Concept Map Acute Renal Failure PDF

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Mae Lapid C42 T3 Clinical

Concept Map: Acute Renal Failure Medical Diagnosis/Pathophysiology: -Acute kidney failure occurs when your kidneys suddenly become unable to filter waste products from your blood. When your kidneys lose their filtering ability, dangerous levels of wastes may accumulate, and your blood's chemical makeup may get out of balance. Signs and Symptoms: -Decreased urine output, fluid Retention, shortness of breath, fatigue, confusion, nausea, weakness, irregular heartbeat Nursing Diagnosis: -Excesses fluid volume related renal failure as evidence by d ecreased Hb/hematocrit (Hct),

altered electrolytes; pulmonary congestion on x-ray Goals: -Improve nutritional intake. Restore fluid balance. Reduce metabolic rate. Nursing Interventions: -Assess level of consciousness. Investigate changes in mentation, presence of restlessness; May reflect fluid shifts, accumulation of toxins, acidosis, electrolyte imbalances, or developing hypoxia. // Monitor heart rate (HR), BP, and JVD/CV; Tachycardia and hypertension can occur because of: (1) failure of the kidneys to excrete urine, (2) excess fluid resuscitation // Accurately record intake and output (I/O) noting to include “hidden” fluids such as IV antibiotic additives, liquid medications, frozen treats, ice chips. Religiously measure gastrointestinal losses and estimate insensible losses (sweating), including wound drainage, nasogastric outputs, and diarrhea. Diagnostic Tests & Labs: -Urinalysis- may reveal abnormalities that suggest kidney failure. Blood tests- a sample of your blood may reveal rapidly rising levels of urea and creatinine — two substances used to measure kidney function. Urea/Creatinine, Serum Sodium, Serum potassium. Evaluation: -Goals will be met by limiting foods that are high in potassium, Limit milk and dairy products to 8 oz per day, Choose fresh fruits and vegetables, Avoid salt substitutes and Fluid Therapy. Complications: - Fluid buildup. Acute kidney failure may lead to a buildup of fluid in your lungs, which can cause shortness of breath, chest pain, muscle weakness, permanent kidney damage, death. Medications: -Diuretics: furosemide (Lasix), bumetanide (Bumex), torsemide (Demadex), mannitol (Osmitrol) > Given early in oliguric phase of ARF in an effort to convert to non-oliguric phase, flush the tubular lumen of debris, reduce hyperkalemia, and promote adequate urine volume.

Mae Lapid C42 T3 Clinical -Antihypertensives: clonidine (Catapres), methyldopa (Aldomet), prazosin (Minipress). > May be given to treat hypertension by counteracting effects of decreased renal blood flow and/or circulating volume overload. Calcium channel blockers. > Given early in nephrotoxic ATN to reduce influx of calcium into kidney cells, thereby helping to maintain cell integrity and improve GFR. Prostaglandins. Vasodilatory effect may improve circulating volume and reestablish renal blood flow to aid in clearing nephrotoxic agents from nephrons....