Acute Kidney Injury Flashcards
Most common cause of AKI
Ischemia
Exposure to mephrotoxins
Other causes of AKI
Major surgery
Sepsis
Severe pneumonia
AKI:
Rapid decline in renal function, particularly GFR
Categories of AKI
Prerenal
Intrinsic/Intrarenal
Postrenal
What is Prerenal:
Hypovolemia
Low CO altered vascular resistance
Intrinsic/Intrarenal
Glomerular/micro vascular injury
Acute Tubular necrosis
Interstitial nephritis
Postrenal
Ureteral/urethral obstruction
What is the most common type of AKI
Prerenal
Prerenal results from
Results from conditions that affect renal blood flow and perfusion
Trauma
Surgery
Critically ill patients
Is Prerenal AKI irreversible
Yes rapidly when blood flow restored and renal parenchyma in damaged
Prerenal can lead to ____ disease if renal ischemia is prolonged
Intrarenal
Postrenal AKI:
Can result from any condition that prevents
Urine excretion
What is the most common precious thing factor of Postrenal AKI
BPH
Other factors of Postrenal AKI
Renal Tumors
Urinary Tract Calculi
Intrarenal AKI
Characterized by
Acute damage to renal parenchyma and nephrons
Most common cause of intrarenal AKI
Acute tubular necrosis
AKI related to which population of people
Older adults
Critically ill
Rick Factors of AKI
Major trauma or surgery Infection Hemorrhage Severe heart failure Severe liver disease Lower urinary tract obstruction Drugs and radiologic contrast media Older adults Child with renal insufficiency
Diagnostic Tests:
UA w/ specific gravity, proteinuria, presence of RBCs, and cell casts GFR Serum Cr, BUN, electrolytes ABGs CBC Renal ultrasound CT scan IV retrograde, pyelography Renal Biopsy Rediographic studies
Pharmacological Therapy
Low dose dopamine Loop diuretic Osmotic diuretics ACEs Nephrotoxic drugs Antacids PPIs H2 Blockers Reduce serum K levels Aluminum hydroxide
Fluid Management
Restrict fluid intake
Monitor fluid balance
Nutrition Management
Limit protein
Increase carbs
PTN as needed
Renal replacement therapy
Dialysis
Hemodialysis
CRRT
Dialysis:
Diffusion of solutes across semipermeable membranes
Hemodialysis:
Removes electrolytes, waste products, excess water from body via diffusion
Blood pumped from body, returned
At risk for
Hypovolemia
Promptly report fall in urine output ____ in adult
30 ml/hr
Diagnosis
Excess fluid volume Less than imbalanced nutrition Ineffective renal perfusion Altered skin integrity risk for Infection risk for Risk for altered cardiac perfusion
AKI: Possible Causes
Severe heart failure Hemorrhage Radiologic contrast media Major trauma Cerebrovascular disease
Major trauma
Heart failure
Hemorrhage
Radiologic contrast media
Conditions that can cause damage to the renal parenchyma and nephrons resulting in AKI
Dehydration Glomerulonephritis Hemolysis HTN Vasculitis
HTN
Hemolysis
Glomerulonephritis
vasculitis
Most common causes of AKI
Insufficient blood supply Fluid overload Dehydration Exposure to nephrotoxins Chemical imbalance
Ischemia
Exposure to nephrotoxins
Most common precipitating factor for post renal AKI
BPH
A child is admitted to the hospital with nausea, vomiting, lethargy, oliguria, in the healthcare provider suspects fluid depletion associated with AKI. Which prescribed order should the nurse expect
Isotonic saline solution
Hyperkalemia associated with acute kidney injury. The nurse should monitor for which manifestation
ECG changes
Diet for acute kidney injury
An increase in carbohydrates
What can cause Prerenal AK I
Sepsis
For which lab value should the nurse suspect hemodialysis to be ordered
Increasing serum potassium level
Contrast media is associated as a cause of acute kidney injury
True
What does muddy casts look like
Red blood cells in the urine. Can look brownish
