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Acute Kidney Injury NCLEX Review and Nursing Care Plans The kidneys have a wide range of functions. Their primary role is to remove waste from the bloodstream. They also manage blood pressure by removing excess fluid from the blood. Also, kidneys aid in the production of red blood cells, the regulation of electrolytes, and the activation of vitamin D. Knowing that our kidneys serve a variety of roles in maintaining our bodies’ health, one can only imagine what would happen if they were damaged. One of the common kidney diseases that occur most of the time in conjunction with another medical condition or event is acute kidney injury (AKI). Acute kidney injury is a sudden loss of kidney function in which the kidneys are unable to filter waste products from the blood. When the kidneys lose their ability to filter waste, the chemical makeup of the blood may go out of balance, and dangerous levels of waste may accumulate. Acute renal failure is another name for acute kidney injury. It can damage other organs, including the brain, heart, and lungs, and develops fast, generally in a few hours or days. Acute kidney injury is more likely to occur among individuals who have already been admitted to a hospital, particularly those who are severely ill and require intensive care. Acute kidney injury affects one in every million persons in the United States each year, and it is identified in 1% among all hospital admissions. If left untreated, acute kidney injury can lead to chronic renal failure, which is fatal and requires a lot of treatment. Acute kidney injury may also be reversible in patients who do not have other serious health problems. These patients may regain normal or near-normal kidney function if managed earlier. The goal of nursing care for individuals with acute kidney injury is to address or eliminate any causes that can be reversed. Prompt diagnosis of AKI’s underlying causes, correcting fluid and electrolyte imbalances, acid-base balance stabilization, proper nutrition, and preventing complications are all part of patient care. Signs and Symptoms of Acute Kidney InjuryAcute kidney injury can have diverse signs and symptoms, depending on the etiology, which includes the following:
In some circumstances, acute kidney injury has no signs and symptoms and is only discovered by coincidence when a healthcare provider orders various tests. Causes of Acute Kidney InjuryAcute kidney injury can be caused by a variety of causes, including the following:
2. Direct Kidney Damage. Diseases, conditions, and substances that damage the kidneys and cause acute kidney injury include:
3. Urine Obstruction. Conditions or disorders that obstruct the flow of urine out of the body can cause acute kidney injury in some individuals. The following circumstances can result in a blockage:
Risk Factors of Acute Kidney InjuryAcute kidney injury typically often develops as a result of another medical illness or occurrence. The following are among the conditions that can increase the risks of getting acute kidney injury: Treatment for Acute Kidney InjuryAcute kidney injury frequently necessitates hospitalization for treatment, though the majority of individuals who have them have already been admitted to a hospital for various reasons. The length of stay in the hospital is determined by the cause of the acute kidney injury and the rate at which the kidneys recover. The primary goal of the healthcare practitioner is to find out what is causing the acute kidney injury so that it can be treated. Until the kidneys recover, the healthcare provider will attempt to address all the symptoms and complications. Dialysis may also be required in more critical situations to assist in the replacement of renal function until the kidneys are fully recovered. After an acute kidney injury, there is an increased risk of developing additional health problems such as other kidney disease, stroke, or heart disease in the future. Recurrence of acute kidney injury is also possible. Every time an acute kidney injury occurs, the chances of developing kidney disease and kidney failure also increase. It is vital to regularly get in touch with the physician to keep track of kidney function. Preventing acute kidney injury or finding and treating it as soon as feasible is the best method to reduce the risk of kidney damage and preserve renal function. Prevention of Acute Kidney InjuryIt can be difficult to anticipate or avoid acute kidney injury, there are a few ways to help kidneys stay in good condition:
Acute Kidney Injury Nursing DiagnosisNursing Care Plan for Acute Kidney Injury 1Fluid Volume Excess Nursing Diagnosis: Fluid Volume Excess related to impaired regulatory mechanism of the kidneys secondary to acute kidney injury as evidenced by generalized edema, decreased urine output with low urine specific gravity, distended neck veins, elevated blood pressure, sudden weight gain, congested lungs in x-ray, electrolytes imbalance, and decreased hematocrit level. Desired Outcome: The patient will have adequate urine output, acceptable laboratory tests results, steady weight, normal range of vital signs, and absence of edema.
Nursing Care Plan for Acute Kidney Injury 2Risk for Decreased Cardiac Output Nursing Diagnosis: Risk for Decreased Cardiac Output related to fluid overload and electrolyte imbalance secondary to acute kidney injury Desired Outcome: The patient will maintain cardiac output as evidenced by an acceptable range of blood pressure and heart rate, firm peripheral pulses, and good capillary refill time.
Nursing Care Plan for Acute Kidney Injury 3Risk for Imbalanced Nutrition Nursing Diagnosis: Risk for Imbalanced Nutrition: Less Than Body Requirements related to dietary restrictions to reduce nitrogenous waste products, increased metabolic needs, and nausea/vomiting secondary to acute kidney injury Desired Outcome: The patient will maintain acceptable weight.
Nursing Care Plan for Acute Kidney Injury 4Risk for Infection Nursing Diagnosis: Risk for Infection secondary to weakened immune system, invasive interventions such as urinary catheterization, and changes in nutritional consumption secondary to acute kidney injury Desired Outcome: The patient will not manifest any signs and symptoms of infection.
Nursing Care Plan for Acute Kidney Injury 5Risk for Deficient Fluid Volume Nursing Diagnosis: Risk for Deficient Fluid Volume related to excessive loss of fluid secondary to acute kidney injury Desired Outcome: The patient will demonstrate good skin turgor, moist mucosal membranes, acceptable input and output balance, palpable peripheral pulses, electrolytes within normal range, and steady weight and vital signs.
Nursing ReferencesAckley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier. Buy on Amazon Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier. Buy on Amazon Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier. Buy on Amazon Disclaimer:Please follow your facilities guidelines, policies, and procedures. The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes. This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment. |