Health Promotion and Maintenance
Simple education to provide healthy adults to prevent acute kidney injury
What is maintain hydration, at least 2-3L of water a day?
Kidney stone
What is a postrenal cause?
A first intervention to promote kidney perfusion
What is a fluid challenge?
The required sodium limit for CKD and ESKD patients.
What is 1-3 g daily?
The position the patient must maintain during PD dwell period.
What is any position? The catheter may be disconnected during dwell time and then reconnected later.
Nursing interventions for early recognition of AKI
What is Accurate I/O measurement and daily weights?
Systemic infection (sepsis)
What is pre and intrarenal cause?
Bypassing the prostate to initiate flow of urine
What is a urethral catheter?
Teaching for signs and symptoms of hypercalcemia (complication from phosphate binders) that should be reported to the doctor.
What are muscle weakness, tremors, bone pain, and anorexia?
A common complication during hemodialysis
What is hypotension?
Ideal urinary output
What is 0.5mL/kg/hr or 30ml/hr?
Glomerulonephritis
What is intrarenal cause?
Frequency for monitoring urinary catheter output in the unstable patient
What is hourly?
Breathing pattern seen in CKD (metabolic acidosis, complication) that aids in the excretion of CO2 via the lungs
What is Kussmaul respirations (Fast and deep)?
The most common complication of PD and how to prevent it
What is infection/peritonitis and use aseptic technique when accessing the catheter/nurse and client wear a mask when changing the dressing?
Important labs to monitor kidney function
What is creatinine, BUN, potassium, sodium, serum osmolarity, GFR, and urinalysis?
Blood loss
What is prerenal cause?
May assist with drug dosage calculations and inclusion/exclusion of medications based on kidney function
What is a pharmacist consult?
Some drugs must have a peak and trough in order to properly dose them.
Aminoglycosides (gentamycin, vancomycin, tobramycin)
Common in patients in late stages of CKD and stems from a decreased erythropoietin level
What is anemia?
Cardiac events during HD are associated with these underlying cardiovascular disease.
What are cardiac dysrhythmias, left ventricle hypertrophy, and coronary artery disease?
Certain antibiotics and chemotherapeutics, NSAIDs, IV contrast
What are nephrotoxic substances? Table 68-5
BPH
What is postrenal cause?
Assistance with maintaining caloric needs in the AKI patient
What is nutritional support consultation and supplementation?
Two leading causative factors of CKD
What are diabetes and hypertension?
After hemodialysis, report these symptoms to the physician if they occur.
What is hypotension, restlessness, headaches, or chest pain, ?