Ch.25&27: Renal and Urinary Part 2 Flashcards
the tendency of biological systems to maintain relatively constant conditions in the internal environment while continuously interacting with and adjusting to changes originating within or outside the system… homeostasis actually involves continuous motion, adaptation, and change in response to environmental factors.
homeostasis
Acute kidney injury:
inability to efficiently/effectively remove waste from blood
develops rapidly
oliguria, azotemia, increased serum creatinine, and urea
fluid and electrolyte disorders
high mortality rate
AKI CLASSIFICATION:
sudden and severe drop in blood pressure (shock) or interruption of blood flow to the kidneys from severe injury or illness
Ischemia of nephrons
Decreased glomerular filtration rate (GFR)
Sharp decrease in urine output *
pre-renal
AKI CLASSIFICATION:
direct damage to the kidneys by inflammation, toxins, drugs, infection, or reduced blood supply
Glomerulonephritis
intra-renal
AKI CLASSIFICATION:
sudden obstruction of urine flow due to enlarged prostate, kidney stones, bladder tumor, or injury
SYMPTOMS: abdominal distention/ suprapubic tendernessRisk
post-renal
Disorders associated with pre-renal:
Cardiogenic shock Heart failure Myocardial infarction Burns Trauma Renal artery obstruction
Risk factors
reduced grr, immobility, diabetes, diuretics, hypotension, dehydration, polypharmacy, CVD, infection
Management of acute kidney injury:
Nutritional concern
manage the potassium and sodium
adequate calorie intake
carbs/fat prevent ketosis
Nursing management of AKI:
monitor( VS, weight, lab, mental)
skin/color (appearance, edema, Jed, oral)
ausculate ( lungs/heart)
urine (output color, glucose, sediment, protein)
Kidney function
Progressive, irreversible loss
Mortality
High; Between 19-24% for those on dialysis
Major causes
#1: Diabetes; #2. Hypertension
Notable facts
*Mortality increases as the disease progresses
*CKD is more common than AKI
*CKD is often asymptomatic, underdiagnosed
*CKD = when GFR < 60 mL/min/1.73 m2 > 3 months
*ESRD is the last stage when GFR is <15.
*Transplant or dialysis are the only options to sustain life when ESRD is diagnosed
chronic Kidney Disease
Higher than normal levels of creatinineor urea in the blood
Blood or protein in the urine
Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
A family history of polycystic kidney disease
Stage 1 cKD
Higher than normal levels of creatinineor urea in the blood
Blood or protein in the urine
Evidence of kidney damage in an MRI, CT scan, ultrasound or contrast X-ray
Stage 2 CKD
Fatigue
Fluid retention, swelling of extremities and shortness of breath
Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal)
Kidney pain felt in their back
Sleep problems due to muscle cramps or restless legs (Davita, 2017)
Stage 3 CKD
Fatigue
Fluid retention, swelling, shortness of breath
Urination changes (foamy; dark orange, brown, tea-colored or red if it contains blood; and urinating more or less than normal)
Kidney pain felt in their back
Sleep problems due to muscle cramps or restless legs
Nausea and/or vomiting
Taste changes such as a metallic taste in the mouth
Bad breath due to urea buildup in the blood
Loss of appetite
Difficulty in concentrating
Numbness or tingling in the toes or fingers (Davita, 2017)
Stage 4 cKD
Loss of appetite Nausea or vomiting Headaches Being tired Being unable to concentrate Itching Making little or no urine Swelling, especially around the eyes and ankles Muscle cramps Tingling in hands or feet Changes in skin color Increased skin pigmentation
Stage 5 CKD
