Kidneys.
The RN knows azotemia refers to...
What is an accumulation of nitrogenous waste products such as urea, nitrogen, creatine, & progressive increase of K+?
The RN knows this electrolyte can be a complication associated with AKI and is treated with IV glucose and regular insulin...
What is Hyperkalemia?
The RN knows this conditions may increase risk for CKD...
Name 3
What is anything that causes potential damage to the kidneys!!!!
DM & CV: perfusion issues, recurrent UTIs, PKD, hyperlipidemia, HTN, malnutrition, glomerulonephritis
The RN knows during this phase of AKI, output is below 400ml/d and the pt is likely experincing hypervolemia...
What is the oliguric phase?
This can be found in meat, fish, dairy, eggs, nuts, lentils, seeds and soy and should be limited but NOT avoided all together in patients with kidney injury...
This can be found in SODA, dairy, meats, cheeses, chocolate, legumes, wheat, processed foods, and ALSO should be limited when kidney injury is present...
What is Protein?
Does it matter if the protein comes from animals or plants???
What is phosphorous?
The RN knows, if kidney function is normal but an infection present, a prioiity intervention is this to help flush the organism out and prevent kidney damage...
What is administer fluids?
8 glasses/d or 2-3L/d
If urine specific gravity is high, the RN knows the patient is likely experiencing...
What is dehydration?
Remember: hypovolemia: solutes may result higher than expected because there is less fluid, not really more solutes
The RN knows AKI may be caused by any condition that causes this...
What is decreased renal perfusion?
The RN knows this is given to calm the heart when EKG changes are seen related to hyperkalemia...
What is Ca+ gluconate?
The RN knows this phase can last hours to days and is indicated by a high urine output, high specific gravity, and decreased Na+ concentration...
What is the Initiating phase?
The RN knows the patient with kidney injury should limit intake of this electrolyte due to potential for fluid imbalances...
The RN also knows that these (?) cannot be used as a replacement because...
What is sodium?
What are salt substitutes have hidden sources of salt and potassium?
The RN knows these are risk factors for pyelo...
Name at least 3
What are multiple UTIs (treated or untreated), female sexual activity, foley (longer in place, the > the risk), urinary obstruction, not completing ALL abx for UTI, pregnancy?
If urine specific gravity is low, the RN knows the patient is likely experiencing...
What is fluid volume overload/hyoervolemia?
Remember: the same # solutes are floating around in an olympic sized pool of fluids
The RN knows this physiologic factor related to aging is a risk for AKI in the geriatric population...
What is a decreased # of nephrons?
The RN knows these may be monitored to help determine how much fluid a pt is retaining or diuresing?
What are I/Os?
The RN knows this phase of AKI is associated with electrolyte fluctuation and potential for dehydration due to likely increased output up to as much as 5L/d...
What is the diuretic phase?
In AKI & CKD, the patient's intake of this may be limited related to the kidneys inability to fully excrete...
What are fluids?
The RN knows s/s of glomerulonephritis may include...
What is hematuria, proteinuria, edema, erythrocyte casts?
The RN knows these substances are considered nephrotoxic...
Name at least 3
What is contrast, aminoglycosides, myoglobin released from breakdown of muscle, Hgb from hemolyzed RBCs blocking the tubules causing vasoconstriction, NSAIDs, Naproxen, Vancomycin?
The RN knows patient education for good kidney health includes...
Identify three
What is drinking 2-3L fluid/d; do not hold in urine; empty bladder completely when urinating; complete all abx if prescribed for UTI (or anything!)?
This type of treatment pulls fluid from the body, filters it, and replaces it back into the body and may be 3-5 d/wk or continuous?
What is Dialysis/RRT (renal replacement therapy) and CRRT (continuous renal replacement therapy)?
The RN knows this phase may present with swelling & cramping in the LE and may last 14 d or longer...
What is the oliguric phase?
FYI: the longer this phase lasts, the poorer the pts prognosis
The RN knows the patient with kidney injury should limit intake of this electrolyte related to potential for lethal heart dysrhythmias...
What is potassium?
The RN knows these are complications related to polycystic kidney disease...
What are long term liver cysts, long term HTN, renal calculi?
The RN knows a map below this level may indicate decreased perfusion and an SBP below this level indicates an unstable pt...
What is a map below 65 and an SBP < 90?
MAP: (SBP + 2 x DBP) divided by 3
The RN knows this is the best non-invasive indicator of fluid status and is used for any pt with any type of kidney dysfunction...
What are daily weights?
The RN knows if the pt has low hgb, this may be administered...
The RN knows the pt with kidney dysfunction is at risk for anemia because...
What are erythropoiesis stimulating agents (ESAs) like Epogen or Procrit or Aranesp?
Epoetin alfa
What is as kidney dysfunction decreases, the kidneys release less erythropoietin, which is the hormone that tells the bone marrow to make more RBCs?
The RN knows this phase of AKI is associated with GFR returning to about 70-80% of normal and can take from several months up to 1 year...
What is the RECOVERY phase?
This term refers to when the pt does not intake enough protein and therefore the body pulls protein from muscles...
What is catabolism?
The RN knows these are risk factors for glomerulonephritis...
Name 2
What is recent strep infection and autoimmune diseases like Lupus or Goodpasture's (the immune system produce anti-glomerular basement membrane (anti-GBM) antibodies that attack the lungs and kidneys, leading to pulmonary hemorrhage and rapidly progressive glomerulonephritis)?