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Acute Renal Failure
Renal 2 Exam
| Question | Answer |
|---|---|
| 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
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