Learning Guide for Acute Renal Failure/Kidney Trauma CMJ and LC
1.
What are the functions of the kidney? Name at least 6:
2.
The kidney regulates acid-base balance of HCO3 and ___+. (name the ion).
Explain why metabolic acidosis develops in renal failure.
Why does Kussmaul breathing occur?
3.
Bonus question; what role do prostaglandins play in renal disease and
hypertension and why?
What category of drugs inhibit prostaglandin synthesis and thus may effect
renal function (even lead to renal failure)?
4.
Where is erythropoietin produced?
What effect does ARF have on erythropoietin production?
What lab values do you expect to be altered?
5.
Activated Vitamin D is necessary to absorb Calcium in GI tract. If a client has
ARF, what usual changes are seen in the client’s serum calcium level? Why does
this occur?
6.
(Review) Compare/contrast the following disease processes:
Lewis pp. 1166-1169; 1176-1177
Disorder
Acute Poststreptococcal
Glomerulonephritis
Rapidly progressive
Glomerulonephritis
Caused
by/Manifestation
Usual Treatment
Chronic Glomerulonephritis
Nephrotic Syndrome
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7. Vascular Disorders of the Kidneys: What percentage of the cardiac output do the
kidneys receive? ______. What is the pathophysiology of hypertension that leads
to renal failure?
Explain why blood pressure control is important in preventing renal failure.
Why is proteinuria seen in HTN?
8. What are several risk factors for renal vein stenosis/thrombosis?
What are some common manifestations/complications of renal vein
stenosis/thrombosis?
9.
Renal artery stenosis: What is the most common manifestations/complication of
renal artery stenosis?
10. Renal trauma: Why is the H&H important when there is renal trauma? What is
Turner’s sign?
Describe the usual management of renal trauma.
11. Renal surgery: Nephrectomy
Why is TCDB & use of incentive spirometry important post-op?
12. Define acute renal failure. What is acute tubular necrosis?
13. Complete the table to compare/contrast the various types of ARF:
Type
Pre-renal
Cause/Management of Acute Renal Failure
Caused by
Key Features
Intra-renal
Post-renal
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14. What lab test most accurately reflects renal function and how is it determined?
15. What is the normal serum phosphorus level?
level?
What is the normal serum calcium
Explain why these values are altered when a client has acute renal failure.
How are these alterations “managed”…include diet, medications?
16. Stages in ARF/Laboratory Studies/Priority Actions
Typical onset &
duration
Most critical lab
ARF Stages
results
Priority
management
Issues
Initiating Phase
Oliguric Phase
Diuretic Phase
Recovery Phase
17. How is fluid managed in acute renal failure once vascular volume and renal
perfusion has been restored. What formula is used to ensure that the client does
not become fluid overloaded (if fluid restriction the formula is 600ml + previous
24 hour fluid loss)
18. Why would a “fluid challenge” be used when a client is first discovered to have
acute renal failure (may be anuric or oliguric)?
Why would Dopamine be given IV and what effect would it have on the on the
kidneys?
19. What is Kayexalate and when would this be used?
20. Name some phosphate binders. When should phosphate binders be given and
why?
RNSG 2432  465
21. Why would Epogen/Procrit sc be ordered?
22. Why is a diet low in protein usually indicated for the client with renal failure?
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