AKI-PrepU

A creatinine level above ____ is concerning for AKI?

1.3

an older adult client diagnosed with cancer is admitted to the oncology unity for surgical treatment. the client has been on chemotherapeutic agents to decrease tumor size prior to the planned surgery. the nurse caring for the client is aware that what precipitating factors in this client may contribute to AKI? SATA anxiety and agitation low BMI age-related physiologic changes chronic systemic disease NPO status

age-related physiologic changes, chronic systemic disease, NPO status

a client is admitted to the hospital with a prerenal disorder, a non-urologic condition that disrupts renal blood flow to the nephrons, affecting their filtering ability. one cause of prerenal acute kidney injury is: myoglobinuria anaphylaxis polycistic disease ureteral stricture

anaphylaxis

The nurse is caring for a client whose AKI resulted from a prerenal cause. Which condition most likely caused this client's health problem? glomerulonephritis pregnancy calculi burns

burns (hypovolemic shock)

a client develops acute renal failure after receiving IV therapy with a nephrotoxic antibiotic. because the client's 24-hour UO totals 240mL, the nurse suspects that the client is at risk for: dehydration paresthesia pruritus cardiac dysrhythmias

cardiac dysrhythmias (due to hyperkalemia)

The nurse cares for a client after extensive abdominal surgery. the client develops an infection that is treated with IV gentamicin. after 4 days of treatment, the client develops oliguria, and laboratory results indiciate azotemia. the cient is diagnosed with acute tubular necrosis and transferred to the ICU. the client is hemodynamically stable. which dialysis method would be most appropriate for the client? CRRT CAVH hemodialysis CVVH

hemodialysis (because the patient is hemodynamically STABLE)

based on the pathophysiologic changes that occur as renal failure progresses, the nurse identifies the following indicators associated with the disease. SATA hyperkalemia metabolic alkalosis anemia hyperalbuminemia hypocalcemia

hyperkalemia, anemia, and hypocalcemia

acute dialysis is indicated during which situation? dehydration impending pulmonary edema hypokalemia metabolic alkalosis

impending pulmonary edema (or hyperkalemia, fluid overload, or metabolic acidosis)

a client with acute renal failure progresses through four phases. which describes the onset phase? accompanied y reduced blood flow to the nephrons fluid volume excess develops normal glomerular filtration and tubular function are restored excretion of wastes and electrolytes continues to be impaired despite increased water content of the urine

it is accompanied by reduced blood flow to the nephrons (KINGS OF THE KIDNEYS ARE THE NEPHRONS)

a client is scheduled for a CT scan of the abdomen with contrast. the client has a baseline cr level of 2.3 in preparing this client for the procedure, the nurse anticipates what orders? obtain a cr clearance by collecting a 24-hour urine specimen provide adequate hydration before the procedure monitor client's electrolytes every hour pre-procedure

provide adequate hydration before the procedure

a patient has been diagnosed with postrenal failure. the nurse reviews the patient's electronic health record and notes a possible cause. which of the following is the possible cause? hypovolemia renal calculi recent CT with contrast

renal calculi

Which of the following would a nurse classify as a prerenal cause of acute renal failure? ureteral stricture polycystic disease prostatic hypertrophy septic shock

septic shock

what is the most sensitive indicator of renal function?

serum creatinine

a client is admitted to the ICU after a motor vehicle accident. on the second day of the hospital admission, the client develops acute kidney injury. the client is hemodynamically unstable, and renal replacement is needed to manage the client's hypervolemia and hyperkalemia. which of the following therapies will the client's hemodynamic status best tolerate? continuous venovenous hemodialysis hemodialysis peritoneal dialysis plasmaphoresis

continuous venovenous hemodialysis (CVVHD)

the nurse passes out medications while a client prepares for hemodialysis. the client is ordered to receive numerous medications including anti-hypertensives. what is the best action for the nurse to take? hold the medications until after dialysis check with the dialysis nurse about the medications administer the medications call the pharmacy to get a change on the medication

hold the medications until after dialysis (dialysis has a complication of hypotension)

a patient undergoing a CT scan with contrast has a baseline creatinine level of 3, identifying this patient as a high risk for developing kidney failure. what is the most effective intervention to reduce the risk of developing radiocontrast-induced nephropathy (CIN)? performing the test without contrast administration of acetylcysteine administration of sodium bicarbonate hydrating with saline intravenously before the test

hydrating with saline intravenously before the test (you could also administer mucomyst to decrease nephrotoxicity from the contrast)

the nurse is caring for a client's status after a motor vehicle accident. te lcient has developed AKI. what are the nurse's roles in caring for this client? SATA providing emotional support for the family monitoring for complications participating in emergency treatment of fluid and electrolyte imbalances providing nursing care for primary disorder (trauma) directing nutritional interventions

providing emotional support for the family, monitoring for complications, participating in emergency treatment of fluid and electrolyte imbalances, and providing nursing care for primary disorder

The nurse is caring for a patient that has developed oliguria. oliguria is defined as urine output less than ____mL/kg/hr

0.5

The nurse is caring for an acutely ill client. what assessment finding should prompt the nurse to inform the health care provider that the client may be exhibiting signs of AKI? acute flank pain inability to void/and or urine hesitancy visible sediment/cloudy urine average urine output has been 10mL/hr for several hours

average urine output has been 10mL/hr for several hours (this would mean oliguria)

a client requires hemodialysis. which type of drug should be withheld before this procedure? antibiotics insulin cardiac glycosides phosphate binders

cardiac glycosides (such as digoxin)

patient education regarding a fistulae or graft includes which of the following? SATA check daily for thrill and bruit avoid compression of the site no IV or BP taken on extremity with dialysis access no tight clothing cleanse site b.i.d.

check daily for thrill and bruit, avoid compression of the site, no IV or BP taken on extremity with dialysis access, no tight clothing

the nurse monitors the client for potential complications during dialysis but recognizes NOT to monitor for? muscle cramping dysrhythmias hypertension air embolism

hypertension

a client with decreased urine output refractory to fluid challenges is evaluated for renal failure. which condition may cause the intrinsic (intrarenal) form of acute renal failure? poor perfusion to kidneys damage to epithelial cells of the renal tubules obstruction of the urinary collecting system nephrotoxic injury secondary to use of contrast media

nephrotoxic injury secondary to use of contrast media

a client is experiencing a decreasing glomerular filtration. what laboratory values should the nurse expect to follow the change? SATA serum creatinine increases blood urea nitrogen (BUN) increases creatinine clearance decreases hypokalemia hypophosphatemia

serum creatinine increases, BUN increases, and creatinine clearance decreases (it would be hyperkalemia not hypokalemia, and hyperphosphatemia not hypophosphatemia)