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NCLEX - HURST REVIEW (Renal) > Acute Kidney Injury (AKI) > Flashcards

Acute Kidney Injury (AKI) Flashcards

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1
Q

What is an Acute Kidney Injury ?

A

Sudden episode of renal damage

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2
Q

What is the goal of an acute kidney injury ?

A

To reverse it to prevent chronic renal failure

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3
Q

What are the causes of an Acute Kidney Injury ?

A
  • Pre-renal failure (blood can’t get to the kidneys)
  • Intra-renal failure
  • Post-renal failure
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4
Q

What falls within Pre-renal failure ?

A
  • Hypotension (need a BP above 90 for good perfusion)
  • Decreased HR (arrhythmia)
  • Hypovolemia
  • Any type of shock (shock can kill your kidneys)
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5
Q

What is Pre-renal failure ?

A

Blood can’t get to the kidneys

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6
Q

What is Intra-renal failure ?

A

Damage has occurred inside the kidney

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7
Q

What things fall under Intra-renal failure ?

A
  • Glomerulonephritis or Nephrotic syndrome
  • Malignant hypertension
  • Acute tubular necrosis
  • Dyes used in tests/imaging
  • Drugs (Aminoglycosides are nephrotoxic)
  • NSAIDS
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8
Q

What is Malignant Hypertension ?

A

Uncontrolled HTN and Diabetes mellitus

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9
Q

What is Acute tubular necrosis ?

A

Damage to the filtering bodies of the kidneys

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10
Q

What is Post-renal failure ?

A

Urine can’t get out of the kidneys

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11
Q

What things fall under Post-renal failure ?

A
  • Enlarged prostate
  • Kidney stone
  • Tumors
  • Ureteral obstruction
  • Edematous stoma (Ileal conduit)
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12
Q

What are the four phases of Acute Kidney Injury ?

A

a. ) Initiation phase (Injury occurs)
b. ) Oliguric phase (output may be less than or equal to 100mL/24hr)
c. ) Diuretic phase (kidney recovering)
d. ) Recovery phase (3 to 12 months)

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13
Q

Signs & symptoms of an Acute Kidney Injury ?

A
  • Increased Creatinine & BUN
  • Increased specific gravity , Fixed specific gravity
    - may loose ability to concentrate & dilute urine
  • HTN (retaining fluid)
  • HF (retaining fluid(
  • Anorexia (retaining toxins)
  • Nausea/vomiting (retaining toxins)
  • Itching frost (uremic frost) –> need good skin care
  • Retain phosphorus (causing serum calcium to go down)
  • Anemia (not enough EPO)
  • Hyperkalemia
  • Metabolic acidosis
    (unable to filter or retain hydrogen or bicarb)
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14
Q

What are the Tx goals for Acute Kidney Injury ?

A
  1. ) Prevent complications
  2. ) Manage Signs & symptoms
  3. ) Eliminate the cause of the kidney injury
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15
Q

What are nursing measures for an Acute Kidney Injury ?

A
  • Bedrest
  • Turn, cough, deep breathe
  • Monitor I & O
  • Daily weights
  • Monitor VS closely
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16
Q

Why do you want a client with an Acute Kidney Injury to be on bedrest for Treatment ?

A

To decrease metabolism and caloric needs

17
Q

What medications would a client with an Acute Kidney Injury (AKI) get for treatment ?

A
  • Loop diuretics or osmotic diuretics
  • IV glucose and Insulin
  • IV calcium gluconate
  • Polystyrene sulfonate
  • Phosphate binding drugs
  • give any IV medications in the smallest volume allowed*
18
Q

Why is IV glucose and insulin given as a treatment modality for Acute Kidney Injury ?

A

To Tx Hyperkalemia

19
Q

Why is IV calcium gluconate given for client’s with Acute Kidney Injury ?

A

For Dysrhythmias

20
Q

Why is Polystyrene sulfonate given for the Tx of Acute Kidney Injury (AKI) ?

A

To decrease potassium

21
Q

Why are phosphate binding drugs given for Tx of Acute Kidney Injury (AKI) ?

A

To prevent Hypocalcemia

22
Q

Nutrition for AKI:

What food groups should be increased in client’s with an Acute Kidney Injury ?

A

Carbohydrates & fats

23
Q

Nutrition for AKI:

What food group should be low/decreased in a client with an Acute Kidney Injury ?

A

Protein

24
Q

Nutrition for AKI:

In clients with an Acute Kidney Injury, what foods/fluids should be avoided ?

A

foods & fluids high in phosphate

25
Q

What foods should be avoided in client’s with an Acute Kidney Injury (AKI) ?

A

Foods high in potassium, like bananas, citrus, and coffee

26
Q

How should Infection prevention be maintained in a client with an Acute Kidney Injury (AKI) ?

A
  • Use aseptic technique
  • Meticulous skin care
  • Prevent pressure ulcers
  • Mouth care
  • No Catheter, if possible
  • Protect from others who have an infectious disease
27
Q

what may be needed in a client with an Acute Kidney Injury (AKI) ?

A

Renal Replacement Therapy (RRT)

28
Q

What kind of support does a client with an AKI need ?

A

Client and family support

29
Q

With an Acute Kidney Injury, when does the Oliguric phase end ?

A

10 - 14 days

30
Q

When does the Diuretic phase begin in a client with an Acute Kidney Injury ?

A

Begins when output goes up

fluid & electrolyte replacement based on lab results

31
Q

What is a client with an AKI placed on in the recovery phase ?

A

Placed on Increased proteins and increased calories

32
Q

In a client with an AKI in the recovery phase, when can they resume activity ?

A

Can resume activity as tolerated

NCLEX - HURST REVIEW (Renal) (7 decks)

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