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acute renal failure
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Acute tubular necrosis is a type of acute renal failure that results primary from __________ and ___________
ischemia
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
tubules
Acute tubular necrosis from nephrotoxic injury is more likely to be reversible because the _________________ is usually not initially destroyed.
basement membrane
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?
prerenal
which type of renal failure is caused by mechanical outflow obstruction?
postrenal
Initial cause of most acute renal failure?
prerenal
renal failure caused by prostate cancer?
postrenal
Renal failure caused by prostate cancer?
postrenal
Renal failure caused by tubular obstruction by myoglobin?
intrarenal
Renal failure caused by hypovolemia?
prerenal
Renal failure caused by renal stones?
postrenal
Renal failure caused by nephrotoxic drugs?
intrarenal
Renal failure caused by bladder cancer?
postrenal
Renal failure caused by renal vascular obstruction?
prerenal
Renal failure caused by acute glomerulonephritis?
intrarenal
Renal failure caused by anaphylaxis?
prerenal
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.
prerenal
decrease
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?
ammonia synthesis
Metabolic acidosis occurs in ARF because the kidneys can not synthesize _________ needed to excrete H+, resulting in an increased _______
ammonia
acid load
A pt is with ARF is in the recovery phase when his BUN and serum creatinine levels?
decrease
The most common cause of death in ARF is ?
infection
Serum ________ and ________ are increased during catabolism of body protein.
potassium
urea
During the oliguric phase of ARF, daily fluid intake is limited to ______ ml plus the prior day's measurable fluid loss.
600
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 __________.
Daily wts
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
hemodialysis
peritoneal dialysis
Therapies to treat elevated K+ levels
regular insulin IV
sodium bicarbonate
calcium gluconate IV
dialysis
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 assessment
Clinical manifestations in urinary system for ARF
decreased urinary output
proteinuria
casts
decreased specific gravity
decreased osmolality
increased urinary sodium
Clinical manifestations in cardiovascular system for ARF
volume overload
heart failure
hypotension (early ARF)
hypertension
pericarditis
pericardial effusion
dysrhythmias
Clinical manifestations in respiratory system in ARF
pulmonary edema
Kussmaul respirations
pleural effusions
Clinical manifestations in GI system in ARF
nausea and vomiting
anorexia
stomatitis
bleeding
diarrhea
constipation
Clinical manifestations in hematologic system in ARF
anemia (w/in 48 hrs)
increased susceptibility to infection
leukocytosis
defect in platelet functioning
Clinical manifestations in neurologic system in ARF
lethargy
seizures
asterixis
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
Author
jean
ID
53577
Card Set
acute renal failure
Description
from study guide
Updated
2010-12-06T01:25:40Z
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