Acute kidney injury Flashcards
What is acute kidney injury?
Rapid loss of kidney function
AKI will have 3 increased 1 decreased
BUN creatinine urine
AZOTEMIA
Increase of nitrogen in blood
3 categories of ARF
Prerenal, intrreanal, postrenal
What causes prerenal 2
Sever drop in BP interruption of blood flow to kidneys
what causes intrarenal 6
Direct damage to the kidneys toxins, drugs, infection, reduced blood flow, inflammation, prerenal
what causes post renal 5
Sudden obstruction of urine flow enlarged prostate, kidney stones, tumor, injury, reflux
4 things to look at that cause prerenal
hypovolemia, Decreased CO, Decreased peripheral vascular resistance, decreased renal blood flow
2 things to look at with intrarenal YOu didnt know
Acute tubular necrosis, hemoglobin from hemolyzed rRBC
What is Acute tubular necrosis
Acute tubular necrosis is a condition that causes the lack of oxygen and blood flow to the kidneys in the basement membrane
Why are nephrotoxins with tubular necrosis
They cause it and the epithelial cells come off and get stuck
What causes acute tub necro 3
Ischemia, nephrotoxins, sepsis
Risks of Acute tub necro 5
Surgery, shock, blood transfusion, mm injury, prolonged hypotension
4 nephrotoxins
NSAIDS, Vanco, chemo, contrast
hydronephorsis
swelling in kidney
phases of AKI
Oliguric, Diuresis, recovery
Olugaric urine number and specific gravity and what does that mean?
Less than 400ml/day 1.010 kidneys can’t concentrate urine.
casts and when do they mean?
tube shaped particles indicative of AKI
S/S of Olugaric 6
Na+ K+ increase, widening QR intervals, med acidosis, Neurological(Seizures) From build up of toxins, leukocytosis
Why is there an increase in urine output in the diuresis phase?
Because of the oncotic pressure from the o stage
What needs to be monitored in the Diuretic stage?
fluid level
How much urine output could we see with Diuresis stage?
more than 5l a day
What function is lacking in the Diuresis stage?
urine concentration
2 things to know about the recovery stage
Older people may not recover and go to chronic renal fail and it may last 3-12 months
Normal BUN
Less than 20
What to know about Creatinine and AKI
May not show up until 50% is gone
Normal BUN to creatinine level
20:1
Normal creatinine clearance level
less than 70
Management of Oli stage 4
Watch for fluid overload, loop diuretics, fluid and electrolytes, daily weights
Management of Diuretic phase 2
Fluid/electrolytes, daily weights
Nursing priorities 1 step in AKI
Make sure there is CO and fluid volume
Other nursing priorities 5
Protect against infection, monitor antibiotic use, Question NSAIDS, Skin care, oral care
What is an NSAID you didn’t know
Ketorolac
Why oral care for AKI what can it cause?
Because of the elevation in urea stomatitis
Nutrition for AKI 3
Cals should come from fats and carbs, 0.8-1.0g prots, K+, Na+ and phosphate restriction
One thing that can decrease perfusion
Ace inhib
