Acute Renal Failure

Question 1

ARI reversible ?

Answer 1

Yes if Tx early
-symptoms may be mild,
Moderate, or severe depending on stage of ACI

Question 2

Etiology: types/causes of ARI- first stage

Answer 2

1) prerenal (before kidneys;@ glomeruli): severe reduce renal blood flow decreasing GFR & BP
- Ex: dehydration, burns, hemorrhage, HF, shock, anti HTN

Question 3

Causes of CRF

Answer 3

-glomeeulonephritis, HTN, DM, cirrhosis, chronic pyelonephritis

Question 4

Patho of acute renal injury

Answer 4

• Deterioration of renal f*n that occurs over hrs to days & results in azotemia (elevation in creatine & BUN)
• decrease blood flow leading to decrease GFR & perfusion of kidneys

Question 5

Patho of chronic renal failure

Answer 5

Kidney damage or decreased kidney f*n for 3+ mo where nephrons are permanently damaged

Question 6

Clinical manifestations of ARI

Answer 6

1) initiation phase: increase creatine &BUN; decrease urine output (oliguria)

Question 7

Low Na?

Answer 7

• hyponatremia
• leads to low blood vol
• S: CNS complications (confusion, lethargic), postural HYPOtn, tachycardia, n/v, poor skin turgor, dry mucous membranes
• normal levels Na: 135-145

Question 8

High K?

Answer 8

• hyperkalemia
• MURDER ac.
• muscle twitches
• urine output low
• resp distress
• diarrhea(increase motility) & decreased cardiac contractilirt
• normal levels K: 3.5-5.5

Question 9

Diagnostic tests for ARI

Answer 9

• Hx & physical exam
• increased BUN, cr, k, mg, bi carb
• lower Hct, Hgb, Na
• MRI: not suggested
• CT scan
• look at notes

Question 10

Nursing management

Answer 10

• I & o & weights
• VS
• labs
• low protein, high cal, low Na, high K
• oral hygiene
• prevent infection
• surgical renal transplant
• temporary dialysis

Question 11

Define ARI

Answer 11

An abrupt onset c decline in kidney f*n leading to increased serum creatine & BUN & decreased GFR & urine output (or all of these)

Question 12

Second stage of cause/type of AKI?

Answer 12

2) intrarenal (intrinsic): cause direct damage to kidneys/renal tissue
- ex: ATN*, allergies, infections, inflammation, drugs

Question 13

Third cause/type acute kidney injury ?

Answer 13

3) postrenal: sudden obstruction of urinary outflow d/t …

- ex: BPH, bladder tumor, trauma to pelvis/perineum

Question 14

Clinical manifestations of ARI maintenance phase

Answer 14

• lower GFR, Uranus, oliguria, proteinuria,
• fluid vol excess (Edema, bound pulse, HTN)
• n, v, anorexia, slowed bowels
• low Na
• high K
• immunodeficiency & seizure/stupor/coma

Question 15

Recovery phase manifestations of acute renal injury

Answer 15

• marked return of BUN & creatine

- may have diuretic phase (1-3 wks) monitor for hyoponatremia, hypokalemia, dehydration

Question 16

Function of Na

Answer 16

Maintains water levels & [ ] of ECF , nerve impulse conduction, regulated by kidneys
-135-145