Medical-Surgical Nursing Urinary System 2023 Update 100% Rated Review A+

RBC production BP regulation - These are the functions of the urinary system Erythropoietin - This is used to stimulate RBC production Hypoxia Renal blood flow - The kidneys secrete erythropoietin in response to this Acute kidney injury (AKI) - This is a rapid loss of renal function Low MAP - This vital sign can be seen with acute kidney injury Raise in creatinine Lower urine output - Labs for acute kidney injury Usually reversible Can have a high mortality rate depending on what is going on - Prognosis of acute kidney injury Pre-renal Intra-renal Post-renal - Types of acute kidney injuries Decreased perfusion - Pre-renal acute kidney injury is due to this Direct kidney damage - Intra-renal acute kidney injury is due to this Mechanical obstruction that does not allow it to go out - Post-renal acute kidney injury is due to this Hypovolemia Low cardiac output Low MAP - Causes of pre-renal acute kidney injury Aminoglycosides ACE inhibitors NSAIDs Lead Contrast dye Infections Acute tubular necrosis (ATN) - Causes of intra-renal acute kidney injury Kidney stones Strictures BPH Bladder cancer - These are causes of post-renal acute kidney injury 48 hours - Acute kidney injury can be completely healed if treated within this timeframe RIFLE - This is the progression for kidney damage Risk Injury Failure Loss ESRD - RIFLE Kidney stones - This puts a person at risk for a kidney injury Greater than 4 weeks of kidney failure - The "loss" in RIFLE happens when this occurs End-stage renal disease - ESRD Complete low renal function for more than 3 months - The "ESRD" in RIFLE happens when this occurs Oliguric phase Diuretic phsae Recovery phase - Three phases of acute kidney injury Less than 400mL/day - Signs and symptoms of the oliguric phase in acute kidney injury 24 hours of ischemia - If oliguria from acute kidney injury is due to ischemia, it will be within this time 1 week - If oliguria from acute kidney injury is due to nephrotoxicity, it will be delayed until this time Fluid volume changes Metabolic acidosis Sodium balance damage Potassium excess - Complications of the oliguric phase in acute kidney injury Renal tubules cannot hold sodium and it is excreted - This is how the sodium balance is damaged in the oliguric phase in acute kidney injury ST depression - This EKG change is seen with too much potassium Waste excretion Low electrolytes Hypovolemia/hypotension Acid-base balance is improving - This is what happens in the diuretic phase of acute kidney injury GFR increases - This is what happens in the recovery phase of acute kidney injury Months to years - This is how long it can take for the GFR to improve in the recovery phase of acute kidney injury Neurological disorders Hematologic disorders Waste product accumulation - General signs and symptoms of acute kidney injury Leukocytosis - This is a hematological disorder that occurs with acute kidney injury Increased BUN - This lab is seen with waste product accumulation History U/A Renal U/S - Diagnosis of acute kidney injury Dehydration/blood loss - In diagnosing acute kidney injury, this is looked for in the history Change in creatinine levels - In diagnosing acute kidney injury, this is looked for in the U/A 50% - Any change in the creatinine means that the patient lost more than this percent of kidney function Treat the cause Manage signs and symptoms Prevent complications - Treatment for acute kidney injury Watch the labs - This is how to treat the cause with acute kidney injury BUN *GFR* - These labs are watched with acute kidney injury Protein intake Fever Steroids - BUN can increase with this Strict I&O - This is how to manage the signs and symptoms of acute kidney injury Treat hyperkalemia - This is how to prevent complications with acute kidney injury Arrhythmias - Hyperkalemia can cause this IV insulin Sodium bicarbonate Calcium gluconate Dialysis Polystyrene sulfonate (Kayexalate) - Treatments for hyperkalemia with acute kidney injury Allows glucose to be followed by potassium into the cell - This is how IV insulin treats hyperkalemia Short-term treatment - IV insulin is used as this type of treatment for hyperkalemia Corrects metabolic acidosis Lowers potassium by shifting it into the cell - This is how sodium bicarbonate treats hyperkalemia Raises the threshold of arrhythmias - This is how calcium gluconate treats hyperkalemia Dialysis - This is the fastest way to remove potassium in the body Excretes potassium through stool - This is how polystyrene sulfonate (Kayexalate) treats potassium Mix with water and sorbitol - This may be done with polystyrene sulfate to increase the effectiveness of excreting potassium Paralytic ileus - This is a contraindication to giving polystyrene sulfonate Peritonitis - Giving polystyrene sulfonate with a paralytic ileus will cause this Elderly - This demographic is more susceptible to acute kidney injuries Polypharmacy Aminoglycosides Diuretics Hypotensive Dehydration Obstructive disorder Surgery Infections - These are reasons why elderly people are more susceptible to acute kidney injuries Lasix Laxatives Acid-base imbalance - These are causes of dehydration for elderly Antihypertensives Diuretics - These are medications that can cause hypotension for elderly Hypovolemic - Surgery can make an elderly person this Febrile illnesses - These types of infections can especially cause acute kidney injury with the elderly Progressive Irreversible loss - Prognosis for chronic kidney disease GFR less than 60mL/minute for three months - Chronic kidney disease criteria GFR less than 15mL/minute - End-stage renal disease criteria Dialysis Transplant - This is needed for surviving with ESRD Diabetes - About 50% of people with chronic kidney disease have this condition Diabetic nephropathy - This is a huge issue with chronic kidney disease Hypertension - About 25% of people with chronic kidney disease have this condition Harder to control - This is the problem with hypertension with chronic kidney disease Asymptomatic - Initially chronic kidney disease shows this Uremia - This is the cause of signs and symptoms of chronic kidney disease Increased waste products causing renal function to decline - This is what uremia does to cause signs and symptoms Neurological Respiratory Cardiac Hematologic GI Urinary...