Acute Kidney Injury (AKI)
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Questions and Answers

What is the typical duration of the oliguria phase in patients with acute kidney injury?

  • 10 to 14 days (correct)
  • 5 to 7 days
  • Less than 5 days
  • 7 to 10 days

    • What is the main reason for fluid retention in the oliguria phase of acute kidney injury?

  • Increased atrial natriuretic peptide (ANP) levels
  • Increased antidiuretic hormone (ADH) levels
  • Decreased urine output (correct)
  • Decreased aldosterone levels

    • What is a characteristic of the urinalysis in the oliguria phase of acute kidney injury?

  • Low specific gravity and low osmolality (correct)
  • High specific gravity and low osmolality
  • High specific gravity and high osmolality
  • Low specific gravity and high osmolality

    • What is the effect of impaired kidney function on serum bicarbonate levels in the oliguria phase of acute kidney injury?

    <p>Decreased production</p> Signup and view all the answers

    What is a complication of severe acidosis in the oliguria phase of acute kidney injury?

    <p>Kussmaul respirations</p> Signup and view all the answers

    What is the effect of acute kidney injury on sodium balance in the oliguria phase?

    <p>Increased sodium excretion</p> Signup and view all the answers

    What is a characteristic of potassium excess in the oliguria phase of acute kidney injury?

    <p>Asymptomatic with abnormal ECG</p> Signup and view all the answers

    What percentage of patients with acute kidney injury develop non-oliguric acute kidney injury?

    <p>50%</p> Signup and view all the answers

    What is the primary cause of death in patients with Acute Kidney Injury (AKI)?

    <p>Infection</p> Signup and view all the answers

    What is the term for the accumulation of nitrogenous waste products in the blood?

    <p>Azotemia</p> Signup and view all the answers

    What is the term for the slow and gradual loss of kidney function over time?

    <p>Chronic Kidney Disease</p> Signup and view all the answers

    What is the primary cause of Prerenal Azotemia?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the obstruction of the urinary tract that can cause Postrenal Acute Kidney Injury?

    <p>Hydronephrosis</p> Signup and view all the answers

    What is the term for the phase of Acute Kidney Injury characterized by a decrease in urine output?

    <p>Oliguric phase</p> Signup and view all the answers

    What is the term for the damage to the tubular epithelial cells caused by ischemia or nephrotoxins?

    <p>Acute Tubular Necrosis</p> Signup and view all the answers

    What is the primary difference between Acute Kidney Injury and Chronic Kidney Disease?

    <p>All of the above</p> Signup and view all the answers

    What is the term for the slow and irreversible loss of kidney function over time?

    <p>Chronic Kidney Disease</p> Signup and view all the answers

    What is the primary goal of conservative care for patients with Chronic Kidney Disease?

    <p>To slow the progression of the disease</p> Signup and view all the answers

    What is a potential neurologic disorder associated with acute kidney injury?

    <p>Seizures, stupor, coma</p> Signup and view all the answers

    What is a common hematologic disorder associated with acute kidney injury?

    <p>Leukocytosis</p> Signup and view all the answers

    What is a primary goal of interprofessional care in acute kidney injury?

    <p>All of the above</p> Signup and view all the answers

    What is a potential complication of diuretic phase in acute kidney injury?

    <p>Hypovolemia</p> Signup and view all the answers

    What is the primary indication for renal replacement therapy in acute kidney injury?

    <p>All of the above</p> Signup and view all the answers

    What is a key component of nutrition therapy in acute kidney injury?

    <p>All of the above</p> Signup and view all the answers

    What is a key aspect of nursing assessment in acute kidney injury?

    <p>All of the above</p> Signup and view all the answers

    What is a primary focus of health promotion in acute kidney injury?

    <p>Early recognition of high-risk populations</p> Signup and view all the answers

    What is a key component of nursing implementation in acute kidney injury?

    <p>All of the above</p> Signup and view all the answers

    What is the definition of chronic kidney disease?

    <p>Progressive, irreversible loss of kidney function</p> Signup and view all the answers

    Study Notes

    Acute Kidney Injury (AKI)

    • Defined as partial or complete impairment of kidney function that results in the inability to excrete metabolic waste products and water
    • Affects all body systems, requiring challenging treatments and dietary changes that impact lifestyle, occupation, family relationships, and self-image

    Comparison of AKI and Chronic Kidney Disease (CKD)

    • Onset:
      • AKI: Sudden
      • CKD: Gradual, over years
    • Causes:
      • AKI: Acute tubular necrosis, ischemia, nephrotoxins, sepsis
      • CKD: Diabetic nephropathy, hypertension, glomerulonephritis
    • Diagnostic criteria:
      • AKI: Acute reduction in urine output and/or elevation in serum creatinine
      • CKD: GFR < 60 mL/min/1.73m2 for > 3 months and/or kidney damage > 3 months
    • Reversibility:
      • AKI: Potentially reversible
      • CKD: Progressive and irreversible
    • Cause of death:
      • AKI: Infection
      • CKD: Cardiovascular disease

    Acute Kidney Injury (AKI)

    • Ranges from slight deterioration to severe impairment
    • Rapid loss of kidney function characterized by:
      • Rise in serum creatinine and/or reduction in urine output
      • Elevated BUN and K+
      • Azotemia—accumulation of nitrogenous waste products
    • High mortality rate; often associated with other life-threatening conditions

    Causes of Acute Kidney Injury

    • Prerenal:
      • Factors reducing systemic circulation, causing decreased renal blood flow and oliguria
      • Examples: Severe dehydration, heart failure, decreased CO
    • Intrarenal:
      • Direct damage to kidney tissue
      • Examples: Prolonged ischemia, nephrotoxins, hemoglobinuria, myoglobinuria
    • Postrenal:
      • Mechanical obstruction of outflow, causing reflux into renal pelvis and impaired kidney function
      • Examples: Benign prostatic hyperplasia, prostate cancer, calculi, trauma, extrarenal tumors

    Clinical Manifestations of AKI

    • Oliguric phase:
      • Urinary changes: Oliguria, casts, RBCs, WBCs, protein
      • Fluid volume: Decreased urine output, fluid retention, edema, hypertension
      • Metabolic acidosis: Impaired kidney function, decreased bicarbonate production
      • Sodium balance: Increased excretion, hyponatremia
      • Potassium excess: Impaired excretion, hyperkalemia
      • Hematologic disorders: Leukocytosis, infection
      • Waste product accumulation: Increased BUN and serum creatinine levels
      • Neurologic disorders: Fatigue, difficulty concentrating, seizures, stupor, coma
    • Diuretic phase:
      • Increased urine output, osmotic diuresis
    • Recovery phase:
      • Increased GFR, decreased BUN and creatinine levels

    Diagnostic Studies for AKI

    • Thorough history
    • Serum creatinine, BUN, electrolytes
    • Urinalysis
    • Renal ultrasound
    • Renal scan
    • CT scan
    • Renal biopsy

    Interprofessional Care for AKI

    • Eliminate cause
    • Manage signs and symptoms
    • Prevent complications
    • Ensure adequate intravascular volume and cardiac output
    • Closely monitor fluid intake during oliguric phase
    • Hyperkalemia therapies
    • Indications for renal replacement therapy (RRT)
    • Renal replacement therapy (RRT) options: Peritoneal dialysis, intermittent hemodialysis, continuous renal replacement therapy
    • Nutrition therapy: Maintain adequate caloric intake, restrict sodium, potassium, and phosphate

    Nursing Management for AKI

    • Nursing assessment: Measure vital signs, daily weights, strict intake and output, examine urine
    • Nursing diagnoses: Electrolyte imbalance, fluid imbalance, risk for infection, anxiety
    • Nursing planning: Patient will completely recover without loss of kidney function, maintain normal fluid and electrolyte balance, have decreased anxiety, adhere to follow-up care
    • Health promotion: Prevention and early recognition, identify and monitor high-risk populations, control exposure to nephrotoxic drugs and industrial chemicals
    • Nursing implementations: Accurate intake and output, daily weights, assess for hypervolemia or hypovolemia, assess for potassium and sodium disturbances, meticulous aseptic technique, careful use of nephrotoxic drugs, skin care measures/mouth care
    • Nursing evaluation: Patient will regain and maintain normal fluid and electrolyte balance, adhere to treatment regimen, have no complications, and have complete recovery

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    Description

    Acute Kidney Injury is a sudden impairment of kidney function, affecting all body systems, requiring challenging treatments and dietary changes. Compare and contrast AKI with Chronic Kidney Disease (CKD).

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