AKI and CKD

Question 1

What is the range for BUN?

Answer 1

10-20 mg/dL

Question 2

What is the normal range for Creatinine?

Answer 2

0.5-1.2 mg/dL

Question 3

What is the normal range for potassium?

Answer 3

3.5-5.0 mEq/L

Question 4

What is the normal range for Urine Specific Gravity?

Answer 4

1.010-1.025

Question 5

What is the normal range for Glomerular Filtration Rate (GFR)?

Answer 5

125 mL/min or greater

Question 6

What does BUN and Creatinine represent?

Answer 6

Waste products of digestion and metabolsim

Question 7

What does BUN and Creatinine represent?

Answer 7

Waste products of digestion and metabolism

Question 8

Where is prerenal? What does it do?

Answer 8

The heart; decreased renal blood flow causes kidney tissue damage

Question 9

Where is intrarenal? What does it do?

Answer 9

Kidney directly; direct damage to kidney tissue, hardest to reverse

Question 10

Where is postrenal? What does it do?

Answer 10

Below the kidneys, urine blocked; mechanical obstruction in urine outflow causes urine reflux back to kidneys (hydronephrosis) which causes kidney damage

Question 11

What classifies the severity of AKI?

Answer 11

R-Risk
I-Injury
F-Failure
L-Loss
E-End-stage Renal Disease

Question 12

What are the three stages of AKI?

Answer 12

Oligonic Phase
Diuretic Phase
Recovery Phase

Question 13

How much urine output do patients have in oliguria phase?

Answer 13

Less than (<) 400mL/day of urine

Question 14

What is the range for urine?

Answer 14

800-2000mL

Question 15

What are the clinical manifestations of oliguric phase?

Answer 15

Fluid Retention (Hypervolemia)
Jugular Venous Distention (JVP)
Edema
Bounding pulse
Crackles
Kussmaul Respirstions
Low sodium (Na+) (<136)
High potassium (K+) (>5.0)
Waste Product Accumulation (Increased BUN and Creatinine)
Fatigue, confusion, seizures, coma

Question 16

What are the clinical manifestations of the diuretic phase?

Answer 16

Increased urine output (kidneys cannot concentrate urine)
Hypovolemia and hypotension
Large losses of electrolytes

Question 17

What is the clinical manifestation of recovery phase?

Answer 17

GFR increases
BUN and Creatinine decreases
Filtration function returns

Question 18

(T/F) Diuretics are used early to prevent fluid retention in AKI

Answer 18

True

Question 19

(T/F) Dialysis is used in late stages to manage AKI

Answer 19

True

Question 20

What are the lab results your see in AKI? BUN, Creatinine, Potassium, Urine Specific Gravity, and GFR. Up or down

Answer 20

BUN increases
Creatinine increases
Potassium increases
Urine Specific Gravity decreases
GFR decreases

Question 21

Who is at high risk for AKI?

Answer 21

Elderly
Heart or Kidney failure
Burn patients
Patients receiving nephrotoxic medication (NSAIDs, ACE inhibitors)
Patients with contrast dye

Question 22

(T/F) CKD is reversible

Answer 22

False, CKD is progressive and irreversible

Question 23

What is the range of GFR for CKD?

Answer 23

Greater than (<) 60mL/min/1.73m2

Question 24

What are clinical manifestations of CKD?

Answer 24

Uremia
Increased BUN, Creatinine and Potassiun
Metabolic Acidosis
Anemia
Infection
Cardiovascular disease
Lethargy, confusion, fatigue, coma