A condition in which damaged skeletal muscle tissue breaks down rapidly. Breakdown products of damaged muscle cells are released into the bloodstream; some of these, such as the protein myoglobin, are harmful to the kidneys and may lead to kidney failure
Onset phase of acute renal failure
starts with the precipitating event and continues to the development of renal symptoms (labwork)
Oliguric - Anuric phase of acute renal failure
lasts 1-8 weeks, the longer this phase lasts the poorer the prognosis
Diuretic phase of acute renal failure
starts when BUN and Creat get back to normal
What is most important in the diuretic phase of acute renal failure?
Hydration! Patients can die in the this phase if they aren't hydrated
Recovery phase of acute renal failure
3-12 months long, mild abnormalities, decreased concentration of urine
What is patient at risk of for the rest of their life in the recovery phase of acute renal failure?
Fluid and Electrolyte imbalances
What is a significant cause of death for patients with ARF?
How to prevent infection for pts with ARF?
strict sterile technique, avoidance of indwelling cath's
Medical management of ARF
Prevention, hydration, adequate diuresis, watch labwork, I&O, weights, maintain fluid and electrolyte balance, replace renal function (dialysis), prevent infection
Complications associated with ARF
Pericarditis (fluid backs up), Tachy, fever, friction rub, seizures (due to increased BUN), anemia (due to bleeding from trauma)
Nursing management for ARF
fluid volume deficit or excess, imbalanced nutrition, impaired skin integrity, risk for infection, anxiety
What kind of diet do you want for ARF?
High calorie, low protein
Older clients are at risk for ARF due to decreased what?
Chronic Renal failure
Progressive and irreversible reduction of functional renal tissue
Stage 5 of chronic renal failure is called what?
End stage renal disease
When kidneys can no longer maintain the body's internal environment
If ARF event happens and a pt does not recover what can happen?
#1 cause of CRF?
Diabetes (more than 30% of dialysis patients are diabetic
#2 cause of CRF?
ESRD involves deterioration of _________ with progressive loss of renal function.
Clincial manifestations of CRF
Electrolyte imbalance which includes weakness, diarhea, abd cramping, hyperkalemia, hypercalcemia, loss of blood pressure regulation, loss of erythropoietin
Types of dialysis
Peritoneal (continuous and automated), hemodialysis
maintain themselves at home, used for clients with severe cardiovascular disease
requires AV fistula, dialysis catheter, go to a facility to have done
Most common type of Peritoneal dialysis
Nursing management before dialysis
complete assessment, v/s, weight, assess the access site (listen for bruit on fistula), review lab results, check meds
What to do with meds for dialysis pt
hold 4 hours before give after
What med is given for BP drops in dialysis?
Nursing Management after dialysis
assessment, v/s, weight, assess access site, monitor for s/s of bleeding or infection, watch for signs of confusion, decreased level of consiousness, sudden severe headache, monitor lab results, administer meds
Why will dialysis get stopped?
Low BP, sudden severe headache, decreased level of consiousness
surgical implantation of human kidney from a compatible donor
Where is a transplanted kidney placed?
It is attached to the iliac artery
Nursing management for renal transplant?
Monitor for graft rejection, cardiopulmonary complications
S/S of graft rejection
fever, fatigue, tenderness at site, anemia, increased BUN