Wk 5 Acute Kidney Injury Flashcards Preview

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Flashcards in Wk 5 Acute Kidney Injury Deck (60)
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1
Q

Define acute kidney injury.

A

A rapidly progressive, sudden decline in kidney function that may be reversible

2
Q

What would a GFR be for someone with AKI?

A

<90ml/min

3
Q

What would urine output look like for someone with AKI?

A

<30 ml/hr

4
Q

What would BUN look like for someone with AKI?

A

> 20 mg/dL

5
Q

What would creatinine look like for someone with AKI?

A

> 1.2 mg/dL

6
Q

How fast does AKI occur?

A

It usually occurs within hours of onset of the problem

7
Q

What are four labs that we can use to determine if someone is having an AKI?

A

GFR, urine output, BUN, creatinine

8
Q

What urine output is normal for 24 hours?

A

Greater than 400 mLs in 24 hours

9
Q

What is the medical term for decreased urine output?

A

oliguria

10
Q

What is the normal BUN range?

A

10-20

11
Q

What is the normal range for creatinine?

A

0.5-1

12
Q

AKI encompasses the entire scope of the syndrome, which means…

A

It can range from slight deterioration in kidney function to severe

13
Q

What is AKI characterized by?

A

Rapid loss in kidney function, within hours to days

14
Q

Does someone with AKI always have decreased urine output?

A

No, it can be with or without urine output

15
Q

Although AKI is potentially reversible, it has a very high __ __.

A

mortality rate

16
Q

A person who suffers an AKI is typically suffering from other…

A

life threatening conditions

17
Q

What are three typical precursors to an AKI?

A

Severe, prolonged hypotension, hypovolemia, or exposure to a nephrotoxic agent

18
Q

Why does hypotension and/or hypovolemia result in an AKI?

A

Decreased perfusion to the kidneys

19
Q

Where do most AKI occur?

A

Prerenal

20
Q

What is a prerenal cause of AKI?

A

It originates in the intravascular system, before the kidneys, such as decreased cardiac output

21
Q

What is the most common cause of intrarenal AKI?

A

Acute tubular necrosis

22
Q

What is acute tubular necrosis?

A

Damage to the tubule cells which results in the kidneys not being able to filter the blood, a build up of wastes occurs

23
Q

What causes acute tubular necrosis?

A

Ischemia of the kidneys or damage from a toxic substance

24
Q

Hypokalemia would cause which type of AKI?

A

Prerenal

25
Q

What is an example of a post renal cause of AKI?

A

BPH, a back up of urine causes AKI

26
Q

What are the three different phases of AKI?

A

Oliguric, diuretic, and recovery phase

27
Q

How long does it take for someone to recover from AKI?

A

It can last 1-3 weeks

28
Q

Someone with an AKI will develop __ __ excess

A

Fluid volume excess

29
Q

Because an AKI can lead to fluid volume excess, what will this result in?

A

Hyponatremia

30
Q

A patient whose kidneys are not working build up wastes in the blood which leads to __ __

A

Metabolic acidosis

31
Q

What is a neurological sign of AKI?

A

Altered LOC

32
Q

Is someone with AKI/CKD hypokalemic or hyperkalemic?

A

Hyperkalemic

33
Q

What is the primary treatment in AKI?

A

Undo what is causing the injury and correct fluid and electrolyte imbalances

34
Q

What are the manifestations of acute kidney injury?

A

Hyperkalemia
Hyponatremia (dilutional)
Fluid volume excess
Metabolic acidosis
Altered LOC
Decreased urine output

35
Q

What are four additional treatments for AKI?

A

Manage BP
Prevent/Treat infections
Maintain Nutrition
Avoid nephrotoxic drugs

36
Q

Someone with AKI may have __ restrictions

A

fluid

37
Q

What orders might someone with an AKI have?

A

Fluid restrictions
Daily weights
Diuretics

38
Q

Dietary restriction of potassium is used for what?

A

Prevention of recurrent hyperkalemia, not acutre hyperkalemia treatment

39
Q

What are three GI drugs that can be used to lower serum potassium?

A

Patiromer (Veltassa)
Sodium zirconium cyclosilicate (Lokelma)
Sodium polystyrene sulfonate (Kayexalate)

40
Q

Sodium polystyrene sulfonate can be given __ or __

A

Po or enema

41
Q

Kayexalate can be given __ or __

A

PO or enema

42
Q

What is the brand name of sodium polystyrene sulfonate?

A

Kayexalate

43
Q

What is the generic name of Kayexalate?

A

sodium polystyrene sulfonate

44
Q

What is the brand name of patiromer?

A

Veltassa

45
Q

What is the generic name of Veltassa?

A

Patiromer

46
Q

What is the brand name of sodium zirconium cyclosilicate?

A

Lokelma

47
Q

What is the generic name of Lokelma?

A

sodium zirconium cyclosilicate

48
Q

What type of drug is lokelma, veltassa, and kayexalate?

A

Potassium binders in the GI tract, cation exchange resins

49
Q

Kayexalate should not be used for…

A

emergency, life threatening hyperkalemia

50
Q

What is a contraindication to GI potassium binders?

A

Paralytic ileus because we count on peristalsis to move the potassium out of the body

51
Q

What is an intravenous medication that can be given when someone is hyperkalemic, but it doesn’t actually lower serum potassium?

A

Calcium gluconate

52
Q

How does calcium gluconate IV work?

A

Calcium increases the threshold potential, thus restoring the normal gradient between threshold potential and resting membrane potential, which is abnormally elevated in hyperkalemia.

53
Q

What is a combination that can be given IV to correct hyperkalemia?

A

Insulin and glucose

54
Q

How does insulin and glucose help to correct hyperkalemia?

A

It temporarily shifts potassium back into the cells and out of the blood

55
Q

What base can be given IV to correct hyperkalemia?

A

Sodium bicarbonate

56
Q

How does sodium bicarbonate correct hyperkalemia?

A

It corrects acidosis and forces K back into the cells

57
Q

What is the disadvantage of Calcium gluconate, Insulin, and Bicarb for hyperkalemia correction?

A

They are all temporary, only buys you some time

58
Q

Potassium is a major __ __ of the body

A

intracellular cation

59
Q

Cations have a __ charge

A

positive

60
Q

What is the most effective way to remove potassium from the body?

A

Hemodialysis