AKI,CKD,Dialysis, organ transplant
What are the types of Acute Kidney Injury
Pre-Renal
Intra-Renal
Post-Renal
Fluid Volume Excess
Weight Fluid restriction
Edema Na restriction
VS Lung sounds
Oxygen I & O
skin neuro status
elevate extremities Fowler's
In Chronic Kidney Disease these lab values have an inverse relationship
What is Calcium and Phosphorus
Epoetin
anti anemic that stimulates the production of rbc
3.5 - 5.0
Normal K
What is the glomerular filtration rate ranges for CKD stages 1-5
Stage 1 > 90
Stage 2 60 -89
Stage 3 30 -59
Stage 4 15-29
Stage 5 <15
Fluid/Electrolyte Imbalance
Labs (K, Mg, Na, BUN,Cr, Ph, Ca)
VS Weight
Lung sounds GI assessment
Skin I & O
Falls Dietary consult
Explain the procedure for a 24 hour urine creatinine clearance
Start collecting first thing in the morning after the first void. Collect until the first void of the next day. Keep on ice
Sevelamer
phosphate binder that binds to phosphate in the GI tract preventing its absorption
10 -20
Normal BUN
Types of organ rejection
Hyperacute
Acute
Chronic
Impaired Gas Exchange
Fowler's position Resp. rate
Lung sounds oxygen
Diuretics
Accessory muscles VS
Lab values associated with kidney function
What is BUN/Creatinine
Lisinopril
ace inhibitor---prevents the conversion of angiotensin I to angiotensin II---vasodilation---decrease BP
0.5 - 1.1
0.6 - 1.2
Normal creatinine
0.5-1.1 females
0.6-1.2 males
Pre-renal causes of AKI
any condition causing decrease perfusion to the kidneys:
N/V
Heart failure
Hypovolemia
Fatigue
Frequent rest periods
Review meds/labs
schedule activities when the client has the most energy
enables rbc's to bind to oxygen in the lungs and take to organs/tissues
What is hemoglobin
Glucocorticoids
anti inflammatory/immunosuppressant
9 - 10.5
Normal Calcium
Causes of Intra renal AKI
damage done within the kidney:
acute tubular necrosis
glomerulonephritis
Drugs (NSAIDS, Vanco, Contrast Dye, aminoglycoside abt)
Knowledge Deficit: Diet
protein restriction
k+ restriction
Na restriction
fluid restriction
Lab value closely monitored for client's who are taking diuretic therapy
What is potassium
Immunosuppressants
suppresses cell-mediated immunity and altered antibody formation by antagonizing purine metabolism
3.0 - 4.5
Normal phosphorus