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ADN GU Exam > AKI > Flashcards

AKI Flashcards

1
Q

How would you explain acute kidney injury to a patient?

A

Rapid loss of renal function, Reversible

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2
Q

What are the three causes of Acute Kidney Injury?

A

Prerenal: Severe dehydration, HF, decreased CO
Intrarenal: Nephrotoxins
Postrenal: BPH, Calculi, Trauma, Prostate cancer

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3
Q

What are some nephrotoxic drugs? SATA

A

Antibiotics: Acyclovir, Cephalosporins, Penicillins, Streptomycin, Tetracycline, Sulfanomides
Analgesics: NSAIDS (aspirin, ibuprofen)
ACE inhibitors
Diuretics
Lithium
Methotrexate
Other: Cocaine, Gold, Heroin, Lead, Mercury

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4
Q

What three phases of Acute Kidney Injury?

A

Oliguria, Diuretic, Recovery

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5
Q

S/S of oliguric phase of Acute Kidney Injury

A
  1. Output less than 400 mL/day
  2. Fluid volume overload
  3. Kussmaul respirations
  4. Metabolic acidosis
  5. Hyponatremia/ Hyperkalemia
  6. Elevated BUN & Cr (really high)
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6
Q

What is a big concern during the oliguric phase?

A

cerebral edema from hyponatremia can lead to seizures

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7
Q

What is the biggest change when going from the oliguric phase to diuretic phase?

A

Daily urine goes from less than 400 mL a day to 1-3 L

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8
Q

How long can it take the kidney to recover?

A

up to 12 months

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9
Q

What is the main labs you look at for kidney function?

A

Cr and EGFR

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10
Q

What nursing action do you have to take if your patient with Acute Kidney Injury is going to get a CT?

A

Make sure there is no contrast used

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11
Q

Why do you give mannitol for Acute Kidney Injury?

A

Osmothic diuretic to decrease cerebral edema

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12
Q

How do you treat hyperkalemia caused by Acute Kidney Injury?

A
  1. Insulin and Sodium bicarbonate
  2. Calcium carbonate
  3. D50
  4. Kalexalate (takes longer bc binds to GI tract)
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13
Q

S/S of cardiac tamponade

A

Diminished heart sounds, JVD, hypotension

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14
Q

What is the only way to fully reduce potassium in a patient with Acute Kidney Injury?

A

Dialysis

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15
Q

What dietary teaching needs to be done for Acute Kidney Injury?

A
  1. primary carbohydrates and fats

2. Limit protein

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16
Q

How do you assess a fistula/graft?

A

Auscultate and palpate

17
Q

Acute care for Acute Kidney Injury (directly from slide)

A
  1. Assess I/O
  2. Daily weights
  3. Assess for potassium and sodium disturbance
  4. ASEPTIC TECHNIQUE
  5. Careful use of nephrotoxic drugs
  6. Skin care measures/mouth care
18
Q

Neruologic concerns during oliguric phase

A

Fatigue, difficulty concentrating, seizures, stupor, coma

19
Q

When do you know a patient needs renal replacement therapy (dialysis)?

A 
Volume overload
Cardiac tamponade
BUN >120
Metabolic acidosis 
Elevated Potassium levels

ADN GU Exam (5 decks)

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