Nursing Tips: Renal

Acute Kidney Injury (AKI) may have prerenal, intrarenal, or postrenal causes.

Acute Kidney Injury (AKI): Causes

Renal Medical-Surgical

Acute Kidney Injury (AKI) may have prerenal, intrarenal, or postrenal causes.

The oliguric phase of acute kidney injury (AKI) is marked by urine output less than 400 mL/day. In the diuresis phase of AKI, urine output can reach 4 - 5 L/day.

Acute Kidney Injury (AKI) : Oliguric Phase

Renal Med-Surg

The oliguric phase of acute kidney injury (AKI) is marked by urine output less than 400 mL/day. In the diuresis phase of AKI, urine output can reach 4 - 5 L/day.

Bethanechol

Renal Pharmacology

Bethanechol, used to treat non-obstructive urinary retention, stimulates cholinergic receptors

Spironolactone

Renal Pharmacology

Because spironolactone is a potassium-sparing diuretic, monitor the patient for signs of hyperkalemia. Educate patients to avoid salt substitutes, as most of these contain potassium.

Because oxybutynin is used to treat overactive bladder by inhibiting acetylcholine in the bladder, assess for anticholinergic symptoms. These include dry mouth, urinary retention, constipation, and blurred vision.

A patient undergoing hemodialysis may have an arteriovenous fistula in the arm. Educate patient that blood pressures, IVs, and blood draws must be done from the arm without the shunt.

Hemodialysis: Patient Teaching

Renal Med-Surg

A patient undergoing hemodialysis may have an arteriovenous fistula in the arm. Educate patient that blood pressures, IVs, and blood draws must be done from the arm without the shunt. Also educate patients not to sleep on the arm with the fistula, and perform hand exercises to mature a new fistula.

Acute Kidney Injury (AKI)

Renal Medical Terminology

A patient experiencing Acute Kidney Injury (AKI) will likely have hyperkalemia, hyponatremia, hypocalcemia, metabolic acidosis, anemia, and elevated creatinine and BUN.

A child demonstrating oliguria, cola-colored urine, and signs/symptoms of hypervolemia following a recent streptococcal infection (strep throat) should be evaluated for Acute Glomerulonephritis. Restrict fluids, sodium, and protein.

Acute Glomerulonephritis: Signs and Symptoms

Renal Pediatrics

A child demonstrating oliguria, cola-colored urine, and signs/symptoms of hypervolemia following a recent streptococcal infection (strep throat) should be evaluated for Acute Glomerulonephritis.

Urinary Tract Infection

Renal Med-Surg

With a Urinary Tract Infection (UTI), the urinanalysis may be positive for leukocyte esterase and nitrites.

Key labs with Glomerulonephritis: Serum: Positive antistreptolysin-O titer. Urinanalysis: hematuria, proteinuria. Throat culture: Positive for group A beta-hemolytic streptococcus

Glomerulonephritis Labs

Renal Med-Surg

Key labs with Glomerulonephritis: Serum: Positive antistreptolysin-O titer. Urinanalysis: hematuria, proteinuria. Throat culture: Positive for group A beta-hemolytic streptococcus