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NUR310: Unit 4 - Elimination, Iggy AKI
Terms in this set (42)
Normal reference range for serum creatinine (each gender).
Serum creatinine in AKI every 24-48 hr and what it may do in 1 wk or less.
Males: 0.6-1.2 mg/dL
Females: 0.5-1.1 mg/dL
(May be decreased in older adults).
Increase of 1-2 mg/dL every 24-48 hr
May increase 1-6 mg/dL in 1 wk or less.
Normal reference range for blood urea nitrogen.
BUN in AKI and what it may reach within 1 wk.
(May be slightly increased in older adults).
Often increases by 10-20 mg/dL at the same pace as serum creatinine level. May reach 80/100 mg/dL within 1 wk.
Serum sodium expected values to see in AKI/CKD.
normal, increased, or decreased.
Serum potassium expected values to see in AKI/CKD.
Serum phosphorus expected values to see in AKI/CKD.
Serum calcium expected values to see in AKI/CKD
Serum magnesium expected values to see in AKI/CKD
Serum bicarbonate reference range and expected range in AKI/CKD
Arterial blood pH, expected to see in AKI/CKD
decreased ( in metabolic acidosis) or normal
Arterial blood bicarbonate reference range in expectation in AKI/CKD
arterial blood PaCO2 reference range, expectation in AKI/CKD
AKI caused by reduced perfusion is classed as ___.
Damage to kidney tissue is classed as ___ or __ and reflects injury to the glomeruli, nephrons, or tubules.
intrarenal/intrinisic renal failure
Obstruction of urine flow is called ___
When AKI occurs in patients who already have CKD, it is called ___.
acute-on-chronic kidney disease
With __ or __ pathology, the kidney compensates by the three responses of constriction kidney blood vessels, activating the renin-angiotensin-aldosterone pathway, and releasing ADH. These responses increase blood flow and improve kidney perfusion but also cause __ and ___.
prerenal or postrenal
Oliguria is classified as less than __ ml/day.
The retention and buildup of nitrogenous wastes in the blood is termed ___.
It is important to immediately report to the HCP a urine output of less than ___ mL/kg/hr that persists for more than __ hours. Waiting for 6 hours of oliguria to meet RIFLE criteria may promote kidney damage. Don't do this.
0.5 mL/kg/hr; 2 hours
As AKI progresses in severity, the patient may have manifestations of ___ (because in AKI, fluid is not eliminated)
Which test is useful in diagnosis of kidney and urinary tract obstructions?
ultrasonography, can show kidney size and patency of ureters
Which test is useful for determining adequacy of kidney blood flow and identifying obstructions or tumors? What should be avoided with this test due to potential for causing further kidney damage?
CT scans without contrast; contrast
Enlarged kidneys on an x-ray with obstruction may show ___
What test is performed if the cause of AKI is uncertain and manifestations persist or an immunologic disease is suspected?
Current guidelines suggest that a mean arterial pressure (MAP) of ___ be maintained to promote kidney perfusion.
65 mm Hg
The patient in the diuretic phase of AKI needs a plan of care that focuses on ___ and monitoring.
fluid and electrolyte replacement
Onset of ___ can be the start of recovery from AKI.
What type of drugs may be used to increase urine output in AKI?
diuretic-induced urine output does not preserve kidney function or stop AKI, but diuretics do rid body of retained fluid and electrolytes in patient with AKI that has not progressed to ESKD.
In patients without fluid overload, 500 to 1000 mL of ___ may be infused over 1 hr.
What type of drugs may be used to treat AKI resulting from nephrotoxins?
calcium channel blockers; these drugs prevent movement of calcium into kidney cells, maintain kidney cell integrity, and improve kidney blood flow.
If calcium channel blockers do not improve __ as estimated by serum creatinine, they are stopped.
The rate of protein breakdown correlates with the severity of __ and __.
uremia and azotemia
For the patient who does not require dialysis, __ g/kg of bodyweight or __ g/day of protein is usually prescribed.
For the patients who do require dialysis, the protein level needed will range from __ to __ g/kg. The amount of dietary sodium ranges from __) to __ mEq/kg. If high potassium levels are present, dietary potassium is restricted to __ to __ mEq/kg.
1 to 1.5 g/kg
60 to 90 mEq/kg
60 to 70 mEq/kg
The daily amount of fluid permitted is calculated to be equal to the urine volume plus ___.
As a rule, specialty tube feedings for kidney patients are lower in __, __, and __ and higher in __ than are standard feedings.
sodium, potassium, and phosphorus;
In uremic patients, __ are used in place of glucose to avoid problems of excessive sugars.
What is the onset of AKI?
sudden (hours to days)
% of nephron involvement in AKI
Causes of AKI that include bladder cancer, prostate cancer, and kidney stones is which type of AKI?
Causes of AKI that include systemic infection, drugs, and local infection is which type of AKI?
Causes of AKI that include blood/fluid loss, hypotension, and MI are which type of AKI?
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