Renal Failure - Answer-Occurs when kidneys cannot remove the body's metabolic
wastes or perform regulatory functions.
/.Acute Kidney Injury - Answer-rapid loss of renal function due to damage to the kidneys
/.Causes of AKI - Answer-Hypovolemia
Hypotension
Infections
decreased cardiac output and heart failure
Obstruction of the kidney or lower urinary tract
Blood clot or renal stones (rare)
Obstruction of renal arteries or veins
Nephrotoxic agents
/.Types of AKI - Answer-Prerenal - hypoperfusion of kidney, not enough blood to kidney
Intrarenal - actual damage to glomeruli or kidney tubules
Postrenal - urinary obstruction that impedes forward flow (tumor, stone)
/.Pt has increased creatinine level and increased BUN, what is the issue? - Answer-
Problem with kidney perfusion
/.Pt has increased creatinine and increased BUN, what are the nursing priorities? -
Answer-Check urine output
Check specific gravity - filtration/how concentrated
/.Fixed specific gravity - Answer-Kidney damage - can't dilute urine/accommodate
/.Specific gravity lab value - Answer-1.005-1.030
/.Lab values to monitor for kidney function - Answer-BUN, creatinine, creatinine
clearance, GFR, specific gravity, UA
/.Adult urine output - Answer-30 mL/hr
/.What lab increases during dehydration? - Answer-BUN
/.Normal Na levels - Answer-135-145 mEq/L
/.signs of hyponatremia - Answer-Anorexia, nausea, cramps, fatigue, lethargy, muscle
weakness, headache, confusion, seizures, decreased blood pressure
, /.AKI prerenal causes - Answer-Volume depletion
Decreased cardiac output
Vasodilation
/.AKI intrarenal causes - Answer-Acute tubular necrosis (ATN)
Prolonged renal ischemia
Nephrotoxic agents
Infectious process
/.AKI postrenal causes - Answer-Urinary tract obstruction
Tumors, calculus (stones)
/.AKI phases - Answer-Onset - initial problem
Oliguria - urine output <400ml/24 hrs, accompanied by increase in serum concentration
of substances usually excreted by kidneys
Diuresis - gradual increase in urine output, daily urine output 1-3 L per day (due to
osmotic diuresis) signals that filtration has started to recover, kidneys have recovered
ability to excrete wastes but not to concentrate the urine, observe closely for
hyponatremia, hypokalemia, dehydration
Recovery - signals the improvement of renal function (increasing GFR), may take 3-12
months
/.AKI symptoms - Answer-Lethargic
Drowsiness
Headache
Muscle twitching
Seizures
/.AKI Assessment and Diagnostic Findings - Answer-Laboratory findings - decline in
GFR, increase in Creatinine, increase in BUN
- ultrasound, CT, MRI (anatomical changes)
- high risk for hyperkalemia, metabolic acidosis
/.Chronic Kidney Disease (CKD) manifestations - Answer-Uremia - syndrome
associated with decline in renal functioning resulting in multi system related symptoms
Anemia
Fluid retention
Electrolyte disturbances (hyperkalemia, metabolic acidosis)
Uncontrolled hypertension (cause and consequence)
/.CKD assessment and diagnostic findings - Answer-GFR preferred measure
(decreased), serum creatinine (increased), creatinine clearance (decreased)
Persistent proteinuria (indicates impaired filtration, damaged nephrons)
wastes or perform regulatory functions.
/.Acute Kidney Injury - Answer-rapid loss of renal function due to damage to the kidneys
/.Causes of AKI - Answer-Hypovolemia
Hypotension
Infections
decreased cardiac output and heart failure
Obstruction of the kidney or lower urinary tract
Blood clot or renal stones (rare)
Obstruction of renal arteries or veins
Nephrotoxic agents
/.Types of AKI - Answer-Prerenal - hypoperfusion of kidney, not enough blood to kidney
Intrarenal - actual damage to glomeruli or kidney tubules
Postrenal - urinary obstruction that impedes forward flow (tumor, stone)
/.Pt has increased creatinine level and increased BUN, what is the issue? - Answer-
Problem with kidney perfusion
/.Pt has increased creatinine and increased BUN, what are the nursing priorities? -
Answer-Check urine output
Check specific gravity - filtration/how concentrated
/.Fixed specific gravity - Answer-Kidney damage - can't dilute urine/accommodate
/.Specific gravity lab value - Answer-1.005-1.030
/.Lab values to monitor for kidney function - Answer-BUN, creatinine, creatinine
clearance, GFR, specific gravity, UA
/.Adult urine output - Answer-30 mL/hr
/.What lab increases during dehydration? - Answer-BUN
/.Normal Na levels - Answer-135-145 mEq/L
/.signs of hyponatremia - Answer-Anorexia, nausea, cramps, fatigue, lethargy, muscle
weakness, headache, confusion, seizures, decreased blood pressure
, /.AKI prerenal causes - Answer-Volume depletion
Decreased cardiac output
Vasodilation
/.AKI intrarenal causes - Answer-Acute tubular necrosis (ATN)
Prolonged renal ischemia
Nephrotoxic agents
Infectious process
/.AKI postrenal causes - Answer-Urinary tract obstruction
Tumors, calculus (stones)
/.AKI phases - Answer-Onset - initial problem
Oliguria - urine output <400ml/24 hrs, accompanied by increase in serum concentration
of substances usually excreted by kidneys
Diuresis - gradual increase in urine output, daily urine output 1-3 L per day (due to
osmotic diuresis) signals that filtration has started to recover, kidneys have recovered
ability to excrete wastes but not to concentrate the urine, observe closely for
hyponatremia, hypokalemia, dehydration
Recovery - signals the improvement of renal function (increasing GFR), may take 3-12
months
/.AKI symptoms - Answer-Lethargic
Drowsiness
Headache
Muscle twitching
Seizures
/.AKI Assessment and Diagnostic Findings - Answer-Laboratory findings - decline in
GFR, increase in Creatinine, increase in BUN
- ultrasound, CT, MRI (anatomical changes)
- high risk for hyperkalemia, metabolic acidosis
/.Chronic Kidney Disease (CKD) manifestations - Answer-Uremia - syndrome
associated with decline in renal functioning resulting in multi system related symptoms
Anemia
Fluid retention
Electrolyte disturbances (hyperkalemia, metabolic acidosis)
Uncontrolled hypertension (cause and consequence)
/.CKD assessment and diagnostic findings - Answer-GFR preferred measure
(decreased), serum creatinine (increased), creatinine clearance (decreased)
Persistent proteinuria (indicates impaired filtration, damaged nephrons)
