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Acute Renal Failure

Renal 2 Exam

syndrome characterized by rapid loss of renal function with progressive _________ Azotemia
Two main complications Metabolic acidosis and F/E imbalances
Follows severe prolonged _______, ________, reduced _______, obstruction. hypovolemia, hypotension, CO
Condition must be treated quickly to prevent permanent damage
serum creatinine is ______ 50% or greater above baseline
What are three categories of ARF? Prerenal, Intrarenal, Postrenal
Phase begins at time of insult and continues until s/s appear. Could be ____ to _____ Initiating, hours to days
Initiating phase ID by changes in _______ (Example). labs (creat >50% baseline)
Initiating phase begins when oliguria develops
Oliguria is when urine output is ____mL/day <400 mL/day
Phase begins when output <400 mL day Oliguric
Oliguric phase typically occurs within ________ days of insult 1-7
Urinary sym in oliguric phase UA shows RBC/WBC casts. Sp grav fixed at 1.010, Proteinuria.
Fluid Volume sym of oliguric phase May have fluid volume overload. JVD, edema, HTN, bounding pulses
Fluid volume excess can lead to HF, pericardial and/or pleural effusions
Metabolic acidosis in oliguric phase Kussmaul (rapid, deep), bicarb low, H+ excess, lethargic, stupor, may need dialysis
Sodium imbalance d/t Damaged tubules cant retain Na. Excreted in urine
Oliguric phase K excess K>6 Dysrhthmias, dialysis needed
Oliguric phase anemia develops within 48h
_________ induced platelet dysfunction Uremia
May give what IVPB for hemat. dysfunction Fe
Increased r/o infection in oliguric phase d/t altered WBC, immunodeficiency
Ca ____ and Phos _____ during oliguric phase decreases, increases
Best indicator for RF is ________. Obtain what for this? creatinine, 24h urine
Neuro changes in oliguric phase include; due to what? HA, fatigue, difficulty concentrating, seizures, stupor, coma; excess nitrous waste, uremia
The diuretic phase lasts ________ weeks 1-3
Lab values stabilize at what point of diuretic phase? end
May take how long for renal function to stabilize? 1-3 months. Some don't and develop CRF
Dx of ARF H&P, UA, Labs (BUN, creat, NA, K, Phos, Uric acid), XRay, US, Renal Scan, CT
Goals of ARF Tx Eliminate cause; manage s/s and prevent complications
Diuretics given for ARF Mannitol, lasix, edecrin
Treatment for ARF Strict I/O, daily wt, aseptic technique
How is hyperkalemia treated? Insulin 10 U IV/sodium bicarb to buffer, Kayexalate, dialysis
Nutrition for ARF Adequate calories to prevent catabolism, carbs and fats to prevent ketosis, K/Na regulated with plasma levels, Fat emulsive IV- Lipids, TPN PRN
How much fluid loss in diuretic phase? 1-5 mL/day
What happens during recovery phase? GFR increases, labs return to normal
What does Kayexalate do? Reduces K levels
Created by: mreedy