NUR 312 Exam 5 Renal and Endocrine Exam
Questions & Answers
Cause of prerenal AKI
Dehydration, blood loss, sepsis, heart failure (decreased perfusion)
S/S of prerenal AKI
Low urine output, dry mucous membranes, hypotension
Nursing priorities for prerenal AKI
Restore fluid volume (isotonic saline), hold nephrotoxic meds, monitor urine output, improve
cardiac output if HF (inotropes)
Causes of intrinsic AKI
Nephrotoxic meds, contrast dye, prolonged hypotension (direct damage to kidneys)
S/S of intrinsic AKI
Dark/low urine, swelling, possible SOB
Nursing priorities for intrinsic AKI
Monitor fluid balance, avoid NSAIDs/nephrotoxic meds, may need diuretics if fluid overloaded,
txunderlying cause (antibiotics for infection)
Postrenal AKI cause
Obstruction (BPH, stones)
Postrenal AKI s/s
, Difficulty voiding, bladder distention
Postrenal AKI nursing priorities
Remove obstruction, catheter if ordered, or surgery
Overall nursing actions for AKI
-Urine output goal: ≥30 mL/hr
-Daily weights are the most reliable indicator of fluid status
-Vitals, I&O, monitor electrolytes and renal function tests
-Avoid/hold: NSAIDs, ACE inhibitors, Metformin (when kidneys impaired)
-Monitor respiratory status for fluid overload (crackles, SOB)
-Strict aseptic technique (infection prevention)
-Dietitian referrals
Patient education for AKI
-Drink fluids regularly when ill
-Avoid frequent NSAID use
-Call provider for decreased urine output, swelling, or sudden weight gain (signs of acute kidney
injury)
-Moderate protein, limit potassium, sodium, and phosphorus
Chronic kidney disease major concepts
-Progressive and irreversible; caused commonly by Diabetes + Hypertension, lasts three months
or more; staged 1-5, GFR decreases with progression
Questions & Answers
Cause of prerenal AKI
Dehydration, blood loss, sepsis, heart failure (decreased perfusion)
S/S of prerenal AKI
Low urine output, dry mucous membranes, hypotension
Nursing priorities for prerenal AKI
Restore fluid volume (isotonic saline), hold nephrotoxic meds, monitor urine output, improve
cardiac output if HF (inotropes)
Causes of intrinsic AKI
Nephrotoxic meds, contrast dye, prolonged hypotension (direct damage to kidneys)
S/S of intrinsic AKI
Dark/low urine, swelling, possible SOB
Nursing priorities for intrinsic AKI
Monitor fluid balance, avoid NSAIDs/nephrotoxic meds, may need diuretics if fluid overloaded,
txunderlying cause (antibiotics for infection)
Postrenal AKI cause
Obstruction (BPH, stones)
Postrenal AKI s/s
, Difficulty voiding, bladder distention
Postrenal AKI nursing priorities
Remove obstruction, catheter if ordered, or surgery
Overall nursing actions for AKI
-Urine output goal: ≥30 mL/hr
-Daily weights are the most reliable indicator of fluid status
-Vitals, I&O, monitor electrolytes and renal function tests
-Avoid/hold: NSAIDs, ACE inhibitors, Metformin (when kidneys impaired)
-Monitor respiratory status for fluid overload (crackles, SOB)
-Strict aseptic technique (infection prevention)
-Dietitian referrals
Patient education for AKI
-Drink fluids regularly when ill
-Avoid frequent NSAID use
-Call provider for decreased urine output, swelling, or sudden weight gain (signs of acute kidney
injury)
-Moderate protein, limit potassium, sodium, and phosphorus
Chronic kidney disease major concepts
-Progressive and irreversible; caused commonly by Diabetes + Hypertension, lasts three months
or more; staged 1-5, GFR decreases with progression
