NUR 265 EXAM 1 || 100% Verified Solutions.
Prerenal AKI correct answers **Reduced renal artery blood flow** (↓blood flow to kidneys)
Causes: Hypotension, Hypovolemia, Cardiogenic Shock, Sepsis, Shock
NI:
- replace blood/ volume (Fluid challenge)
- vasopressors (increase BP) (EPI, DOPAMINE, VASOPRESSIN, NOREPI)
- Mean Arterial perfusion (>65)
Complications:
HF (edema, crackles, pulp edema)
Intrarenal AKI correct answers **direct damage to the kidneys** by inflammation, toxins, drugs,
infection, or reduced blood supply, pyelonephritis, glomurlonephritis
- ABX (VANCOMYCIN, RIFAMPIN, LEVOFLOXACIN, TETRACYCLINE) **peak/trough**
NI:
- monitor I&O
- monitor elevated creatinine
- Stop med/ lower dose --> dialysis
- collab w/ pharm/dietary
Postrenal AKI correct answers **sudden obstruction of urine flow** due to enlarged prostate,
kidney stones, bladder tumor, or injury, stenosis
,NI:
- lithotripsy (stones)
- hyrdonephrosis ( percut drain)
- BPH (foley)
Azotemia correct answers (excessive) urea and nitrogenous substances in the blood
SxS of early AKI correct answers - decreased urine output
- decreased systolic BP
- decreased pulse pressure
- ortho hypotension
- increased thirst
Labs:
- increased blood osmolarity
- increased BUN/ Creatnine
- Increased Hgb/ Hct
NI:
- FLUIDS
Lab Values correct answers Hgb: 12-18
Hct: 37-52
BUN: 10-20
Creatinine: 0.5-1.2
GFR: >60
Potassium: 3.5-5
,Sodium: 135-145
Calcium: 9-10.5
Mag: 1.5-2.5
PT: 11-12.5
INR: <1.2
PTT: 20-30
Anemia in kidney disease correct answers when kidneys are damaged they do not make enough
EPO (this prompts the bone marrow to make RBCs, which than carry oxygen throughout the
body), as a result the bone marrow makes fewer RBCs, causing anemia
Hypernatremia correct answers weakness, disorientation, irritability, muscle twitching, decreased
reflex, HTN
Hyponatremia correct answers - confusion
- seizures
- muscle weakness
- hypotension
Hypokalemia correct answers more severe than elevated
- absent t wave
- u waves
- pvc -> Vtach--> Coma
- cramping
- nausea
- confusion
, NI
- heart monitor
Hyperkalemia correct answers - tachycardia
- peaked T wave
- prolonged QRS
- 3 degree heart block
- v fib
- diarrhea
- weakness
- paresthesia--> paralysis
NI
- heart monitor
- concern when > 5.5
Hypocalcemia correct answers - seizures < 6
- tetany
- trousseaus
- chevoscki
- laryngospasm
- resp collapse
- paresthesias
- prolonged ST-QT intravels
- osteoporosis
Hypercalcemia correct answers - short QT interval
Prerenal AKI correct answers **Reduced renal artery blood flow** (↓blood flow to kidneys)
Causes: Hypotension, Hypovolemia, Cardiogenic Shock, Sepsis, Shock
NI:
- replace blood/ volume (Fluid challenge)
- vasopressors (increase BP) (EPI, DOPAMINE, VASOPRESSIN, NOREPI)
- Mean Arterial perfusion (>65)
Complications:
HF (edema, crackles, pulp edema)
Intrarenal AKI correct answers **direct damage to the kidneys** by inflammation, toxins, drugs,
infection, or reduced blood supply, pyelonephritis, glomurlonephritis
- ABX (VANCOMYCIN, RIFAMPIN, LEVOFLOXACIN, TETRACYCLINE) **peak/trough**
NI:
- monitor I&O
- monitor elevated creatinine
- Stop med/ lower dose --> dialysis
- collab w/ pharm/dietary
Postrenal AKI correct answers **sudden obstruction of urine flow** due to enlarged prostate,
kidney stones, bladder tumor, or injury, stenosis
,NI:
- lithotripsy (stones)
- hyrdonephrosis ( percut drain)
- BPH (foley)
Azotemia correct answers (excessive) urea and nitrogenous substances in the blood
SxS of early AKI correct answers - decreased urine output
- decreased systolic BP
- decreased pulse pressure
- ortho hypotension
- increased thirst
Labs:
- increased blood osmolarity
- increased BUN/ Creatnine
- Increased Hgb/ Hct
NI:
- FLUIDS
Lab Values correct answers Hgb: 12-18
Hct: 37-52
BUN: 10-20
Creatinine: 0.5-1.2
GFR: >60
Potassium: 3.5-5
,Sodium: 135-145
Calcium: 9-10.5
Mag: 1.5-2.5
PT: 11-12.5
INR: <1.2
PTT: 20-30
Anemia in kidney disease correct answers when kidneys are damaged they do not make enough
EPO (this prompts the bone marrow to make RBCs, which than carry oxygen throughout the
body), as a result the bone marrow makes fewer RBCs, causing anemia
Hypernatremia correct answers weakness, disorientation, irritability, muscle twitching, decreased
reflex, HTN
Hyponatremia correct answers - confusion
- seizures
- muscle weakness
- hypotension
Hypokalemia correct answers more severe than elevated
- absent t wave
- u waves
- pvc -> Vtach--> Coma
- cramping
- nausea
- confusion
, NI
- heart monitor
Hyperkalemia correct answers - tachycardia
- peaked T wave
- prolonged QRS
- 3 degree heart block
- v fib
- diarrhea
- weakness
- paresthesia--> paralysis
NI
- heart monitor
- concern when > 5.5
Hypocalcemia correct answers - seizures < 6
- tetany
- trousseaus
- chevoscki
- laryngospasm
- resp collapse
- paresthesias
- prolonged ST-QT intravels
- osteoporosis
Hypercalcemia correct answers - short QT interval
