ACUTE KIDNEY INJURY
This phase of AKI is characterized by urine output less than 400 mL/day
OLIGURIC PHASE
1. LAB VALUE THAT IS ALWAYS ELEVATED IN CKD
2. ALWAYS DECREASED IN CKD
1. CREATININE
2. GFR
This dialysis method uses the peritoneal membrane as a filter.
PD Dialysis
This complication involves fluid accumulation in the abdominal cavity
ascities
The liver is especially vulnerable to trauma because of its size and this characteristic.
What is its vascular structure?
Name the three classifications of AKI.
prerenal, intrarenal, and postrenal?
This hormone deficiency causes anemia in CKD patients
What is erythropoietin
This electrolyte imbalance with ECG changes is an indication for emergent dialysis
What is hyperkalemia?
This neurological complication results from ammonia buildup
Hepatic Encephalopathy
This imaging test is commonly used to evaluate renal trauma
CT scan, w or w/o contrast
Name four clinical manifestations of volume overload in AKI.
Edema, pulmonary edema, SOB, JVD, hypertension, heart failure
Name three common treatments for CKD complications
What are treatment of hyperkalemia, hypertension, anemia, and dyslipidemia?
After renal transplant, patients require this type of therapy to prevent rejection
What is immunosuppressant therapy?
This procedure removes fluid from the abdomen to relieve ascites
What is paracentesis?
This fracture is commonly associated with renal trauma due to its proximity to the kidneys
pelvic fx.
The nurse is monitoring a patient in the diuretic phase of AKI. Which complication is most likely during this phase?
A. Fluid overload
B. Hyperkalemia
C. Hypovolemia
D. Metabolic acidosis
Answer: C – Hypovolemia
Rationale: The diuretic phase involves large urine output, putting the patient at risk for dehydration and hypotension
A patient with CKD develops anemia primarily due to:
A. Iron deficiency
B. Blood loss
C. Decreased erythropoietin production
D. Folic acid deficiency
Answer: C – Decreased erythropoietin production
Name two complications of hemodialysis
hypotension, infection, bleeding, disequilibrium syndrome
This severe complication combines liver failure with kidney dysfunction
hepatorenal syndrome
A patient with renal trauma has bright red urine. The priority action is:
A. Document and recheck in 4 hours
B. Increase oral fluids
C. Assess vital signs and monitor output
D. Encourage ambulation
C – Assess vital signs and monitor output
Rationale: Hematuria may indicate worsening injury or bleeding.
A patient with AKI has:
1. Decreased urine output 2. Crackles 3. JVD 4. Weight gain of 3 lbs in 24 hours, what is developing?
Fluid overload
A patient with stage 4 chronic kidney disease presents to the clinic with weakness and palpitations. The nurse reviews the laboratory results:
Potassium: 6.3 mEq/L, Hemoglobin: 9 g/dL, Creatinine: 4.8 mg/dL, Blood pressure: 168/92
A. Administer prescribed erythropoietin
B. Notify the provider about the potassium level
C. Recheck the blood pressure in 30 minutes
D. Educate the patient on low-sodium diet
B – Notify the provider about the potassium level
List three indications for emergent dialysis
Severe volume overload, hyperkalemia with ECG changes, severe metabolic acidosis, altered mental status, pericarditis?
Name three clotting factors produced by the liver
What are prothrombin (Factor II), VII, IX, X?
A patient arrives after a motor vehicle collision with flank pain and visible bruising. Urine is tea-colored. What is the nurse’s priority?
A. Encourage fluids
B. Assess vital signs
C. Provide pain medication
D. Obtain dietary history
Answer: B – Assess vital signs
Rationale: Possible internal bleeding — assess for shock first.