Acute Renal Failure
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Notes on Acute Renal Failure - Nursing |, Study notes of Nursing
Material Type: Notes; Class: Nursing; Subject: Nursing; University: Morehead State University; Term: Forever 1989;
Typology: Study notes
Pre 2010
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Acute Renal Failure
Acute vs. Chronic
- (^) ARF
- (^) Onset
- (^) sudden
- (^) Nephron involvement
- (^) 50%
- (^) Duration
- (^) less than 3 months
- (^) Prognosis
- (^) Good
- (^) CRF
- (^) Onset
- (^) Gradual (months-years)
- (^) Nephron involvement
- (^) 90%-95%
- (^) Duration
- (^) Permanent
- (^) Prognosis
- (^) Fatal without renal replacement therapy
- (^) Good
Renal Insufficiency
- (^) enough function to survive but with significant
loss of function
- (^) 25% of normal function
- (^) GFR of 25-30 ml/min
- (^) any additional stressor can lead to failure
ARF
- (^) Causes (Iggy p 1730,Table 75-2)
- (^) Prerenal: perfusion
- (^) intrarenal (intrinsic): damage to kidney (toxins/infection)
- (^) post renal: obstruction
OLIGURIC
- (^) Potassium Imbalance
- (^) hyperkalemia with oliguric phase
- (^) arrhythmias, death, paresthesias, paralysis
- (^) Sodium Imbalance
- (^) hyponatremia with fluid overload
- (^) warm moist flushed skin, muscle weakness, muscle twitching, mental status changes, seizure
- (^) hypernatremia
- (^) with too much sodium intake
- (^) hyponatremia with fluid overload
OLIGURIC
- (^) Metabolic Acidosis
- (^) H+ secretion & HCO3 production decrease in tubules
- (^) Kussmauls respirations
- (^) respiratory system compensates
CLINICAL MANIFESTATIONS
- (^) CHART
- (^) Laboratory Profile
- (^) Chart
- (^) Radiographic
- (^) X-ray of abdomen-size of kidney
- (^) Renal ultrasound: renal calculi
- (^) CT: obstruction/tumors
- (^) Aortorneal angiography: renal blood flow
Medication Therapy
- (^) determine cause - treat underlying factors
- (^) Prerenal azotemia
- (^) hypovolemia
- (^) hypotonic solutions (.45% NS) or NS
- (^) Diuretics
- (^) blood loss - transfuse/NS
- (^) hyperkalemia
- (^) dialysis, Kaexylate, loop diuretics
- (^) inflammation: glucocorticoids
Dialysis
- (^) Blood is filtered through a semi permeable
membrane
- (^) helps correct
- (^) fluid overload
- (^) azotemia
- (^) hyperkalemia
- (^) metabolic acidosis
- (^) remove certain toxins
Continuous Renal Replacement Therapy
- (^) continuous UF of ECF
and clearance of toxins
- (^) done in ICU
- (^) CVVHD
Activity
- (^) severe activity intolerance
- (^) anemia
- (^) acidosis
- (^) plenty of rest
Referrals
- (^) Dietician
- (^) National Kidney Foundation
Renal Disorders
Nephrosclerosis
- (^) damage to renal arteries, arterioles, glomeruli
- (^) caused by HTN, atherosclerosis, DM
- (^) Benign
- renal arteries - lumen - thick/narrow
- (^) glomeruli capillaries - sclerosed/collapse
- atrophy of renal tubules
- (^) symptoms: mild, proteinuria, casts, renal insufficiency, increased risk for ARF