Renal 2 Exam
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| syndrome characterized by rapid loss of renal function with progressive _________ | Azotemia
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| Two main complications | Metabolic acidosis and F/E imbalances
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| Follows severe prolonged _______, ________, reduced _______, obstruction. | hypovolemia, hypotension, CO
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| Condition must be treated quickly to prevent | permanent damage
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| serum creatinine is ______ | 50% or greater above baseline
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| What are three categories of ARF? | Prerenal, Intrarenal, Postrenal
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| Phase begins at time of insult and continues until s/s appear. Could be ____ to _____ | Initiating, hours to days
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| Initiating phase ID by changes in _______ (Example). | labs (creat >50% baseline)
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| Initiating phase begins when | oliguria develops
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| Oliguria is when urine output is ____mL/day | <400 mL/day
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| Phase begins when output <400 mL day | Oliguric
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| Oliguric phase typically occurs within ________ days of insult | 1-7
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| Urinary sym in oliguric phase | UA shows RBC/WBC casts. Sp grav fixed at 1.010, Proteinuria.
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| Fluid Volume sym of oliguric phase | May have fluid volume overload. JVD, edema, HTN, bounding pulses
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| Fluid volume excess can lead to | HF, pericardial and/or pleural effusions
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| Metabolic acidosis in oliguric phase | Kussmaul (rapid, deep), bicarb low, H+ excess, lethargic, stupor, may need dialysis
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| Sodium imbalance d/t | Damaged tubules cant retain Na. Excreted in urine
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| Oliguric phase K excess | K>6 Dysrhthmias, dialysis needed
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| Oliguric phase anemia develops within | 48h
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| _________ induced platelet dysfunction | Uremia
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| May give what IVPB for hemat. dysfunction | Fe
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| Increased r/o infection in oliguric phase d/t | altered WBC, immunodeficiency
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| Ca ____ and Phos _____ during oliguric phase | decreases, increases
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| Best indicator for RF is ________. Obtain what for this? | creatinine, 24h urine
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| Neuro changes in oliguric phase include; due to what? | HA, fatigue, difficulty concentrating, seizures, stupor, coma; excess nitrous waste, uremia
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| The diuretic phase lasts ________ weeks | 1-3
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| Lab values stabilize at what point of diuretic phase? | end
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| May take how long for renal function to stabilize? | 1-3 months. Some don't and develop CRF
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| Dx of ARF | H&P, UA, Labs (BUN, creat, NA, K, Phos, Uric acid), XRay, US, Renal Scan, CT
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| Goals of ARF Tx | Eliminate cause; manage s/s and prevent complications
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| Diuretics given for ARF | Mannitol, lasix, edecrin
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| Treatment for ARF | Strict I/O, daily wt, aseptic technique
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| How is hyperkalemia treated? | Insulin 10 U IV/sodium bicarb to buffer, Kayexalate, dialysis
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| 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
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| How much fluid loss in diuretic phase? | 1-5 mL/day
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| What happens during recovery phase? | GFR increases, labs return to normal
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| What does Kayexalate do? | Reduces K levels
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