Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pathophysiology > Acute Renal Failure > Flashcards

Acute Renal Failure Flashcards

1
Q

Definition

A

Sudden decrease in renal function resulting in a build up of waste, fluid & electrolyte imbalance and increased pH

Reversible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Etiology

A

Pre-renal
Intrarenal
Post-renal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Prerenal

A

This is before the kidney and is an issue with perfusion to kidney… decreases the function of kidney as it is being deprived of nutrients (eventually leads to intrarenal injury).

The causes consist of:

 (-) cardiac issue like a myocardial infarction, heart failure resulting in decrease cardiac output, anaphylaxis

(-) bleeding: internally or externally 

(-) Dehydration -> hypovolemia 

(-) Burns
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Intrarenal

A

Acute tubular necrosis

A problem with the kidney itself… damage to the nephron… decreased ability to filter the blood, remove waste & excessive H2O, maintain electrolyte.

The causes consist of:

(-) Nephrotoxic drugs: NSAIDS, antibiotics, chemo drugs, contrast dye

(-) Infection ; glomerulonephritis

(-) Injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Postrenal

A

The is after the kidney where there is a blockage that prevents drainage resulting in an elevated pressure in kidneys and waist which decreases kidney function

The causes consists of

(-) Renal calculi (kidney stones)

(-) Enlarged prostate (BPH)

(-) Neurologically injury (“stroke” -> bladder doesn’t empty properly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Basics about the kidney

A

Adults void 1-2 liters/day

Urine consists of “what our body doesn’t need”

  • Water - Ions (sodium, chloride, calcium, phosphate, bicarbonate, potassium)
  • Urea - Creatinine
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Diagnosis

A

*Labs: creatinine level, creatinine clearance, glomerular filtration rate (GFR), BUN

Creatinine: waste product from muscle breakdown

  • Normal level: 0.6 - 1.20 mg/dL
  • Solely filtered from via glomerulus and is not reabsorbed or secreted in the nephron

BUN: normal 6-20 mg/dL

To determine Acute renal failure

  • Increase of serum creatinine above 50% of normal
  • Oliguria less than 500mls per day
  • Non oliguria greater than 800mls per day
  • Anuria less than 50 mls per 24 hour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Pathophysiology

A

INITIATION STAGE

  • starts from the cause of damage to kidney and ends when signs and symptoms occurs (few hrs. - several days)
  • Rise in creatinine levels
  • Rise in k+ levels
  • Some pts. may experience normal urine output

OLIGURIC STAGE

  • some pts skip this stage + enter next stage “diuresis”
  • Urine output less than 400ml/day → why: glomerulus decease ability to filter blood: low GFR
  • Increases in BUN & creatinine levels, neuro changes and itching
  • Hyperkalemia > 5.1 mEq/L which can alter EKG (tall peak T waves, wide QRS, prolonged PR-interval)

DIURESIS STAGE:

  • nephrons on their way to recover, filters blood but can’t concentrate
  • Gradual increase in urinary output
  • Creatinine levels decrease and may return to normal levels
  • voiding 3-5 liters/day due to osmotic diuresis

RECOVERY STAGE

  • May take up to 1 year
  • starts when GFR returns to normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Clinical Manifestations

A 
 Decreased urinary output
 Hematuria
 Low specific gravity
 Dehydration
 Lethargy
 Headaches
 Drowsiness
 muscle twitching
 seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Initiation phase

A

INITIATION STAGE

  • starts from the cause of damage to kidney and ends when signs and symptoms occurs (few hrs. - several days)
  • Rise in creatinine levels
  • Rise in k+ levels
  • Some pts. may experience normal urine output
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Oliguric stage

A

OLIGURIC STAGE

  • some pts skip this stage + enter next stage “diuresis”
  • Urine output less than 400ml/day → why: glomerulus decease ability to filter blood: low GFR
  • Increases in BUN & creatinine levels, neuro changes and itching
  • Hyperkalemia > 5.1 mEq/L which can alter EKG (tall peak T waves, wide QRS, prolonged PR-interval)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Diuresis stage

A

DIURESIS STAGE:

  • nephrons on their way to recover, filters blood but can’t concentrate
  • Gradual increase in urinary output
  • Creatinine levels decrease and may return to normal levels
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Recovery stage

A

RECOVERY STAGE

  • May take up to 1 year
  • starts when GFR returns to normal
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Diagnostic testing

A 
 Ultra sound
 MRI
 CT Scan
 Blood work
 BUN
 Creatinine
 FBC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Preventing acute renal failure

A

Provide adequate Hydration

  • Before surgery and after surgery
  • Persons requiring diagnostic test with contrasts and dyes
  • Patient receiving chemotherapy
  • Treat hypovolemic shock
  • Monitor critically ill patients hourly
  • Treat hypotension promptly
  • Continue to monitor urinary output
  • When administering blood products ensure accuracy
  • Treat infections promptly
  • Treat wound and burns appropriately
  • Treat urinary tract infections meticulously
  • Appropriate care for client with indwelling catheters
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Medical management

A

Eliminate the underlying cause

Restoring fluid balance

Avoiding fluid volume deficit and excess

Correcting Hyperkalemia
   • Kayexalate
   • Calcium resonium
   • Add insulin to the intravenous fluids
   • Ventolin

Correcting acidosis
• Bicarbonate

Nutrition
   • Low proteins
   • High carbohydrates
   • Restrict high potassium foods
        ◼ Fruits
        ◼ Citrus 
        ◼ Bananas coffee

Pathophysiology (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions