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Patient Centered Care 2 > F&E= Acute Kidney Injury > Flashcards

F&E= Acute Kidney Injury Flashcards

1
Q

What happens during the diuretic stage of acute kidney injury?

A
  1. urine output exceeds 400 mL/day; may rise above 4 L/day

2. kidneys excrete BUN, creat, K+, and phosphorus and retain Ca and Bicarb

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2
Q

What happens during the recovery stage of acute kidney injury?

A
  1. as renal tissue recovers, serum electrolytes, BUN, and creat. return to normal
  2. This stage lasts 1-12 months
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3
Q

What can acute renal failure manifest itself as?

A

Metabolic acidosis

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4
Q

What are the causes of prerenal failure?

A
  1. hypovolemia (hemorrhage, dehydration, excess fluid loss from GI tract, burns, wounds)
  2. low cardiac output (HF, Cardiogenic shock)
  3. altered vascular resistance (Sepsis, anaphylaxis, vasoactive drugs)
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5
Q

What are the causes of intrarenal failure (within the kidney)?

A
  1. Glomerular/microvascular injury
  2. Acute tubular necrosis
  3. interstitial nephritis
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6
Q

What causes postrenal failure?

A
  1. Obsructions beyond the kidneys which causes urine to back up into the nephrons (BPH, Renal calculi, tumors)
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7
Q

Is acute renal failure more common in older adults or younger adults?

A

younger adults

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8
Q

What goal should you have for someone with postrenal failure?

A

Maintain blood flow and urine output

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9
Q

What are some causes of inadequate blood flow to the kidneys?

A
  1. heartattack
  2. infection
  3. severe allergic reaction
  4. damage
  5. inflammation in the glomerulus
  6. lupus
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10
Q

Is AKI a rapid change or gradual change in kidney function?

A

Rapid

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11
Q

How can acute tubular necrosis occur?

A

Caused by prolonged ischemia (lack of blood flow to the kidneys) lasting more than 2 hours

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12
Q

Who are at risk for developing Acute Tubular Necrosis?

A
  1. prolonged surger
  2. hypovolemia
  3. sepsis
  4. burns
  5. trauma
  6. NSAIDs
  7. chemo
  8. people around heavy metals (mercury, gold)
  9. exposure to chemicals such as antifreeze
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13
Q

True or false: Acute Tubular Necrosis causes prerenal failure?

A

False: Acute Tubular Necrosis causes intrarenal failure becuase it damages the nephrons.

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14
Q

What will children with AKI most likely experience as a manifestation?

A

Oliguria (Decreased urine output)

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15
Q

What drug is especially nephrotoxic for children?

A

Ibuprofen and acetaminophen

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16
Q

What are some risk factors for AKI?

A
  1. major trauma or surger
  2. infection
  3. hemorrhage
  4. HF
  5. liver disease
  6. Lower urinary tract obstruction
17
Q

What age group is at a higher risk for kidney failure?

A

Older adults because of their higher indicidences of serious illness, hypotension, major surgeries, diagnostic procedures, and treatment with nephrotoxic drugs.

18
Q

Children with what disorder are more at risk for AKI?

A
  1. Renal insufficiency (decrease in ability to conserve sodium and concentrate the urine)
  2. Acute GI illness (risk for dehydration)
19
Q

What is the third most common cause of hospital-aquired AKI?

A

Contrast -induced nephropathy

20
Q

What are the three phases of AKI?

A

Initiation, maintenance, and recovery

21
Q

How long does the initiation of AKI last?

A

hours to days

22
Q

When does the initiation phase of AKI begin?

A

It begins with the initiating event (Such as a hemorrhage) and ends when tubular injury occurs

23
Q

True or false: the initiation phase of AKI is asymptomatic

A

True

24
Q

What characterizes the maintenance phase of AKI?

A

A significant fall in GFR and tubular necrosis with possible oliguria

25
Q

What happens during the maintenance phase of AKI?

A
  1. edema (increases risk for HF and Pulmonary Edema)
  2. Hyperkalemia
  3. Hyperphosphatemia
  4. Hypocalcemia
  5. metabolic acidosis
26
Q

Give some more manifestations of maintenance phase

A
  1. confusion, disorientation, agitation, or lethargy; hyperreflexia; and possible seizures or coma because of azotemia and electrolyte and acid-base imbalances
  2. Anorexia (loss of appetite), nausea, vomiting, and decreased of absent bowel sounds
  3. Uremic syndrome (if AKI is prolonged)
27
Q

What is the recovery phase of AKI characterized by?

A

A process of tubule cell repair eand regeneration and gradual return of the GFR to normal or pre-AKI levels

28
Q

What are the manifestations of the recovery phase of AKI?

A

Diuresis (abnormally large quantities of urine), serum creatinine, BUN, potassium, and phosphate levels reain high and may continue to rise in spite of increasing urine output.

29
Q

What are the goals of treatment for AKI?

A
  1. maintain the fluid and electrolyte balance
  2. identify and correcting the underlying cause
  3. preventing additional kidney damage
  4. restoring the urine output and kidney function
  5. compensating for renal impairment until kidney function is restored
30
Q

Meds for AKI

A
  1. IV fluids and vlood volume expanders
  2. Dopamine (increases renal blood flow)
  3. loop diuretics, osmotic diuretics
  4. ACE inhibitors to lower BP
  5. electrolyte supplements
  6. Kayelxalate (removes potassium from the body)

Patient Centered Care 2 (26 decks)

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