Acute Kidney Injury, Glomerulonephritis (PDF)

Summary

This document provides an overview of acute kidney injury, glomerulonephritis, and nephrotic syndrome. It details key terms, causes, symptoms, management strategies, and practice questions related to these conditions. The content likely serves as an educational resource focusing on medical or nursing education.

Full Transcript

# Acute Kidney Injury, Glomerulonephritis, Nephrotic Syndrome ## Key Terms and Concepts - **Oliguria:** Urine output of less than 400 mL/day. - **Anuria:** Urine output of less than 50 mL/day. - **Bladder capacity:** Typically around 400–600 mL. ## Types of Renal Health Challenges 1. **Glomerulo...

# Acute Kidney Injury, Glomerulonephritis, Nephrotic Syndrome ## Key Terms and Concepts - **Oliguria:** Urine output of less than 400 mL/day. - **Anuria:** Urine output of less than 50 mL/day. - **Bladder capacity:** Typically around 400–600 mL. ## Types of Renal Health Challenges 1. **Glomerulonephritis:** Inflammation of glomerular capillaries. 2. **Nephrotic Syndrome:** Increased glomerular permeability causing protein loss. 3. **Acute Kidney Injury (AKI):** Rapid decline in renal function. 4. **Chronic and End-Stage Renal Failure:** Progressive loss of kidney function. ## Glomerular Diseases ### Acute Glomerulonephritis - **Causes:** Post-infection, lupus nephritis, diabetic nephropathy. - **Symptoms:** Hematuria, edema, azotemia, proteinuria, hypertension. - **Management:** Antibiotics, corticosteroids, and supportive care. ### Chronic Glomerulonephritis - **Causes:** Repeated acute glomerulonephritis, hypertension, hyperlipidemia. - **Symptoms:** Fixed specific gravity in urine, proteinuria, electrolyte imbalances. - **Management:** Drugs and dietary therapy. ### Nephrotic Syndrome - **Symptoms:** Proteinuria, hypoalbuminemia, edema. - **Causes:** Diabetes, lupus, renal vein thrombosis. - **Management:** Drugs and dietary therapy. ## Acute Kidney Injury (AKI) ### Causes - **Pre-renal:** Reduced blood flow (e.g., hypovolemia, hypotension). - **Intra-renal:** Direct kidney damage (e.g., acute tubular necrosis, diabetic nephropathy). - **Post-renal:** Urinary obstruction (e.g., prostate enlargement, kidney stones). ### Phases of AKI 1. **Initiation:** Onset of kidney injury. 2. **Oliguric:** Decreased urine output, lasting days to weeks. 3. **Diuresis:** Gradual urine output increase. 4. **Recovery:** Renal function restoration (up to 12 months). ## Clinical Management and Nursing Care - **Fluid Balance:** Monitor intake and output, daily weights. - **Electrolyte Management:** Manage potassium, sodium, calcium, phosphorus levels. - **Medications:** Antibiotics, diuretics, steroids, dialysis for severe cases. - **Nutritional Support:** Protein restriction, adequate caloric intake. ## Complications - Metabolic acidosis, hyperkalemia, anemia, fluid overload. - **Hyperkalemia:** Life-threatening if serum potassium > 5.5 mmol/L; treat with cation exchange resins like Kayexalate. ## Postoperative Care in Kidney Surgery - **Risks:** Bleeding, infection, deep vein thrombosis. - **Interventions:** Pain relief, deep breathing exercises, monitoring for signs of DVT. - **Patient Education:** Care of drainage systems, signs of complications, follow-up care. ## Practice Questions with Answers 1. **Question:** The most accurate indicator of fluid loss or gain in an acutely ill patient is: - A) Abdominal girth - B) Weight - C) Skin turgor - D) Level of consciousness **Answer:** B) Weight 2. **Question:** Is hypercalcemia the most life-threatening fluid and electrolyte change in renal disturbances? **Answer:** False. Hyperkalemia is more life-threatening. 3. **Question:** As kidney injury progresses and GFR falls below 50 mL/min, what occurs? - A) Metabolic acidosis - B) Hypokalemia - C) Hypercalcemia - D) Hypophosphatemia **Answer:** A) Metabolic acidosis 4. **Question:** What would result in the most pronounced elevations in serum potassium and BUN in acute renal failure? - A) Hemorrhage - B) Nephrotoxic drugs - C) Severe crushing injuries - D) Renal vascular obstruction **Answer:** C) Severe crushing injuries 5. **Question:** Clients with acute glomerulonephritis may exhibit: **Answer:** Hematuria, proteinuria, edema, hypertension. 6. **Question:** The cause of postinfectious glomerular disease in a 16-year-old: **Answer:** Group A beta-hemolytic streptococcal infection of the throat. 7. **Question:** A key nursing diagnosis for nephrotic syndrome would include: **Answer:** Excess fluid volume related to generalized edema. 8. **Question:** During the diuresis phase of AKI, what should a client be closely monitored for? **Answer:** Dehydration. 9. **Question:** The nurse's role in caring for an ARF patient includes: **Answer:** Monitoring for complications, managing fluid/electrolyte imbalances, and providing emotional support. 10. **Question:** To assess for bleeding in a postoperative kidney surgery client, include: **Answer:** Skin condition, level of consciousness, urinary drainage. ## Additional Questions 11. **Question:** Which lab finding would suggest an exacerbation of chronic glomerulonephritis? - A) Persistent hypertension and retinal changes - B) Orthostatic hypotension - C) Increased urine specific gravity - D) Increased WBCs in urine **Answer:** A) Persistent hypertension and retinal changes. 12. **Question:** Which phase of AKI is characterized by a severe decrease in urine output? - A) Initiation - B) Oliguric - C) Diuresis - D) Recovery **Answer:** B) Oliguric 13. **Question:** For hyperkalemia, the nurse should anticipate administering: - A) Calcium gluconate - B) Cation exchange resins - exchanges K+ for Na. - C) Erythropoietin - D) Vitamin D supplements **Answer:** B) Cation exchange resins 14. **Question:** Patients with nephrotic syndrome are at increased risk of: - A) Hypercalcemia - B) Hypoalbuminemia - C) Hyperphosphatemia - D) Anemia **Answer:** B) Hypoalbuminemia 15. **Question:** Intra-renal causes of AKI include: - A) Hypovolemia - B) Renal calculi - C) Acute tubular necrosis - D) Prostatic hyperplasia **Answer:** C) Acute tubular necrosis 16. **Question:** A key indicator of fluid overload in AKI is: - A) Weight loss - B) Jugular venous distension - C) Hypotension - D) Increased hematocrit **Answer:** B) Jugular venous distension 17. **Question:** Post-renal AKI is typically caused by: - A) Hypotension - B) Tubular necrosis - C) Urinary obstruction - D) Infection **Answer:** C) Urinary obstruction 18. **Question:** Following kidney surgery, a major complication to monitor for is: - A) Deep vein thrombosis - B) Increased appetite - C) Euphoria - D) Decreased respiratory rate **Answer:** A) Deep vein thrombosis 19. **Question:** Symptoms of nephrotic syndrome often include: - A) Dehydration - B) Edema and proteinuria - C) Increased urination - D) Anuria **Answer:** B) Edema and proteinuria 20. **Question:** In the recovery phase of AKI, lab values generally: - A) Remain abnormal - B) Return to baseline over months - C) Worsen - D) Show increased proteinuria **Answer:** B) Return to baseline over months

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