Chronic Kidney Disease Nursing: Stages, Labs, Dialysis + Mnemonics (NCLEX)

Chronic kidney disease nursing for NCLEX and med-surg: what healthy kidneys do (A WET BED), why CKD happens (diabetes and high blood pressure), the GFR stages, why every sign shows up, the labs that go up and the ones that go down, the kidney diet, 4 key meds (lisinopril, sevelamer, epoetin alfa, calcitriol), hemodialysis vs peritoneal dialysis, AV fistula care (thrill and bruit), the two emergencies (high potassium and fluid overload), patient teaching, and 4 practice questions that get harder as you go. QUICK ANSWERS • What are the stages of chronic kidney disease? Staged by GFR: stage 1 is 90 or higher with signs of kidney damage, stage 2 is 60 to 89, stage 3 is 30 to 59 (3a 45 to 59, 3b 30 to 44), stage 4 is 15 to 29, stage 5 is under 15 (kidney failure, dialysis or transplant). CKD means the problem lasts more than 3 months. • What labs go up in chronic kidney disease? Creatinine, BUN, potassium, and phosphate go up. GFR, calcium, and hemoglobin go down. Phosphate and calcium move in opposite directions. • Why do people with CKD get anemia? Healthy kidneys make erythropoietin, the hormone that tells the bone marrow to make red blood cells. Failing kidneys make less, so hemoglobin drops. Epoetin alfa replaces it. • What is the A WET BED mnemonic? The 7 kidney jobs: Acid-base, Water, Electrolytes, Toxins, Blood pressure, Erythropoietin, vitamin D. When the kidneys fail, each job fails: acid builds up, fluid overload, high potassium and phosphate, uremia, high blood pressure, anemia, weak bones. • How do you assess an AV fistula? Feel for a thrill (a buzzing vibration) and listen for a bruit (a whooshing sound). Both mean blood is flowing. If either is gone, report it right away. No blood pressures, IVs, or blood draws in that arm. • How is high potassium treated in kidney failure? C BIG K DROP: calcium gluconate IV protects the heart (it does not lower potassium), a beta agonist (albuterol), insulin IV with glucose, a potassium binder, and dialysis to remove it. Put the client on a cardiac monitor and check the blood sugar after the insulin. • When is dialysis needed urgently? AEIOU: Acidosis, Electrolytes (high potassium), Intoxication, Overload of fluid, Uremia. • Why is a phosphate binder taken with meals? Sevelamer works like a sponge in the gut, soaking up phosphate from food, so it has to be taken with each meal. Comment your score out of 4, and which memory trick you'll use first. PRACTICE NCLEX QUESTIONS IN NURSELINGO NurseLingo on the App Store: https://apps.apple.com/us/app/nurseli... Free NCLEX games: https://nurselingo.app/arcade Website: https://nurselingo.app MORE NCLEX REVIEW Fluid and Electrolytes (potassium, calcium, phosphate):    • Fluid and Electrolytes Made Easy for Nursi...   Lab Values (what high and low actually mean):    • Lab Values Made Easy for Nursing Students ...   ABGs (metabolic acidosis):    • ABGs Made Easy for Nursing Students | Tic-...   EKG Rhythms (read any strip):    • EKG Rhythms Made Easy: Read Any Strip in 6...   NCLEX Prioritization: Who Do You See First?:    • NCLEX Prioritization: Who Do You See First...   0:00 Intro 0:28 What CKD is 1:32 Why it happens 2:04 GFR stages 2:44 Signs: why they happen 3:24 Labs 4:41 Diet + fluids 5:18 The meds, fast 7:06 Dialysis basics 7:57 AV fistula care 9:08 Emergencies 10:55 Patient teaching 11:26 The hardest question 12:30 Recap SOURCES OpenStax Medical-Surgical Nursing 20.7 Renal Function and Chronic Kidney Disease: https://openstax.org/books/medical-su... OpenStax Clinical Nursing Skills (dialysis, AV fistula, labs): https://openstax.org/books/clinical-n... National Kidney Foundation, eGFR and CKD stages: https://www.kidney.org/kidney-topics/... NIDDK, Causes of Chronic Kidney Disease: https://www.niddk.nih.gov/health-info... NIDDK, Eating Right for Chronic Kidney Disease: https://www.niddk.nih.gov/health-info... MSD Manual Professional, Chronic Kidney Disease: https://www.msdmanuals.com/profession... MSD Manual Professional, Hyperkalemia: https://www.msdmanuals.com/profession... EPOGEN (epoetin alfa) Prescribing Information: https://www.pi.amgen.com/united_state... All 4 questions are from the NurseLingo question bank. For education only. Lab ranges and dialysis orders vary by facility and provider; always follow your orders and policies. NurseLingo is not affiliated with NCSBN. #NCLEX #NursingStudent #KidneyDisease