AKI Flashcards
How does AKI occur
Sudden decrease in kidney function over hrs/days
- unable to manage fluid, e- & ab balance
- decreased excretion of waste product (urea & creatinine)
- retention of nitrogenous waste products (azotemia) = increased creatinine in bloodstream
- decreased GFR = decreased o/p
What are the modifiable risk factors of AKI
Exposure to nephrotoxic drugs
- ACEI
- NSAID/Acetaminophen
- Diuretics
- Contrast dye
What are the non-modifiable risk factors of AKI
- Advanced age
- Autoimmune disease
- Uncontrolled HTN
- DM
- Ca
- Heart, lung & kidney disease
What are the types of AKI
Pre-renal (smth to do with blood flow/renal perfusion), Intra-renal (problem/damage to kidney itself/inflammation), Post-renal (obstruction/decreased outflow of urine)
What conditions cause pre-renal AKI
- Dehydration
- Haemorrhage
- Hypovolemia
- Burns
- Ascities
- HF
- MI
- Shock
- Toxic drugs to kidney interfering with circulatory system
What conditions cause intra-renal AKi
- Glomerulonephritis
- Damage by toxin
- Prolonged ischaemic injury
What conditions cause post-renal AKI
- Ureter stones
- BPH/enlarged prostate
- Toxic drug
- Stricture
What are the different phases in AKI
Oliguria, diuretic, recovery
What are the SS of AKI
- Decreased urine o/p (*first sign)
- Fluid overload
- Increased weight
- Peripheral oedema
- HTN
- Bounding pulse
- Distended neck vein
- Pulm oedema
- Hyperk (muscle weakness & cardiac arrhythmia)
- HypoCa (tetany - involuntary muscle cramp)
- Phosphate retention/hyperphosphataemia
- Anorexia
- Weight loss
- Vomiting
What are the complications of AKI
- Uremia encephalopathy (confusion & lethargy)
- Seizure
- Coma
- Pulm oedema
- Hypoxia
- Dyspnoea
- Permanent kidney damage/ESRD
- Death
Is AKI a pre-requisite for CKD
No but it can progress to CKD (CKD is more due to DM/HTN)
What measures can be used to assess fluid retention
- Daily weight
- F/E- balance
- BUN
- Creatinine
- GFR
Nursing management of AKI
- Undisturbed rest due to anaemia which makes patient feel tired
- Observe for complications: Fluid overload, Rhonchi oedema, Pulm oedema, wheezing
- Skin care
- Na & fluid restriction (no sauce; *amt depends on how much o/p patient has)
- Emotional support
- Administer meds
