Normal urine output = 30ML/HR
Creatinine = 0.6 – 1.2
BUN = 10 – 20
WBC = 5 – 10
Hgb = Male (14 – 18)
Female (12 – 16)
HCT = Male (42 – 52)
Female (37 – 47)
Albumin = 3.5 - 5
K = 3.5 - 5
Lipase = 0 – 110
Amylase = 56 – 190
Bilirubin = 0.3 - 1
Na = 135 – 145
Magnesium = 1.5 – 2.5
Calcium = 9 – 10.5
Phosphorus = 2 – 4.5
MAP = 65 – 100
ABG
CO2 = 22 – 30
HCO3 = 22 - 26
pH = 7.35 – 7.45
PCO2 = 35 – 45
PaO2 = 80 – 100
SaO2 = 95 – 100
Potassium – assess heart EKG
Sodium – assess LOC/neuro check
low sodium/high potassium = fluid overload
HIGH sodium/low potassium = dehydration
,AKI – ACUTE KIDNEY INJURY
PATHO: abrupt but reversible loss of kidney function due to ammonia build
up – damages renal cells
1st sign = decreased urine output (oliguria), azotemia (body builds up
waste /nitrogenous products due to kidneys inability to filter waste)
Progressed = crackles in lungs (dx by x-ray)
Unable to filter = edema, anasarca (full body edema), confusion,
tachypnea (high RR), dyspnea (low O2, difÏculty breathing)
Reduced perfusion = MAP less than 65, high HR, thready pulse
Respiratory alkalosis = pH greater than 7.5, low O2 88%, SOB (dx by ABG)
Metabolic acidosis: pH below 7.35, high K+, Na is low
Shock = hypotension & tachycardia
No contrast until kidney function is assessed
if contrast necessary, hydrate & stop Metformin 24 hrs. before & after
procedure
Use peak and trough on “- mycin” antibiotics
Causes:
Pre renal (perfusion reduction) = dehydration, HTN, shock, sepsis, burns
Intra renal (in renal) = damage from contrast, antibiotics, NSAIDs (naproxen,
ibuprofen), chemo, glomerulonephritis
Post renal (after renal blockage) = calculi (kidney stones), enlarged prostate,
cancer (tumor)
Labs =
elevated BUN (Norm: 10 – 20)
elevated creatinine (Norm: 0.6 – 1.2)
decreased GFR (Norm: greater than 90)
decreased Hgb/Hct
low calcium (Norm: 9 – 10.5)
high potassium (Norm: 3.5 – 5)
high phosphorus (Norm: 2 – 4.5)
, 4 Phases =
onset: decreased urine output for 1 – 3 weeks
oliguric: less than 400ml/24hrs, anorexia, N/V, decreased urine output, high
specific gravity
diuretic: 3 – 6L/day, low specific gravity, output 1000 – 1200ml/day (foley
cath to monitor urine output), replace fluids/monitor electrolytes, polyuria =
sign of recovery
recovery: 12 month or less
Interventions:
VS, I/O, daily weights (1lb/day = fluid retention), TREAT acidosis with sodium
bicarb, 2L fluid/day, avoid/prevent hypotension
Meds = diuretics
Diet – moderate protein/high carbohydrate – restrict K & Na – avoid
nephrotoxic meds – poor appetite = enteral or parenteral nutrition (TPN)
Prevention = hydration – avoid indwelling caths to prevent infection –
maintain electrolytes
Complication = pericarditis (friction rub, pleuritic pain, tachy, fever), seizures
(due to decreased BUN), anemia (decreased production of erythropoietin,
bleeding form trauma)
On dialysis = possible addition of protein
Tests: UA, ABGs, U/S, CT, KUB (kidney, ureter, bladder), cystoscopy (identify
obstruction), kidney biopsy (monitor BP after due to risk of hemorrhage), CT
w/o contrast, tele = peaked T waves
Goal: fluid challenge 500 – 1000mL to promote kidney perfusion, with loss of
kidney function = hemodialysis or CRRT/CKRT (continuous renal/kidney
replacement therapy)
CKD - CHRONIC KIDNEY DISEASE
PATHO: slow progression – irreversible loss in kidney function
S/S = oliguria, anemia, metabolic acidosis (pH less than 7.35) – Kussmaul
respirations (sign of metabolic acidosis) = hyperventilating – too
much acid in bloodstream – Pt. needs to deep breathe, azotemia (body
builds up waste /nitrogenous products due to kidneys inability to filter
waste), elevated potassium, low calcium (expect muscle weakness or
tremors)
Creatinine = 0.6 – 1.2
BUN = 10 – 20
WBC = 5 – 10
Hgb = Male (14 – 18)
Female (12 – 16)
HCT = Male (42 – 52)
Female (37 – 47)
Albumin = 3.5 - 5
K = 3.5 - 5
Lipase = 0 – 110
Amylase = 56 – 190
Bilirubin = 0.3 - 1
Na = 135 – 145
Magnesium = 1.5 – 2.5
Calcium = 9 – 10.5
Phosphorus = 2 – 4.5
MAP = 65 – 100
ABG
CO2 = 22 – 30
HCO3 = 22 - 26
pH = 7.35 – 7.45
PCO2 = 35 – 45
PaO2 = 80 – 100
SaO2 = 95 – 100
Potassium – assess heart EKG
Sodium – assess LOC/neuro check
low sodium/high potassium = fluid overload
HIGH sodium/low potassium = dehydration
,AKI – ACUTE KIDNEY INJURY
PATHO: abrupt but reversible loss of kidney function due to ammonia build
up – damages renal cells
1st sign = decreased urine output (oliguria), azotemia (body builds up
waste /nitrogenous products due to kidneys inability to filter waste)
Progressed = crackles in lungs (dx by x-ray)
Unable to filter = edema, anasarca (full body edema), confusion,
tachypnea (high RR), dyspnea (low O2, difÏculty breathing)
Reduced perfusion = MAP less than 65, high HR, thready pulse
Respiratory alkalosis = pH greater than 7.5, low O2 88%, SOB (dx by ABG)
Metabolic acidosis: pH below 7.35, high K+, Na is low
Shock = hypotension & tachycardia
No contrast until kidney function is assessed
if contrast necessary, hydrate & stop Metformin 24 hrs. before & after
procedure
Use peak and trough on “- mycin” antibiotics
Causes:
Pre renal (perfusion reduction) = dehydration, HTN, shock, sepsis, burns
Intra renal (in renal) = damage from contrast, antibiotics, NSAIDs (naproxen,
ibuprofen), chemo, glomerulonephritis
Post renal (after renal blockage) = calculi (kidney stones), enlarged prostate,
cancer (tumor)
Labs =
elevated BUN (Norm: 10 – 20)
elevated creatinine (Norm: 0.6 – 1.2)
decreased GFR (Norm: greater than 90)
decreased Hgb/Hct
low calcium (Norm: 9 – 10.5)
high potassium (Norm: 3.5 – 5)
high phosphorus (Norm: 2 – 4.5)
, 4 Phases =
onset: decreased urine output for 1 – 3 weeks
oliguric: less than 400ml/24hrs, anorexia, N/V, decreased urine output, high
specific gravity
diuretic: 3 – 6L/day, low specific gravity, output 1000 – 1200ml/day (foley
cath to monitor urine output), replace fluids/monitor electrolytes, polyuria =
sign of recovery
recovery: 12 month or less
Interventions:
VS, I/O, daily weights (1lb/day = fluid retention), TREAT acidosis with sodium
bicarb, 2L fluid/day, avoid/prevent hypotension
Meds = diuretics
Diet – moderate protein/high carbohydrate – restrict K & Na – avoid
nephrotoxic meds – poor appetite = enteral or parenteral nutrition (TPN)
Prevention = hydration – avoid indwelling caths to prevent infection –
maintain electrolytes
Complication = pericarditis (friction rub, pleuritic pain, tachy, fever), seizures
(due to decreased BUN), anemia (decreased production of erythropoietin,
bleeding form trauma)
On dialysis = possible addition of protein
Tests: UA, ABGs, U/S, CT, KUB (kidney, ureter, bladder), cystoscopy (identify
obstruction), kidney biopsy (monitor BP after due to risk of hemorrhage), CT
w/o contrast, tele = peaked T waves
Goal: fluid challenge 500 – 1000mL to promote kidney perfusion, with loss of
kidney function = hemodialysis or CRRT/CKRT (continuous renal/kidney
replacement therapy)
CKD - CHRONIC KIDNEY DISEASE
PATHO: slow progression – irreversible loss in kidney function
S/S = oliguria, anemia, metabolic acidosis (pH less than 7.35) – Kussmaul
respirations (sign of metabolic acidosis) = hyperventilating – too
much acid in bloodstream – Pt. needs to deep breathe, azotemia (body
builds up waste /nitrogenous products due to kidneys inability to filter
waste), elevated potassium, low calcium (expect muscle weakness or
tremors)
