Acute Kidney Injury

Question 1

What is acute kidney injury?

Answer 1

sudden cessation of renal function but patients will usually recover

Question 2

What are the types of AKI?

Answer 2

prerenal, intrarenal, and postrenal

Question 3

what is urine specific gravity at the prerenal stage?

Answer 3

urine specific gravity is at 1.030

Question 4

what is prerenal AKI?

Answer 4

this occurs before the kidneys due to factors external to the kidneys causing reduction in kidney blood flow but this is usually reversable

Question 5

What are causes of prerenal AKI and how can it be treated?

Answer 5

causes of prerenal AKI include heart failure, decreased cardiac output, and hypovolemmia and the main treatment is FLUIDS because it restores perfusion

Question 6

What is intrarenal AKI?

Answer 6

direct damage to kidneys from lack of oxygen due to surgery, medications, or injury and is the hardest to reverse

Question 7

What is treatment for intrarenal AKI?

Answer 7

treatment includes fluids if patient is still producing urine but dialysis if it is prolonged

Question 8

what is postrenal AKI?

Answer 8

this occurs after the kidneys and is a result of obstruction such as BPH or kidney stones and is the easiest to treat

Question 9

What is treatment for postrenal AKI?

Answer 9

remove blockage

Question 10

What are the phases of AKI?

Answer 10

onset, oliguria, diuresis, and recovery

Question 11

What happens in the oliguria phase of AKI?

Answer 11

urine output is 100-400 mL/24 hours so watch for fluid overload and there will also be electrolyte imbalances

Question 12

what happens in the diuresis phase of AKI and how long does it last?

Answer 12

kidneys start to recover because there is a diuresis of large amounts of fluids, and lasts 2-6 weeks

Question 13

what happens in the recovery phase of AKI and how long does it last?

Answer 13

continues until full function is restored and can take up to a year

Question 14

What are clinical manifestations of AKI?

Answer 14

1. anemia
2. fluid overload
3. hyponatremia
4. hyperkalemia

Question 15

What does fluid overload look like?

Answer 15

edema, crackles, dyspnea, weight gain, JVD, and tachycardia

Question 16

What electrolytes should be monitored with AKI?

Answer 16

hyperphosphatemia, hypocalcemia, hyponatremia, and hyperkalemia

Question 17

What are other labs that should be monitors with AKI other than electrolytes?

Answer 17

1. creatinine and BUN, USG, 24 urine collection test

2. screen for lupus or autoimmune disorders

Question 18

What are nursing interventions that should be done when caring for a patient with AKI?

Answer 18

1. Force IV fluids IF patient is still producing urine
2. give diuretics and restrict sodium, fluids, and potassium
3. high protein diet to replace high rate of protein breakdown