AKI
This treatment is usually reversible but if left untreated it can progress to end-stage disease or death
What is Acute Renal Failure?
A nurse reviews laboratory results for a patient with glomerulonephritis. The patient’s glomerular filtration rate (GFR) is 40 mL/min as measured by a 24-hour creatinine clearance. How would the nurse interpret this finding?
What is Reduced GFR?
What is the potential for fluid overload?
The GFR refers to the initial amount of urine that the kidneys filter from the blood. In the healthy adult, the normal GFR ranges between 100 and 120 mL/min, most of which is reabsorbed in the kidney tubules. A GFR of 40 mL/min is drastically reduced, with the patient experiencing fluid retention and risks for hypertension and pulmonary edema as a result of excess vascular fluid.
This is the irreversible destruction of the kidneys, leading to loss of renal function.
What is chronic renal failure?
A nurse assesses a patient with nephrotic syndrome. For which clinical manifestations would the nurse assess?
Name up to 3
Whatis Proteinuria?
What is Hypoalbuminemia?
What is Lipidura?
Nephrotic syndrome is caused by glomerular damage and is characterized by proteinuria (protein level higher than 3.5 g/24 hr), hypoalbuminemia, edema, and lipiduria. Fluid overload leading to edema and hypertension is common with nephrotic syndrome; dehydration does not occur. Dysuria is present with cystitis. CVA tenderness is present with inflammatory changes in the kidney.
The nurse is teaching a patient with nephrotic syndrome and a normal glomerular filtration, the nurse assesses the patient’s understanding. What nutritional education should be included in this education?
What is I will increase my protein intake?
In nephrotic syndrome, the renal loss of protein is significant, leading to hypoalbuminemia and edema formation. If glomerular filtration is normal or near normal, increased protein loss would be matched by increased intake of protein. The patient would not need to adjust fat, carbohydrates, or vitamins based on this disorder.
In acute renal failure, the creatinine clearance will be __________
What is low?
A nurse evaluates a patient with acute glomerulonephritis (GN). Which manifestation would the nurse recognize as a positive response to the prescribed treatment?
What is weight loss?
Fluid retention is a major feature of acute GN. This weight loss represents fluid loss, indicating that the glomeruli are performing the function of filtration. A urine specific gravity of 1.048 is high. Blood is not usually seen in GN, so this finding would be expected. A blood pressure of 152/88 mm Hg is too high; this may indicate kidney damage or fluid overload
Name 2 complications that are associated with Chronic renal failure?
What is anemia?
What is heart failure?
What is stomatitis?
What is hyperkalemia?
A nurse cares for a middle-aged female patient with diabetes mellitus who is being treated for the third episode of acute pyelonephritis in the past year. The patient asks, “What can I do to help prevent these infections?” How would the nurse respond?
What is drink more water? and empty your bladder frequently every day.
Patients with long-standing diabetes mellitus are at risk for pyelonephritis for many reasons. Chronically elevated blood glucose levels spill glucose into the urine, changing the pH and providing a favorable climate for bacterial growth. The neuropathy associated with diabetes reduces bladder tone and reduces the patient’s sensation of bladder fullness. Thus, even with large amounts of urine, the patient voids less frequently, allowing stasis and overgrowth of microorganisms. Increasing fluid intake (specifically water) and voiding frequently prevent stasis and bacterial overgrowth
a progressive disease of kidneys in which there occurs hardening (sclerosis) of the small blood vessels of the kidneys.
What is nephrosclerosis?
An emergency department nurse cares for a patient who is severely dehydrated and is prescribed 3 L of intravenous fluid over 6 hours. At what rate (mL/hr) would the nurse set the intravenous pump to infuse the fluids? (Record your answer using a whole number.) mL/hr
What is 500 ml/hr?
A school-aged child is diagnosed with acute glomerulonephritis. What nursing actions take priority when caring for this child?
What is monitor blood pressure every 4 hours?
Hypertension is a major complication that can occur during the acute phase of glomerulonephritis, blood pressure should be monitored q4h. Specific gravity should also but it doesn't take priority over blood pressure.
What is protein?
Proteins are typically restricted in clients with chronic renal failure because of their metabolites.
A nurse cares for a patient who has pyelonephritis. The patient states, “I am embarrassed to talk about my symptoms.” How would the nurse respond?
What is to take your time and use words that you are familiar with saying?
Patients may be uncomfortable discussing issues related to elimination and the genitourinary area. The nurse would encourage the patient to use language that is familiar to the patient. The nurse would not make promises that cannot be kept, like keeping the patient’s symptoms confidential. The nurse must assess the patient and cannot take the time to stop the discussion or find another nurse to complete the assessment
Old -age, African-Americans, Male these are ____________
What is affected people with nephrosclerosis?
A health care provider orders 500 mL of D50.45% NS to infuse at 50 mL/h. The tubing drop factor is 60 gtt/mL. Calculate the rate in drops per minute. ____________________
900mg=___________g
What is 0.9g?
This is to remove the toxic wastes and other impurities from the blood.
What is Hemodialysis?
This patient is anorexia, burning upon urination, flank pain, temperature of 102, and shaking with chills_________
What is signs and symptoms of Nephritis?
This drug class is often used in the treatment of nephrosclerosis to decrease blood pressure and preserve kidney function.
What is ACE Inhibitors?
The critical care nurse learns that in the report the client experience prerenal AKI following surgery. What cause should the nurse expect?
What is hypovolemia?
Prerenal type of AKI is caused by factors such as hypovolemia and decrease cardiac output that reduces renal blood flow and perfusion.
Name at least 3 infectious agents associated with glomerulonephritis?
What is Group A beta-hemolytic strep?
What is Syphilis?
What is TB?
See page 1376
After a diagnosis of CRF, the client was startes on epoetin alfa. Which finding indicates that the medication has been effective?
What is an increase of H&H?
This is targeted to the specific infecting organism, the course of therapy is 10-14 days.
What is antibiotic therapy?
A patient is receiving lidocaine at 15 mL/h. The concentration of lidocaine is 2 g/500 mL of D5W. Calculate the milligrams per minute the patient is receiving. ____________________
What is 1mg/min?