Acute Kidney Injury Flashcards
A wet bed
Acid base balance
Water removal
Erythropoesis
Toxin removal
Blood pressure control
Electrolyte balance
Vitamin d activation
Renal failure
AKI
CKD
AKI
Acute, rapid loss of renal function
Oliguria may be present
Uremia may be present
May see metabolic acidosis
Oliguria
Abnormal small amounts of urine
Uremia
Urine in the blood
AKI s/s
Rapid decrease in renal function
Increase in BUN creatine and K+(heart)
Decreased of urine output
Azotemia
Azotemia
Biochemically abnormally nitrogenous compounds
AKI 3 major categories for causes
Pre renal intrarenal postrenal
Prerenal
Due to decreased blood flow into the kidneys
Hemorrhage
Renal artery issue
Loss of fluid
Post renal
Obstruction from the outflow of the kidneys
Unilateral obstruction
Kidney stone
Bilateral obstruction
From a tumor (recognized quicker)
Intrarenal
Damage to tubeless, the glomerulus or the interstitium (space between the tubules)
What causes intrarenal
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
What causes POSR renal
Intraabdominal tumors benign prostatic
Hyperplasia
Kidney stones
Acute kidney injury
AKI s/s Oliguric phase
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
Diuretic phase s/s
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
Recover stage s/s
Begins when GFR increase
BUN and creatine levels plateau then decrease
Initiating phase
First indication
In the oliguric stage what are we going to watch?
The heart =hyperkalemia in this stage
What are we going to monitor closely in diuretic phase?
Hypovolemia , dehydration hypotension
AKI s/s
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)
What stage is your pt a candidate for dialysis ?
ESRD only
Nursing management
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
Acute on chronic
When kidneys shut down & unknown cause of lack of blood flow
They don’t recover how the kidneys use to work
What is sodium polystyrene sultanate-kayexalate used for?
Hyperkalemia
What meds do we administer in AKI
Diuretics(furosemide)
Kayexalate (sodium polyrene)
Calcium chancel blockers
Nephrotoxic agent
Contrast dye
Chemo
Some antibiotics
Nutrition we can teach
High calorie
Low sodium
Low potassium
Lean meats
Avoid can food , table salts, if they do can foods rinse them
Other therapy involved
Renal replacement therapy
In older pt
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
