Chapter 21, urinary, acute renal failure

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tville01
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155517
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Chapter 21, urinary, acute renal failure
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2012-05-25 06:43:56
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Chapter 21 urinary acute renal failure
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Chapter 21, urinary, acute renal failure
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  1. rapid. reversible decline of renal function
    acute renal failure
  2. What is the onset of acute renal failure
    Rapid
  3. What are the causes of acute renal failure
    • bilateral renal ischemia-shock
    • Nephrotoxic injury-antibiotics
    • urinary obstruction-renal calculi
    • acute bilateral kidney infection/inflammation-pyelonephritis
  4. When does renal ischemia occur
    • when there is a prononuced drop in the systemic BP
    • cardiac damage
    • Shock
  5. decreased blood flow to the kineys from damage to the basement membranes of the nephron tubules
    bilateral renal ischemia
  6. Failure of the cardiovascular system to meet tissue needs results in diminished blood flow to kidneys
    shock
  7. Name the examples given of shock
    • hypovolemic-hemmorhage or fluid loss
    • surgical- after surgeries or trauma
    • shock- after blood transfusion
    • burn shock-damged RBC release hemoglobin, accumulates in tubules, it's toxic to tubule epithelium
    • causes necrosis & inflammation
  8. what happens to the excreation of the urine if the BP decreases as with shock
    decreases as well
  9. intrarenal damage from toxic substances
    nephrotoxic injury
  10. nephrotoxins usually damage what
    basement membrane of tubular epithelium
  11. What are some examples of nephrotoxins
    • solvents-carbon tetrachloride
    • heavy metals- lead, arsenic
    • pesticides
    • antibiotics
    • analgesics-asprin & acetaminophen
  12. If you are on a nephrotoxin what should you do
    Increase fluid intake
  13. What are things that can cause urinary obstruction
    • renal calculi
    • blood clots
    • tumors
  14. What are the signs of acute renal failure
    • elevated BUN and serum creatine
    • olguria
    • anuria
    • hyperkalemia-muscle weakness, can cause cardiac arrest
    • gastrointestinal disturbances-nausea,vomiting,diarrhea
    • neurological changes-headache,drowsy,CNS depression,coma
  15. what causes hyperkalemia in acute renal failure
    elevated potassium
  16. what is olguria
    • reduction in urine
    • less than 500ml/24 hours
  17. what is anuria
    failure of kidneys to produce urine
  18. what causes neruological changes in acute renal failure
    accumulation of nitrogenous waste
  19. What are the diagnostic test for acute renal failure
    • Urinalysis-elevated proteins, glucose, leukocytes, casts
    • decreased specific gravity
    • elevated BUN and serum creatine
    • electrolytes-elevated potassium
    • KUB or IVP
  20. What is the earliest manifestation of tubular damage and the inability of the tubules to concentrate urine
    decreased specific gravity
  21. What are the complications of acute renal failure
    • complete kidney failure
    • death
  22. What is the treatment for acute renal failure
    • identify and correct cause
    • decrease fluids, monitor intake and output
    • dialysis-1-2 weeks
  23. What is the prognosis for acute renal failure
    • good if treated promptly, reversible
    • fatal if severe damage, infection, or other complication present
  24. Is fluid intake treatment increased or decreased and why
    decreased to reduce strain on the kidneys

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