acute renal failure
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Acute tubular necrosis is a type of acute renal failure that results primary from __________ and ___________
- nephrotoxic injury
Renal ischemia leads to acute tubular necrosis by disrupting the _____________ and causing patchy destruction of the ____________.
- basement membrane
- tubular epithelium
nephrotoxic agents cause necrosis of the _____________________ that sloughs off and blocks the
- tubular epithelium cells
Acute tubular necrosis from nephrotoxic injury is more likely to be reversible because the _________________ is usually not initially destroyed.
There is no correlation between the amount of ______ ________ and the extent of ______ _______.
- urine produced
- renal failure
Which type of renal failure is caused by decreased cardiac output?
which type of renal failure is caused by mechanical outflow obstruction?
Initial cause of most acute renal failure?
renal failure caused by prostate cancer?
Renal failure caused by prostate cancer?
Renal failure caused by tubular obstruction by myoglobin?
Renal failure caused by hypovolemia?
Renal failure caused by renal stones?
Renal failure caused by nephrotoxic drugs?
Renal failure caused by bladder cancer?
Renal failure caused by renal vascular obstruction?
Renal failure caused by acute glomerulonephritis?
Renal failure caused by anaphylaxis?
The nurse determines that a pt w/oliguria has rerenal oliguria when
reversal of the oliguria occurs with fluid replacement
In ________ oliguria, the oliguria is caused by a _________ in circulating blood volume and there is no damage yet.
Tubular damage is indicated in the pt w/acute renal failure by a UA finding of ?
specific gravity at 1.010
Metabolic acidosis occurs in the oliguric phase of acute renal failure as a result of impaired?
Metabolic acidosis occurs in ARF because the kidneys can not synthesize _________ needed to excrete H+, resulting in an increased _______
A pt is with ARF is in the recovery phase when his BUN and serum creatinine levels?
The most common cause of death in ARF is ?
Serum ________ and ________ are increased during catabolism of body protein.
During the oliguric phase of ARF, daily fluid intake is limited to ______ ml plus the prior day's measurable fluid loss.
Dietary sodium and potassium during the oliguric phase of ARF are managed according to the pt's _____ and ______ levels.
serum sodium and potassium levels
One of the most important nursing measures in managing fluid balance in the pt in ARF is taking __________.
The most common indications for dialysis in ARF include (6)
- volume overload
- elevated potassium level
- metabolic acidosis
- BUN level >120
- significant change in menatal status
- pericarditis, pericardial effusion, or cardiac tamponade
Two options available for dialysis in ARF
- peritoneal dialysis
Therapies to treat elevated K+ levels
- regular insulin IV
- sodium bicarbonate
- calcium gluconate IV
- Sodium polystyrene sulfonate-(Kayexalate)
- Dietary Restriction
Nutritional therapy for ARF
- adequate protein intake
- potassium restriction
- phosphate restriction
- sodium restriction
What should never be given to a pt with a paralytic ileus? Why?
- sodium polystyrene sulfonate
- bowel necrosis can occur
What is the most important guide in determining the need for dialysis?
Clinical manifestations in urinary system for ARF
- decreased urinary output
- decreased specific gravity
- decreased osmolality
- increased urinary sodium
Clinical manifestations in cardiovascular system for ARF
- volume overload
- heart failure
- hypotension (early ARF)
- pericardial effusion
Clinical manifestations in respiratory system in ARF
- pulmonary edema
- Kussmaul respirations
- pleural effusions
Clinical manifestations in GI system in ARF
- nausea and vomiting
Clinical manifestations in hematologic system in ARF
- anemia (w/in 48 hrs)
- increased susceptibility to infection
- defect in platelet functioning
Clinical manifestations in neurologic system in ARF
- memory impairment
Clinical manifestations in metabolic system in ARF
- increased BUN
- increased Creatinine
- decreased sodium
- increased potassium
- decreased pH
- decreased bicarb
- decreased calcium
- increased phosphate
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