Acute Renal Failure

Question 1

Acute tubular necrosis (ATN) renal parenchymal failure
Acute tubule-interstitial Nephritis

Answer 1

Acute Renal Failure

Question 2

Reversible condition characterized by:
• A sudden reduction or cessation of renal function
• Retention of waste products
• Increased UN & creatinine

Answer 2

Acute Renal Failure

Question 3

Causes of Acute Renal Failure:
Hypoperfusion of kidney
Volume depletion
Impaired cardiac efficiency
Vasodilation

Answer 3

Pre-renal

Question 4

Causes of Acute Renal Failure:
Actual damage to kidney tissue
Prolonged renal ischemia
Nephrotoxic agents
Infectious process

Answer 4

Intra-renal

Question 5

Causes of Acute Renal Failure:
Obstruction to urine flow
Urinary tract obstruction
Calculi (stones), tumors
Benign prostatic hyperplasia
Blood clots

Answer 5

Post renal

Question 6

Phases of Acute Renal Failure: Benign with initial insult and ends when oliguria develops

Answer 6

Onset

Question 7

Phases of Acute Renal Failure: Initial phase of injury 1-3 days

Answer 7

Onset

Question 8

Phases of Acute Renal Failure: accompanied by an increase in the serum concentration of substances usually excreted by the kidney

Answer 8

Oliguric Phase

Question 9

Phases of Acute Renal Failure: Urine output <400 cc/24 hrs for 3 days – 2 weeks

Answer 9

Oliguric Phase

Question 10

Phases of Acute Renal Failure:
BUN, creatinine
Edema, hypertension
Hyperkalemia

Answer 10

Oliguric Phase

Question 11

Phases of Acute Renal Failure:
Hyponatremia
Hyperphosphatemia
Metabolic Acidosis

Answer 11

Oliguric Phase

Question 12

Phases of Acute Renal Failure: signals the improvement of renal function and may take 3 to 12 months

Answer 12

Recovery Phase

Question 13

Phases of Acute Renal Failure:
Avoid nephrotoxic drugs
May lead to CRF

Answer 13

Recovery Phase

Question 14

Acute Renal Failure S/Sx: 1st (4)

Answer 14

Irritability
Headache
Anorexia
Tingling of Extremities

Question 15

Acute Renal Failure S/Sx: ? that can progress to stupor & coma

Answer 15

Lethargy

Question 16

Acute Renal Failure S/Sx: Sudden dramatic drop in ?

Answer 16

Urinary output

Question 17

Acute Renal Failure S/Sx: ? odor breath & perspiration

Answer 17

Ammonia

Question 18

Acute Renal Failure S/Sx: ? Edema

Answer 18

Generalized

Question 19

Acute Renal Failure S/Sx: ? which can progress to pulmonary edema & CHF

Answer 19

Hypertension

Question 20

Acute Renal Failure Management

Answer 20

Correct Underlying Cause

Question 21

Acute Renal Failure Pharmacologic Management: to restore renal perfusion in hypertensive client

Answer 21

Volume Expanders (Dopamine)

Question 22

Acute Renal Failure Pharmacologic Management: for diuresis

Answer 22

Loop diuretics

Question 23

Acute Renal Failure Pharmacologic Management: for hypertension

Answer 23

ACE Inhibitors

Question 24

Acute Renal Failure Pharmacologic Management: to prevent gastric ulcers

Answer 24

H2 blockers

Question 25

Acute Renal Failure Pharmacologic Management: to reduce potassium

Answer 25

Kayexalate

Question 26

Acute Renal Failure Pharmacologic Management: to treat acidosis

Answer 26

Sodium Bicarbonate

Question 27

ARF Nursing Management: Diet

Answer 27

Moderate protein restriction
High Carbohydrates
Restricted Potassium

Question 28

ARF Nursing Management: Nutrition

Answer 28

Total Parenteral Nutrition

Question 29

ARF Nursing Management: Monitor (2)

Answer 29

I and O
Electrolyte Imbalance (Acidosis & Hyperkalemia)

Question 30

ARF Nursing Management: ? daily

Answer 30

Weight

Question 31

ARF Nursing Management: Assess for sign of overhydration (5)

Answer 31

Edema
Crackles
Headache
Distended Neck Veins
Hypertension

Question 32

ARF Nursing Management: Observe for (3)

Answer 32

Oliguria followed by Polyuria
Edema
Early Signs of Complication

Question 33

ARF Nursing Management: Provide (2)

Answer 33

Periods of undisturbed rest
Skin care