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Acute Kidney Injury

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Acute Kidney Injury
Acute Kidney Injury (Paper #6)
Tracy Gilbert
ITT Earth city

Acute Kidney Injury (Paper #6)
“Acute kidney injury (AKI) describes the spectrum of acute-onset kidney failure that can occur with critical illness; it replaces the traditional term acute renal failure (ARF) and acute tubular necrosis (ATN).” (Urden, Stacy, & Lough, 2012, p. 400). “In renal failure, acute or chronic, one most commonly sees patients who have a tendency to develop hypervolemia, hyperkalemia, hyperphosphatemia, hypocalcemia, and bicarbonate deficiency (metabolic acidosis). Sodium is generally retained, but may appear normal, or hyponatremic, because of dilution from fluid retention.” (Chambers, 1987, p. 815). “Because the kidneys are primarily responsible for the regulation of fluid and electrolyte balance, acute or chronic changes in renal function can result in multiple imbalances. Acutely, the rapidity of onset of renal deterioration makes nursing assessment and intervention critical to the prevention of complications and potentially fatal outcomes.” (Chambers, 1987, p. 815).
Assessment
Once AKI is suspected the assessment of laboratory values is very important. Serum electrolyte values become increasingly elevated as AKI develops (Urden et al., 2012). Some of the electrolytes to assess are: potassium, sodium, calcium, and magnesium. The important test to run for the assessment of electrolytes and other laboratory values are: urinalysis, and cbc.
Nursing Diagnoses
Some possible nursing diagnoses related to AKI are: * Risk for electrolyte imbalance * Risk for infection * Risk for imbalanced fluid volume (Ackley & Ladwig, 2011).

Planning
Some of the goals for an AKI patient include but are not limited to: maintain or return electrolyte and acid-base balance to within normal limits, prevent infection or treat infection, and maintain or return fluid volume to within normal limits. Some patient outcomes are: patient will not develop hospital



References: Ackley, B. J., & Ladwig, G. B. (2011). Nursing diagnosis handbook (9th ed.). St. Louis, MO: Mosby Elsevier. Chambers, J. (1987, December). Fluid and electrolyte problems in renal and urologic disorders. Nursing Clinicals of North America, 22(4), 815-26. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/3317287 Urden, L. D., Stacy, K. M., & Lough, M. E. (2012). Priorities in critical care nursing (6th ed.). St. Louis, MO: Elsevier.

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