Vital sign change can cause the most drastic harm to the kidneys, leading to AKI?
What is low BP/Hypotension?
Kinked foley
What is post renal AKI
Expected potassium levels if AKI is left untreated
What is Hyperkalemia?
The minimum urine output rate for normal kidney function
What is urine output > 0.5 mL/kg/hr
The first treatment option to help an intravascularly dry patient to increase urine output.
What is Fluid replacement?
The best nursing sign/indicator of impaired kidney function
What is decreased urine output?
Nephrotoxins
What is intrarenal AKI?
Expected to occur with sodium lab results if AKI is left untreated
What is hyponatremia
Signs and symptoms of hyponatremia
What is: Confusion, nausea, vomiting, muscle cramps, headache?
The next step to treat the blood pressure after fluid replacement has been deemed adequate, yet the patient is still hypotensive.
What are vasopressors?
The system that the kidney activates to keep the BP stable.
What is RAAS - renin-angiotensin-aldosterone system?
Shock
What is pre-renal AKI?
Expected to occur with creatinine and BUN lab results if AKI is left untreated
What is increase?
Urine output of 45 mL in the last hour for a 85 kg patient is adequate
What is Yes? The minimum urine output for this patient is 42.5 mL/hr
Best method of dialysis for a patient with stable and robust blood pressure who has never had dialysis before.
What is Intermittent-hemodialysis (HD)?
A patient with renal impairment is expected to have this acid/base imbalance
What is Metabolic acidosis?
Hepatorenal syndrome
What is pre-renal AKI?
DARE!!! You must do a happy dance!
Yay!!
How to check if the patient is intravascularly dry before giving fluids to correct hypotension and AKI symptoms?
What is CVP, bedside Echo, or cardiac output
CRRT preferred over other types of dialysis during this patient condition.
What is hemodynamic instability?
The normal functioning kidney uses this much circulating cardiac output.
What is 20-25% of the cardiac output
Glomerulonephritis
What is intra-renal AKI?
The quickest emergency treatment for hyperkalemia?
What is: IV insulin, glucose, calcium?
Patiromer or Kayexalate - removing K through intestines before it is absorbed
Other organs affected if AKI persists to renal failure
What is Brain, Heart, Liver, GI, skeletal, hematologic, integumentary, etc.
A patient is scheduled for HD at 1500 today. Overnight the patient became hypotensive and was started on levophed. What is the best course of action for the RN?
Contact the provider to see if they would like to switch to CRRT?