Flashcards in Kidney/Pudenda - Unit 4 - AKI and CDK Deck (66)
What is acute renal failure?
Abrupt loss of kidney function
Acute Renal Failure - not reversible. T/F?
False - it is if you have prompt medical intervention.
What is azotemia?
the accumulation of nitrogen and waste products in blood.
What is uremia?
Azotemia WITH symptoms.
What is the mortality rate for acute renal failure?
What is the Pre-Renal cause of AKI?
Perfusion to kidney's is decreased (map
What is the intra-renal cause of AKI?
damage to kidney itself, like acute tubular necrosis (nephrotoxic chemicals, meds, etc), infections (cytomeglovirus), diseases that precipitate vascular changes
What is the post-renal cause of AKI?
Obstruction of urinary collecting system - urethral stricture, BPH, bladder cancer, ureteral obstruction, abdominal tumor, etc.
What are the most common causes of AKI?
Medication, hypovolemia, hypotension
What are some nursing things to watch for with AKI?
Watch for low U/O
What are the 4 phases of AKI?
Onset, oliguric, diuretic, recovery
What happens during "onset" ?
Insult - may occur hours or days before oliguria
What happens during the "oliguric" phase?
May lass 7-14 days,
What happens during the diuretic phase?
Urinary output greater than 500CC/24 hours. Tubule system unable to concentrate urine, hypovolemia and hypotension, BUN stops increasing, watch for hypovolemia and hyponatremia
What happens during the recovery phase?
Continues until renal function is fully restored, although some permanent loss of possible.
What are some symptoms of AKI?
sudden or decrease in urine output, low BP, tachycardia, pulmonary edema, kussmaul respirations, anemia, leukocytosis, altered platelet function, decrease in LOC, fluid retention, hyperkalemia, hyponatremia, metabolic acidosis
Should we worry about decreasing the potassium level for AKI?
Is sodium bicarb the antidote for K+?
Bicarb brings it back out to the cell.
What are some dietary things for AKI?
Fluid restriction, intake of protein, potassium and sodium is regulated according to blood work, increase intake of carbs.
When is dialysis indicated?
Volume overload, BUN >120, metabolic acidosis, increased potassium w/EKG changes, pericardial effusion, cardiac tamponade
What are some nursing considerations for patients with AKI?
Daily weight, VS, daily lab, fluid balance, fluid restriction, restrict protein, K+, sodium, fluid, encourage carbs and fats, prevent infection, prevent skin breakdown, emotional support
What is Chronic Kidney Disease?
Progressive irreversible destruction of kidney tissue.
How much damage can the kidney's handle?
ESRD (End-stage-renal-disease) more common in what nationalities?
African Americans, Native Americans and Asian Americans
What is the relationship between chronic kidney disease and diabetes?
The vascular damage of DM causes the problems in CKD
What are some risk factors for CKD?
Acute renal failure, poorly controlled diabeetus, chronic glomerularnephritis, chronic HTN, lupus, polycystic kidney disease, etc.
What happens in stage 1 of CKD?
Minimal kidney damage with normal GFR (greater than 90 mL/Min)
What happens in stage 2 of CKD?
Mild kidney damage with mildly decreased GFR (60-90 mL/min)
What happens in stage 3 of CKD?
Moderate kidney damage with moderate decrease in GFR (30-60 mL/min) - decreases renal reserve and 50% of nephrons lost - SYMPTOMS can start here.