Labs
What does Urine specific gravity measure?
How concentrated or dilute the urine is
A kidney infection is considered what kind of acute kidney injury?
a) pre-renal
b) intrarenal
c) post-renal
b) intrarenal
Name the top 2 causes of Chronic Kidney Disease
Kyla is an 18 year old track athlete who suffered an episode of severe dehydration after her meet yesterday. She has been given IV and oral fluids, but is still not urinating enough. She is beginning to have swelling in her legs and adventitious lung sounds. What is the cause of Kyla's symptoms?
Acute Kidney Injury due to Dehydration
Pre-renal
Who is at highest risk for kidney problems
Elderly,
HTN, DM, heart patients
What lab would include the following:
BUN, Potassium, Creatinine, Calcium
Heart failure is considered what kind of cause of Acute Kidney Injury?
a) pre-renal
b) intrarenal
c) post-renal
a) pre-renal
What happens to potassium and waste products (BUN and creatinine) with Chronic Kidney Disease?
a) they increase
b) they decrease
c) they remain normal
a) they increase
Shiraj is a 40 year old patient with severe kidney infection. Initially, they were having trouble urinating with decreased urine output and lower extremity edema. Now, they cannot stop urinating. Their urine appears very clear and their blood pressure is 89/60. What is happening?
Acute Kidney Injury -Diuretic phase
Intrarenal cause
Through what part of the patient does peritoneal dialysis take place?
The peritoneum or abdomen
a) normal
b) high
c) low
b) high
What type of fluid shift does the patient INITIALLY have with an acute kidney injury?
Fluid volume excess
At what stage of chronic kidney disease will someone require dialysis or a kidney transplant?
Stage 5
Leslie is a patient with chronic kidney disease and diabetes. The doctor has ordered a CT scan with contrast dye of Leslie's spine due to recent fall injury. What might the nurse want to discuss with the doctor before bringing the patient for his CT scan?
Kidney function with contrast dye
Acute Kidney Injury may cause which of the following:
a) respiratory acidosis
b) respiratory alkalosis
c) metabolic acidosis
d) metabolic alkalosis
c) metabolic acidosis
If the patient has an Acute Kidney Injury and is in the diuretic phase, the urine specific gravity will likely be:
a) normal
b) high
c) low
c) low
Name 2 symptoms the nurse might see on physical exam in the BEGINNING stages of an acute kidney injury
JVD, edema, bounding pulse, crackles, kussmaul, decreased urine, fatigue, confusion, seizures, coma,
What kind of fluid volume changes may happen with Chronic kidney disease?
Fluid volume excess
Mildred is a patient with stage 5 chronic kidney disease and is on dialysis. She states: "I try to keep my electrolytes in line by eating lots of bananas, leafy greens, and increasing my fluid intake."
What teaching should the nurse do next?
Educate Mildred on decreasing potassium/calcium rich foods and decreasing fluid intake to avoid elevated levels of electrolytes and fluids.
Give an example of a nephrotoxic substance
The stage of Chronic Kidney Disease can be determined by what lab?
GFR
If caught early, what kind of medication class can we treat acute kidney injury with to avoid fluid volume overload?
Diuretics
Name two clinical manifestations or complications of Chronic kidney disease
Infection, Anemia, Cardiovascular disease, Infertility, Skin and skeletal problems, Abnormal electrolyte levels, abnormal waste products in blood, metabolic acidosis
Juan is a patient with stage 5 chronic kidney disease and is on dialysis. His CMP returns with the following results:
Sodium: 138
Potassium 5.5
Creatinine: 2.0
Blood Urea Nitrogen: 35
Which of these is most alarming to the nurse?
Potassium 5.5
What kind of diet or fluid restrictions should a patient follow if they have AKI or CKD?
Low potassium, low sodium, low fluid intake
Keep glucose well controlled