Chapter 46: Acute Kidney Injury and Chronic Kidney Disease
After the insertion of an arteriovenous graft (AVG) in the right forearm, a patient complains of pain and
coldness of the right fingers. Which action should the nurse take?
a. Teach the patient about normal AVG function.
b. Remind the patient to take a daily low-dose aspirin tablet.
c. Report the patient's symptoms to the health care provider.
d. Elevate the patient's arm on pillows to above the heart level. ✔️✔️C
The patient's complaints suggest the development of distal ischemia (steal syndrome) and may require
revision of the AVG. Elevation of the arm above the heart will further decrease perfusion. Pain and
coolness are not normal after AVG insertion. Aspirin therapy is not used to maintain grafts.
When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an
assessment finding of
a. persistent skin tenting
b. rapid, deep respirations.
c. hot, flushed face and neck.
d. bounding peripheral pulses. ✔️✔️B
REMEMBER –
What is the primary function of the kidneys?
,The primary function of the kidneys is to filter waste products from the blood, regulate fluid balance,
and maintain electrolyte levels. ✔️✔️
What is prerenal AKI?
Prerenal AKI occurs due to decreased blood flow to the kidneys, often resulting from dehydration, heart
failure, or blood loss. ✔️✔️
What is intrinsic AKI?
Intrinsic AKI results from direct damage to the kidney tissue, which can be caused by toxins,
medications, or infections. ✔️✔️
What is postrenal AKI?
Postrenal AKI occurs due to obstruction in the urinary tract that prevents urine from draining properly
from the kidneys. ✔️✔️
How can imaging studies aid in diagnosing AKI?
Imaging studies, such as ultrasound or CT scans, can help identify obstructions or structural
abnormalities in the kidneys. ✔️✔️
What role does blood pressure play in kidney health?
High blood pressure can damage blood vessels in the kidneys, leading to reduced kidney function and
increasing the risk of CKD. ✔️✔️
What is the significance of proteinuria in CKD?
Proteinuria, or the presence of excess protein in the urine, is a key indicator of kidney damage and
disease progression in CKD. ✔️✔️
What are common symptoms of advanced CKD?
Advanced CKD may cause symptoms such as nausea, vomiting, persistent itching, swelling in the legs,
and changes in urine output. ✔️✔️
, What is the purpose of measuring eGFR?
Measuring eGFR helps assess kidney function and determine the stage of CKD, guiding treatment
decisions. ✔️✔️
How can controlling blood sugar levels help with CKD?
Controlling blood sugar levels in diabetic patients can slow the progression of kidney damage and
reduce the risk of developing CKD. ✔️✔️
What are the potential benefits of renal replacement therapy?
Renal replacement therapy, including dialysis or kidney transplantation, can restore kidney function or
manage waste removal in patients with severe CKD. ✔️✔️
What lifestyle factors can negatively affect kidney health?
Poor diet, lack of physical activity, smoking, and excessive alcohol consumption can all negatively impact
kidney health. ✔️✔️
How often should kidney function be monitored in at-risk individuals?
Individuals at risk for kidney disease should have their kidney function monitored annually or as
recommended by their healthcare provider. ✔️✔️
What is the impact of age on kidney function?
As people age, kidney function typically declines, increasing the risk for both AKI and CKD. ✔️✔️
What educational resources are available for patients with CKD?
Patients with CKD can access resources from organizations like the National Kidney Foundation, which
provides information on management and support. ✔️✔️
Patients with metabolic acidosis caused by AKI may have Kussmaul respirations as the lungs try to
regulate carbon dioxide. Bounding pulses and vasodilation are not associated with metabolic acidosis.
Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in AKI.
After the insertion of an arteriovenous graft (AVG) in the right forearm, a patient complains of pain and
coldness of the right fingers. Which action should the nurse take?
a. Teach the patient about normal AVG function.
b. Remind the patient to take a daily low-dose aspirin tablet.
c. Report the patient's symptoms to the health care provider.
d. Elevate the patient's arm on pillows to above the heart level. ✔️✔️C
The patient's complaints suggest the development of distal ischemia (steal syndrome) and may require
revision of the AVG. Elevation of the arm above the heart will further decrease perfusion. Pain and
coolness are not normal after AVG insertion. Aspirin therapy is not used to maintain grafts.
When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will expect an
assessment finding of
a. persistent skin tenting
b. rapid, deep respirations.
c. hot, flushed face and neck.
d. bounding peripheral pulses. ✔️✔️B
REMEMBER –
What is the primary function of the kidneys?
,The primary function of the kidneys is to filter waste products from the blood, regulate fluid balance,
and maintain electrolyte levels. ✔️✔️
What is prerenal AKI?
Prerenal AKI occurs due to decreased blood flow to the kidneys, often resulting from dehydration, heart
failure, or blood loss. ✔️✔️
What is intrinsic AKI?
Intrinsic AKI results from direct damage to the kidney tissue, which can be caused by toxins,
medications, or infections. ✔️✔️
What is postrenal AKI?
Postrenal AKI occurs due to obstruction in the urinary tract that prevents urine from draining properly
from the kidneys. ✔️✔️
How can imaging studies aid in diagnosing AKI?
Imaging studies, such as ultrasound or CT scans, can help identify obstructions or structural
abnormalities in the kidneys. ✔️✔️
What role does blood pressure play in kidney health?
High blood pressure can damage blood vessels in the kidneys, leading to reduced kidney function and
increasing the risk of CKD. ✔️✔️
What is the significance of proteinuria in CKD?
Proteinuria, or the presence of excess protein in the urine, is a key indicator of kidney damage and
disease progression in CKD. ✔️✔️
What are common symptoms of advanced CKD?
Advanced CKD may cause symptoms such as nausea, vomiting, persistent itching, swelling in the legs,
and changes in urine output. ✔️✔️
, What is the purpose of measuring eGFR?
Measuring eGFR helps assess kidney function and determine the stage of CKD, guiding treatment
decisions. ✔️✔️
How can controlling blood sugar levels help with CKD?
Controlling blood sugar levels in diabetic patients can slow the progression of kidney damage and
reduce the risk of developing CKD. ✔️✔️
What are the potential benefits of renal replacement therapy?
Renal replacement therapy, including dialysis or kidney transplantation, can restore kidney function or
manage waste removal in patients with severe CKD. ✔️✔️
What lifestyle factors can negatively affect kidney health?
Poor diet, lack of physical activity, smoking, and excessive alcohol consumption can all negatively impact
kidney health. ✔️✔️
How often should kidney function be monitored in at-risk individuals?
Individuals at risk for kidney disease should have their kidney function monitored annually or as
recommended by their healthcare provider. ✔️✔️
What is the impact of age on kidney function?
As people age, kidney function typically declines, increasing the risk for both AKI and CKD. ✔️✔️
What educational resources are available for patients with CKD?
Patients with CKD can access resources from organizations like the National Kidney Foundation, which
provides information on management and support. ✔️✔️
Patients with metabolic acidosis caused by AKI may have Kussmaul respirations as the lungs try to
regulate carbon dioxide. Bounding pulses and vasodilation are not associated with metabolic acidosis.
Because the patient is likely to have fluid retention, poor skin turgor would not be a finding in AKI.
