NUR 265 Exam 1 Study Guide: Key Concepts and Nursing Interventions for AKI and CKD

265 Exam 1
AKI
oRapid reduction in kidney function resulting in a failure to maintain waste
elimination, fluid & electrolyte balance, & acid-base balance.
oDetermined by the creatinine level
oS/S
Oliguria (less than 0.5 mL/kg/hr of urine output for 2 or more hours)
Symptoms of fluid overload
Pulmonary crackles, dependent/generalized edema, decreased
O2, confusion, increase respiratory rate & dyspnea.
Mean arterial pressure below 65 mm Hg, tachycardia, thready pulses.
oInterventions
Avoid hypotension & maintain normal fluid balance
Maintaining a mean arterial pression of 80 – 85 mm Hg
Reduce exposure to nephrotoxic agents & drugs that alter kidney
function
Communicate with radiologist so that the lowest dose of contrast agent is
used in high-risk adults.
Observations about new-onset or increased peripheral edema, increased
daily weight, and reduced urine output can identify patients with a
positive fluid balance from AKI
Onset of polyuria can signal the start of recovery from AKI
oNutrition
oWhen to report to the MD
Chronic Kidney Disease
oHyperkalemia in late stages
oDietary restrictions
Hemodialysis
oWhat to teach the patient
Vascular access
oAV fistula
Peritoneal dialysis
Cirrhosis
oHepatic encephalopathy
oLactulose
oWhat to teach patient
oTreatment
oDiet
Paracentesis