AKI

Question 1

staging of AKI

Answer 1

uses serum creatinine and urine output

Question 2

why consider chest xray in AKI

Answer 2

pulmonary infiltrates could indicate fluid or haemorrhage

Question 3

bloods to take for AKI

Answer 3

FBC
U+Es
bicarbonate
LFTs
Calcium
phosphate
glucose 
VBG

Question 4

how assess renal anatomy and exclude renal failure?

Answer 4

renal tract USS

Question 5

immediate management of AKI pneumonic

Answer 5

STOP AKI

Question 6

STOP AKI

Answer 6

sepsis 6 is suspected
TOXINS - avoid nephrotoxins (gentamicin, NSAIDs, iodinated contrast)

OPTIMISE bloood pressure and volume status (consider witholding antihypertensives)

PREVENT harm - treat complcations - acidosis, hyperkalaemia, pulmonary oedema, identify cause, review meds and fluid

Question 7

monitor what in AKI

Answer 7

daily volume assessment
fluids balance
U+Es
bicarbonate

Question 8

referalls for AKI

Answer 8

discuss with senior member
contact critical care outreach team
referral to renal team for particular patients
consider referral to ICU

Question 9

when to refer to renal team

Answer 9

AKI stage 3

persistent oliguria or rising serum creatinine despite supportive therapy

complications refractory to medical management - intractable pul od., hyperkalemia, acidosis, uraemic pericarditiis, encephalopathy

AKI with - absence of defined cause, systemic features, paraproteins, haemolysis and low platelets, suspected poisoning

Question 10

when to consider ICU

Answer 10

failrue to repsond to medical management

requires ventilator support

required blood pressure support

deterioration of blood gas following medical management