Week 11 - AKI & UTD assessment

Question 1

What is AKI divided into ?

Answer 1

1. Pre-renal
2. Intra Renal
3. Post renal

Question 2

What is Pre-renal AKI?

Answer 2

A problem with perfusion - usually a heart issue/circulatory issue
- decreased perfusion TO kidney

Question 3

what is intraRenal AKI?

Answer 3

A problem with the renal tissue itself
- direct damage to renal tissue

Question 4

What is Post renal AKI?

Answer 4

A problem with urine outflow after the kidneys
- a mechanical obstruction of urinary flow

Question 5

What are the 2 characteristics of AKI?

Answer 5

1. abrupt kidney function decline
2. quick rise in serum creatinine

Question 6

What are the 3 things a nurse must monitor in someone with AKI?

Answer 6

1. I &O
2. daily weight
3. labs (Urea, creatinine)

Question 7

If someone has pre-renal issues what needs to be corrected?

Answer 7

BP

Question 8

If someone has post-renal issues what needs to be corrected?

Answer 8

obstruction

Question 9

What are the 3 phases of *Intrarenal injury and how long is each?

Answer 9

1. Initiation (24 hrs to a week)
2. Maintenance (10-14 days to months)
3. Recovery (up to 1 year)

Question 10

What do we assess in someone who is in the initiation stage of an intrarenal injury?

Answer 10

1. Sudden drop in urine output
2. sudden rise in creatinine
   (same as pre-renal AKI and post-renal AKI )

Question 11

What do we assess in someone who is in the maintenence stage of intrarenal injury?

Answer 11

1. Oliguria (most common manifestation)
2. assessment is same as CKD

Question 12

What do we assess in someone who is in the recovery phase of intrarenal injury?

Answer 12

1. Diuretic phase b/c nephrons are learning to work again so still letting some proteins through which disrupts the osmotic pressure causing more water to leave the body
2. I&O
3. hypokalemia K+ signs
4. hyponatatrimia Na signs
5. hypovolemia/dehydration signs

Question 13

What systems do we check for someone with Intrarenal injury AKI and what do we look for in each system?

Answer 13

(same as uremia)
1. CNS - fatigue - seizures/coma
2. CVS - HTN, Edema, dysrhythmias
3. Resp: crackles
4. GI - N&V, Pain
5. GU- decreased urine output
6. Lab work - (abnormal) lytes, increase waste products, acid/base imbalance, WBC and platelet dysfunction, reduced hemoglobin (Hgb)

Question 14

What informs our physical assessment for AKI intrarenal injury?

Answer 14

blood work

Question 15

What nutrient should people not eat large amounts of with AKI?

Answer 15

Sodium Na

Question 16

When does the body release lots of K+?

Answer 16

• massive tissue trauma
• bleeding
• blood transfusion
• acidosis

Question 17

If an EKG shows abnormalities what do we treat the patient with?

Answer 17

Ca Gluconate IV

Question 18

If K+ levels are >6.0 what do we do?

Answer 18

• IV glucose and insulin
• IV sodium bicarb
• dialysis

Question 19

If K+ levels are around 5.5 what do we do?

Answer 19

1. Kayexalate (can be out patient)
2. dietary - K restriction
3. diuretics