40 BPM. Her blood pressure is 80/40 with a pulse of 120. The patient has a history of CRF and is on peritoneal dialysis. You note a large tube coming from her abdomen that is connected to other tubes and large empty bags. Patient’s daughter states that it is time to “drain mom’s dialysis water.” Based upon your knowledge of peritoneal dialysis which of the following is an appropriate response?

5 (cont). Appropriate response? ,[object Object],[object Object],[object Object],[object Object],A

6. Renal failure often occurs in trauma patients who have had sustained hypotension because: ,[object Object],[object Object],[object Object],[object Object],C

7. You arrive on scene for a dialysis patient with a history of kidney failure complaining of shortness of breath. You notice the right arm has large bulging veins. When taking a blood pressure which of the following answers best describes appropriate actions: ,[object Object],[object Object],[object Object],[object Object],A

8. You are transporting an unconscious dialysis patient to the hospital. The arm with is AV shunt was left dangling over the cot. When loading in the ambulance the arm banged against the wall of the rig. During transport you notice that there is a large hematoma over one of the veins of the arm. The hematoma is growing quickly. What is the most appropriate action: ,[object Object],[object Object],[object Object],[object Object],C

9. Which of the following could potentially cause renal failure: ,[object Object],[object Object],[object Object],[object Object],D

References ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

44 de martino renal-failure

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