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1、RenalFailure AcuteandChronicNPN200MedicalSurgicalNursingIAcuteRenalFailureSuddeninterruptionofkidneyfunctionresultingfromobstruction,reducedcirculation,ordiseaseoftherenaltissueResultsinretentionoftoxins,fluids,andendproductsofmetabolismUsuallyreversiblewithmedicaltreatmentMayprogresstoendstageren
2、aldisease,uremicsyndrome,anddeathwithouttreatmentAcuteRenalFailurePersonsatRisksMajorsurgeryMajortraumaReceivingnephrotoxicmedicationsElderlyAcuteRenalFailureCausesPrerenalHypovolemia,shock,bloodloss,embolism,poolingoffluidd/tascitesorburns,cardiovasculardisorders,sepsisIntrarenalNephrotoxicagents
3、,infections,ischemiaandblockages,polycystickidneydiseasePostrenalStones,bloodclots,BPH,urethraledemafrominvasiveproceduresAcuteRenalFailureStagesOnset–1-3dayswith^BUNandcreatinineandpossibledecreasedUOPOliguric–UOP<400/d,^BUN,Crest,Phos,K,maylastupto14dDiuretic–UOP^toasmuchas4000mL/dbutnowasteprod
4、ucts,atendofthisstagemaybegintoseeimprovementRecovery–thingsgobacktonormalormayremaininsufficientandbecomechronicAcuteRenalFailureSubjectivesymptomsNauseaLossofappetiteHeadacheLethargyTinglinginextremitiesAcuteRenalFailureObjectivesymptomsOliguricphase–vomitingdisorientation,edema,^K+decreaseNa^BU
5、NandcreatinineAcidosisuremicbreathCHFandpulmonaryedemahypertensioncausedbyhypovolemia,anorexiasuddendropinUOPconvulsions,comachangesinbowelsAcuteRenalFailureObjectivesystomsDiureticphaseIncreasedUOPGradualdeclineinBUNandcreatinineHypokalemiaHyponaturmiaTachycardiaImprovedLOCAcuteRenalFailureDiagno
6、stictestsH&PBUN,creatinine,sodium,potassium.pH,bicarb.HgbandHctUrinestudiesUSofkidneysKUBABDandrenalCT/MRIRetrogradepyloegramAcuteRenalFailureMedicaltreatmentFluidanddietaryrestrictionsMaintainE-lytesD/CorchangecauseMayneeddialysistojumpstartrenalfunctionMayneedtostimulateproductionofurinewithIVfl
7、uids,Dopomine,diuretics,etc.AcuteRenalFailureMedicaltreatmentHemodialysisSubclavianapproachFemoralapproachPeritonealdialysisContinousrenalreplacementtherapy(CRRT)CanbedonecontinuouslyDoesnotrequiredialysateAcuteR
