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rapid. reversible decline of renal function
acute renal failure
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What is the onset of acute renal failure
Rapid
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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
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When does renal ischemia occur
- when there is a prononuced drop in the systemic BP
- cardiac damage
- Shock
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decreased blood flow to the kineys from damage to the basement membranes of the nephron tubules
bilateral renal ischemia
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Failure of the cardiovascular system to meet tissue needs results in diminished blood flow to kidneys
shock
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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
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what happens to the excreation of the urine if the BP decreases as with shock
decreases as well
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intrarenal damage from toxic substances
nephrotoxic injury
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nephrotoxins usually damage what
basement membrane of tubular epithelium
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What are some examples of nephrotoxins
- solvents-carbon tetrachloride
- heavy metals- lead, arsenic
- pesticides
- antibiotics
- analgesics-asprin & acetaminophen
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If you are on a nephrotoxin what should you do
Increase fluid intake
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What are things that can cause urinary obstruction
- renal calculi
- blood clots
- tumors
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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
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what causes hyperkalemia in acute renal failure
elevated potassium
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what is olguria
- reduction in urine
- less than 500ml/24 hours
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what is anuria
failure of kidneys to produce urine
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what causes neruological changes in acute renal failure
accumulation of nitrogenous waste
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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
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What is the earliest manifestation of tubular damage and the inability of the tubules to concentrate urine
decreased specific gravity
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What are the complications of acute renal failure
- complete kidney failure
- death
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What is the treatment for acute renal failure
- identify and correct cause
- decrease fluids, monitor intake and output
- dialysis-1-2 weeks
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What is the prognosis for acute renal failure
- good if treated promptly, reversible
- fatal if severe damage, infection, or other complication present
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Is fluid intake treatment increased or decreased and why
decreased to reduce strain on the kidneys
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