Learning Guide for Acute Kidney Injury/Vascular/Trauma
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.
What role do prostaglandins play in renal disease/hypertension? Why?
What category of drugs inhibit prostaglandin synthesis (have anti-inflammatory effect) and thus may
effect renal function (even lead to renal failure)?
Why are ACE Inhibitors sometimes contraindicated in renal failure?
4.
Where is erythropoietin produced? What effect does AKI have on erythropoietin production?
Why would Epogen/Procrit sc be ordered? (p.) *Note-use generally for CKD.
What lab values (include all) do you expect to be altered?
5.
(Review) Key features of these disease processes:
Lewis(p. )
Disorder
Due to/Manifestation/Treatment
Acute Poststreptococcal
Glomerulonephritis
Goodpasture Syndrome
Chronic Glomerulonephritis
Nephrotic Syndrome
6.
What percentage of the cardiac output do the kidneys receive? ________
7.
What are several risk factors for renal vein thrombosis (occlusion?
8.
What is the most common manifestations/complication of renal artery stenosis?
9.
Why is the H&H important when there is renal trauma?
Describe the usual management of renal trauma.
10.
Renal surgery: What is the urinary output be if client has a bilateral nephrectomy?
Why is TCDB & use of incentive spirometry important post-op
11.
Define acute renal failure. What is acute tubular necrosis?
Explain (briefly) the RIFLE classification for ARI.
12.
Complete the table-compare/contrast the various causes ARF: p.; Tab 47-1
Cause/Management of Acute Renal Failure
Type
Causes (name several)
Key Features-Mgt
Pre-renal
Intra-renal
Post-renal
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13.
What lab test most accurately reflects renal function and how are they determined? (Include both
serum and urine based. )
What lab test (inc urine) are important when evaluating renal function when a patient has AKI- and
why?
What is the normal serum phosphorus level? What is the normal serum calcium level?
Explain why these values are altered when a client has acute renal failure (See CKD).
14.
Summarize in ARF/Laboratory Studies/Priority Actions (Lewis p. ) *Include BUN, serum creatinine
clearance; “Fluid management)
Typical onset &
Priority management
ARF Stages
duration
Critical lab results
Issues
Oliguric Phase
Diuretic Phase
Recovery Phase
15. How is fluid managed in acute renal failure once vascular volume and renal perfusion has been
restored (after fluid challenge)- What formula is used to ensure that the client does not become fluid
overloaded?
16.
Why would a “fluid challenge” be used when a client is first discovered to have acute renal failure
(may be anuric or oliguric)? (To discover this answer, read text, p. and notes;& exact wording of “fluid
challenge” is not used)
17.
What is Kayexalate and when would this be used? Why is sodium bicarbonate used in AKI? What are
indications for use of regular insulin and glucose IV:
18. In what situations should renal replacement be indicated for AKI?
20. Identify medications/drugs that are known to be nephrotoxic.
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