Acute Kidney Injury

Question 1

A wet bed

Answer 1

Acid base balance
Water removal
Erythropoesis
Toxin removal
Blood pressure control
Electrolyte balance
Vitamin d activation

Question 2

Renal failure

Answer 2

AKI
CKD

Question 3

AKI

Answer 3

Acute, rapid loss of renal function
Oliguria may be present
Uremia may be present

May see metabolic acidosis

Question 4

Oliguria

Answer 4

Abnormal small amounts of urine

Question 5

Uremia

Answer 5

Urine in the blood

Question 6

AKI s/s

Answer 6

Rapid decrease in renal function
Increase in BUN creatine and K+(heart)
Decreased of urine output
Azotemia

Question 7

Azotemia

Answer 7

Biochemically abnormally nitrogenous compounds

Question 8

AKI 3 major categories for causes

Answer 8

Pre renal intrarenal postrenal

Question 9

Prerenal

Answer 9

Due to decreased blood flow into the kidneys

Hemorrhage
Renal artery issue
Loss of fluid

Question 10

Post renal

Answer 10

Obstruction from the outflow of the kidneys

Question 11

Unilateral obstruction

Answer 11

Kidney stone

Question 12

Bilateral obstruction

Answer 12

From a tumor (recognized quicker)

Question 13

Intrarenal

Answer 13

Damage to tubeless, the glomerulus or the interstitium (space between the tubules)

Question 14

What causes intrarenal

Answer 14

Acute tubular necrosis
big cause can be From prerenal
(Depending how long and how much blood flow was compromised can cause tissue to die and result in CKD

Glomerulonephritis

Acute interstitial nephritis (days to weeks)

Nephrotoxic drugs

Question 15

What causes POSR renal

Answer 15

Intraabdominal tumors benign prostatic
Hyperplasia
Kidney stones

Question 16

Acute kidney injury

Question 17

AKI s/s Oliguric phase

Answer 17

Oliguria <400 ml/day occurs within 1-7 days of KI
Urinalysis casts RBC wbc sp gr fixated at 1.010
Metabolic acidosis
Hyperkalemia &Hyponatremia
Elevated BUN &creatine
Fatigue and malaise

Question 18

Diuretic phase s/s

Answer 18

Gradual increase in urine output 1-3 l/d may reach 3-5 l a day
Hypovolemia , dehydration
Hypotension
BUN and creatine levels began to normalize

Question 19

Recover stage s/s

Answer 19

Begins when GFR increase
BUN and creatine levels plateau then decrease

Question 20

Initiating phase

Answer 20

First indication

Question 21

In the oliguric stage what are we going to watch?

Answer 21

The heart =hyperkalemia in this stage

Question 22

What are we going to monitor closely in diuretic phase?

Answer 22

Hypovolemia , dehydration hypotension

Question 23

AKI s/s

Answer 23

Decrease urine output
Swelling legs , ankle, feet
SOB(Dyspnea)
Fatigue
Loss of apetite
N/v
Arrhythmia
Chest pain or pressure
Easy or unusual bleeding (low platelets )
Confusion (toxins cause neuro effect)

Question 24

What stage is your pt a candidate for dialysis ?

Answer 24

ESRD only

Question 25

Nursing management

Answer 25

Eliminate cause, prevention complications, assist with recovery
Vitals
I&O daily weight
Oxygenation
Manage fluid balance
Positioning
Skin care
Dialysis may need to be considered

Question 26

Acute on chronic

Answer 26

When kidneys shut down & unknown cause of lack of blood flow
They don’t recover how the kidneys use to work

Question 27

What is sodium polystyrene sultanate-kayexalate used for?

Answer 27

Hyperkalemia

Question 28

What meds do we administer in AKI

Answer 28

Diuretics(furosemide)
Kayexalate (sodium polyrene)
Calcium chancel blockers

Question 29

Nephrotoxic agent

Answer 29

Contrast dye
Chemo
Some antibiotics

Question 30

Nutrition we can teach

Answer 30

High calorie
Low sodium
Low potassium
Lean meats
Avoid can food , table salts, if they do can foods rinse them

Question 31

Other therapy involved

Answer 31

Renal replacement therapy

Question 32

In older pt

Answer 32

GFR decline
Increase risk of diabetes and CVD

Increase risk for dehydratopm

Older kidney does not compensate as well for fluid volume , solute load and cardiac output