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Nursing Acutely Ill > AKI > Flashcards

AKI Flashcards

1
Q

What intervention should be used in metabolic acidosis occurring as a result of AKI?

A

Renal replacement therapy.

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2
Q

What are the 10 functions of the renal system?

A 
Water balance 
Electrolyte balance 
Acid-base balance 
BP maintenance 
Waste removal 
Toxin/drug removal 
Erythropoietin 
Calcium and phosphate balance 
Vit D3 synthesis 
Insulin degradation
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3
Q

What are 3 criteria in the diagnosis of AKI?

A

Increase in serum creatinine 26micromol/L within 48 hours.
Increase in serum creatinine >1.5 x above baseline within 1 week
UO of <0.5ml/kg/hr for >6hrs

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4
Q

What is the molecule looked for to assess AKI?

A

Serum creatinine

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5
Q

What are the diagnostic criteria for AKI stage 1?

A

Serum creatinine >26micromol/L in 48 hrs

UO <0.5ml/kg/hr for 6hrs

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6
Q

What are the diagnostic criteria for AKI stage 2?

A

Serum creatinine >2 x baseline

UO <0.5ml/kg/hr for >12hrs

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7
Q

What are the diagnostic criteria for AKI stage 3?

A

Serum creatinine >3 x baseline

UO <0.3ml/hr/kg for 24 hrs

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8
Q

Normal serum creatinine levels?

A

55-120umol/L

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9
Q

What are example baseline risks for AKI?

A 
Older 
Diabetes mellitus 
Chronic kidney disease 
Heart failure 
Hypertension 
Liver failure 
Male 
Race 
Hypoalbuminaemia 
Arterial vascular disease
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10
Q

What are example acute risks of AKI?

A 
Sepsis 
Hypotension 
Volume depletion 
Rhabdomyolysis 
Cardiac/vascular surgery 
Organ transplantation 
Compartment syndrome 
Mechanical ventilation
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11
Q

What are example nephrotoxic agents?

A

Contrast
Antibiotics
Chemotherapy
NSAIDs

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12
Q

What are example causes of intrinsic AKI?

A

Acute tubular injury: pro-longed pre-renal AKI; rhabdomyolysis; nephrotoxins
Glomerulonephritis
Vasculitis

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13
Q

What are example causes of post renal AKI?

A

Kindey stones
Prostatic hypertrophy
Tumours
Retroperitoneal fibrosis

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14
Q

What are example causes of pre-renal AKI?

A 
Sepsis 
Hypovolemia 
Hepato-renal syndrome 
Cardiac failure 
Hypotension
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15
Q

What are examples of cardiac pre-renal AKI?

A 
Heart failure 
Myocardial infarction 
Arrhythmia 
Pulmonary Embolism 
Shock 
Tamponade
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16
Q

What are examples of volume pre-renal AKI?

A 
Haemorrhage 
GI loss 
Renal loss 
Skin loss 
Inadequate hydration
Diuretics
17
Q

What are examples of vasomotor factors pre-renal AKI?

A

Afferent constriction- sepsis, NSAIDs, hypercalcaemia

Efferent dilation- ACE inhibitors

18
Q

What are examples of obstruction pre-renal AKI?

A

Thrombosis
Embolism
Hyperviscosity

19
Q

What are the causes of intrinsic AKI?

A

Vascular
Glomerular
Tubular
Interstitial

20
Q

What are the symptoms of AKI?

A 
Decreased UO 
Fluid retention- oedema 
Dyspnoea 
Chest pain 
Hypertension 
Confusion 
Nausea/vomiting 
Seizures or coma in severe 
Mild back pain 
Cardiac arrhythmias- increased potassium 
Symptoms of the cause- thirst
21
Q

What is uraemia?

A

Deterioration of biochemical, physiological functions as a result of retention of different solutes. Resembles systemic poisoning

22
Q

What are vital sign symptoms of AKI?

A 
Pulmonary oedema 
Dyspnoea 
Tachypnoea- metabolic acidosis 
Hypertension 
Hypertrigliceridaemia 
Nausea 
Constipation/diarrhoea
23
Q

Haematologically what would you see in someone in AKI?

A

Anaemia
Platelet/WBC dysfunction
Increased oxidative stress
Inflamation- increased cytokine release

24
Q

In relation to the skin, how does AKI manifest? And why?

A

Pruritis- itching due uraemic toxins
Dry skin- reduced sweat and secretion from sebaceous glands
Pigmentation- become yellow in colour due to urochrome building up in tissues

25
Q

What leads to pruritis in AKI?

A

Uraemic toxins

26
Q

What causes the yellow pigmentation seen in AKI?

A

Urochrome

27
Q

What eye problems can AKI lead to?

A 
Conjunctivitis 
Corneal calcification 
Glaucoma 
Cataracts 
Diabetic/hypertensive retinopathy
28
Q

What are the main ways to avoid AKI?

A

Maintain volume
Avoid hypotension
Avoid nephrotoxins

29
Q

Where does urea formation occur in the body?

A

Liver

30
Q

What 3 things effect blood levels of urea?

A

Protein intake
Hepatic function
Renal function

31
Q

What are the normal blood values for urea?

A

2.0-6.5mmol/L

32
Q

What does the eGFR test?

A

Measure of how much waste and liquid passing through glomeruli into the urine/minute

33
Q

What is the acronym used for AKI?

A

STOP

34
Q

What does the acronym STOP stand for?

A

Sepsis screen
Toxins
Optimise BP
Prevent harm

35
Q

What are 4 complications of AKI?

A

Hyperkalaemia
Acidosis
Pulmonary oblongata
Uraemic encephalopathy/paricarditis

36
Q

What is the criteria for RRT?

A

Electrolyte abnormalities
<0.3ml/kg/hr
Multiple organ failure with AKI

Nursing Acutely Ill (11 decks)

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