NR 341 COMPLEX CARE FINAL EXAM
STUDY GUIDE
Pre-renalnb-nbanswer--abovenbthenbkidneynbstructure-
nbanbpumpnbproblem,nbifnbpatientnbisnbhypotensivenbornbinnbanbshock,nbthenbperfusion/
volumenbisnbnonblongernbdoingnbtonbthenbkidney
Intrarenalnb-nbanswer--thenbkidneynbitself-
nbanythingnbtonbdonbwithnbstructure,nbmedsnbsuchnbasnbantibioticsnb(NSAIDS),nbcontrastnbd
ye,nbacutenbtubularnbnecrosisnb(ATN)-nbaffectsnbthenbtissue...nbpostnbobstructive
Postrenalnb-nbanswer--
afternbkidney,nbptsnbwhonbhavenbBPH,nbtumorsnbinnbthenbabdominalnbarea,nbstonesnbinnbthen
bureters
AKI/PDnbLabsnb-nbanswer--
CreatininenbandnbBUNnbwillnbincrease,nbdecreasenbinnbGFR,nbsodiumnbisnbgoingnbbenbeithe
rnbnormalnbornblownbduenbtonbdilution,nbphosphorusnbandnbmagnesiumnb(bowelnbcarenbofnbc
hoice)nbandnbpotassiumnbwillnbincreasenb(peakednbTnbwaves,nbwillnbseenbdysrhythmias-
nbwillnbneednbtonbchecknbanbserumnbpotassiumnblevel)
CRRTnb(ContinuousnbRenalnbReplacementnbTherapy)nb-nbanswer--
Patientnbwillnbneednbanbtemporarynbdialysisnbcatheter-nblargenbbore
24nbdegrees-nbreplacenbkidney-nbbalancednbpHnb(metabolicnbacidosis-
nbpatientnbwillnbbenbtachypneanbandnbwillnbbenbhyperventilating),nbbalancenbelectrolytesnb(o
smosisnblowernbtonbhighernbconcentrations),nbpatient'snbweightnbisnbdecreasingnb(willnbnee
dnbdailynbweightnbchecks),nbdecreasednbedemanbandnbdecreasednbcrackles
AKI/PDnbpreventionnb-nbanswer--Stopnbmetformin/
Glucophagenb48nbhoursnbbeforenbtheynbcannbhavenbanynbcontrastnbdye.nbPatientnbneedsnb
hydration-nbNormalnbsalinenbIV,nbthisnbisnbwherenbwenbdonbournbMucomyst
KidneynbBiopsynbPre-procedurenb-nbanswer--
Stopnballnbanticoagulationnbsincenbitnbisnbannbinvasivenbprocedure
KidneynbBiopsynbPostnbProcedure/Complicationsnb-nbanswer--
Bleedingnbisnbthenbmajornbcomplication
VSnbeverynb10nbminutesnbthatnbfirstnbhour
Assessnbthenbdressing
Ptnbisnblayingnbonnbthenbaffectednbside
Bedrestnbofnb12nbhours
Painnbshouldnbbenbminimum,nbifnbpatientnbisnbexperiencingnbanblotnbofnbpain,nbitnbisnbindicativ
enbofnbanbpossiblenbhemorrhage
STUDY GUIDE
Pre-renalnb-nbanswer--abovenbthenbkidneynbstructure-
nbanbpumpnbproblem,nbifnbpatientnbisnbhypotensivenbornbinnbanbshock,nbthenbperfusion/
volumenbisnbnonblongernbdoingnbtonbthenbkidney
Intrarenalnb-nbanswer--thenbkidneynbitself-
nbanythingnbtonbdonbwithnbstructure,nbmedsnbsuchnbasnbantibioticsnb(NSAIDS),nbcontrastnbd
ye,nbacutenbtubularnbnecrosisnb(ATN)-nbaffectsnbthenbtissue...nbpostnbobstructive
Postrenalnb-nbanswer--
afternbkidney,nbptsnbwhonbhavenbBPH,nbtumorsnbinnbthenbabdominalnbarea,nbstonesnbinnbthen
bureters
AKI/PDnbLabsnb-nbanswer--
CreatininenbandnbBUNnbwillnbincrease,nbdecreasenbinnbGFR,nbsodiumnbisnbgoingnbbenbeithe
rnbnormalnbornblownbduenbtonbdilution,nbphosphorusnbandnbmagnesiumnb(bowelnbcarenbofnbc
hoice)nbandnbpotassiumnbwillnbincreasenb(peakednbTnbwaves,nbwillnbseenbdysrhythmias-
nbwillnbneednbtonbchecknbanbserumnbpotassiumnblevel)
CRRTnb(ContinuousnbRenalnbReplacementnbTherapy)nb-nbanswer--
Patientnbwillnbneednbanbtemporarynbdialysisnbcatheter-nblargenbbore
24nbdegrees-nbreplacenbkidney-nbbalancednbpHnb(metabolicnbacidosis-
nbpatientnbwillnbbenbtachypneanbandnbwillnbbenbhyperventilating),nbbalancenbelectrolytesnb(o
smosisnblowernbtonbhighernbconcentrations),nbpatient'snbweightnbisnbdecreasingnb(willnbnee
dnbdailynbweightnbchecks),nbdecreasednbedemanbandnbdecreasednbcrackles
AKI/PDnbpreventionnb-nbanswer--Stopnbmetformin/
Glucophagenb48nbhoursnbbeforenbtheynbcannbhavenbanynbcontrastnbdye.nbPatientnbneedsnb
hydration-nbNormalnbsalinenbIV,nbthisnbisnbwherenbwenbdonbournbMucomyst
KidneynbBiopsynbPre-procedurenb-nbanswer--
Stopnballnbanticoagulationnbsincenbitnbisnbannbinvasivenbprocedure
KidneynbBiopsynbPostnbProcedure/Complicationsnb-nbanswer--
Bleedingnbisnbthenbmajornbcomplication
VSnbeverynb10nbminutesnbthatnbfirstnbhour
Assessnbthenbdressing
Ptnbisnblayingnbonnbthenbaffectednbside
Bedrestnbofnb12nbhours
Painnbshouldnbbenbminimum,nbifnbpatientnbisnbexperiencingnbanblotnbofnbpain,nbitnbisnbindicativ
enbofnbanbpossiblenbhemorrhage
