NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

Student Name

Chamberlain University

NR-325 Adult Health II

Prof. Name:

Date

Pathophysiological Changes in Acute Kidney Injury

Acute Kidney Injury (AKI) involves several pathophysiological changes that impair kidney function. When the flow of urine is obstructed, it refluxes into the renal pelvis, leading to hydronephrosis, increased hydrostatic pressure, and tubular blockage, progressively reducing kidney function. Prompt relief of bilateral ureteral obstruction within 48 hours can result in full recovery; however, prolonged obstruction often leads to tubular atrophy and irreversible kidney fibrosis. Severe ischemia disrupts the basement membrane, causing patchy destruction of the tubular epithelium.

Causes, Signs, Symptoms, and Diagnostics of AKI Types

AKI is classified as prerenal, intrarenal, or postrenal, depending on the underlying cause. Prerenal AKI is caused by conditions such as hypovolemia, decreased cardiac output, or reduced renal vascular blood flow. Intrarenal AKI is associated with nephrotoxic injury, interstitial nephritis, and other diseases like acute glomerulonephritis or systemic lupus erythematosus. Postrenal AKI arises from urinary obstructions such as benign prostatic hyperplasia or calculi formation. Common symptoms include oliguria, shortness of breath, edema, fatigue, and nausea. Diagnoses rely on clinical findings and laboratory investigations, including electrolyte disturbances, elevated creatinine, and abnormal urine output.

Medical and Nursing Management

The management of AKI focuses on treating the underlying cause, monitoring fluid and electrolyte imbalances, and ensuring adequate renal perfusion. Fluid therapy, IV insulin, sodium bicarbonate, and diuretics are used to address imbalances. Dialysis may be initiated when conservative measures fail. Hyperkalemia is treated using sodium polystyrene sulfonate enemas to promote potassium excretion. Preventative strategies during dialysis include aseptic techniques, avoiding compression of access sites, and monitoring for complications such as hypotension or disequilibrium syndrome. Effective patient education on compliance, fluid intake, and infection prevention is also essential for recovery.

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

References

Bellomo, R., Ronco, C., Kellum, J. A., Mehta, R. L., & Palevsky, P. (2012). Acute renal failure – definition, outcome measures, animal models, fluid therapy and information technology needs: The Second International Consensus Conference of the Acute Dialysis Quality Initiative (ADQI) Group. Critical Care, 8(4), R204-R212. https://doi.org/10.1186/cc2042

National Institute of Diabetes and Digestive and Kidney Diseases. (2020). Acute kidney injury. Retrieved from https://www.niddk.nih.gov

NR 325 Week 3 Acute Kidney Injury CAE PNCI Medical Surgical

Singh, P., Rifkin, D. E., & Blantz, R. C. (2014). Acute kidney injury and chronic kidney disease: An integrated clinical syndrome. Kidney International, 88(1), 12-18. https://doi.org/10.1038/ki.2014.78