Every nursing student should understand that acute kidney injury (AKI) is a rapid decline in kidney function, potentially leading to life-threatening complications. Knowledge of its common causes, such as dehydration, medications, and sepsis, along with recognizing early signs and implementing prompt interventions, is crucial for improving patient outcomes.
Acute kidney injury (AKI) represents a sudden and critical deterioration in kidney function, demanding immediate medical attention. This condition can arise from various factors such as severe infections, certain medications, dehydration, or underlying diseases.
When the kidneys are unable to effectively filter waste and excess fluids from the blood, harmful substances accumulate, disrupting the body's delicate balance. AKI may manifest as decreased urine output, fluid retention, fatigue, and nausea.
Timely intervention is essential, as untreated AKI can lead to serious complications like electrolyte imbalances, fluid overload, and even kidney failure. Healthcare professionals work to address the underlying cause while managing the AKI through careful monitoring, medication adjustments, and appropriate interventions to restore kidney function and mitigate potential long-term consequences.
1. Sudden onset of renal damage
2. Loss of renal function due to poor circulation or renal cell damage
3. Usually reversible may resolve on its own, but can lead to permanent damage if not reversed quickly
1. Causes
a. Prerenal
i. Decreased blood flow to the kidneys, accounts for a majority of cases→ Hypotension, Hypovolemia, ↓ Cardiac Output (i.e. Heart Failure, Shock)
b. Intrarenal
i. Damage within the kidney itself→ Tubular necrosis, infection, obstruction, contrast dye, nephrotoxic medications
c. Postrenal
i. Damage between the kidney and urethral meatus backs up, causing damage to kidneys→ due to infection, calculi, or obstruction
2. Phases
a. Onset→ Note a decrease in baseline urine output
b. Oliguric→ Decreased urine output <400 mL/ day. This is the sickest phase where there is a ↑ BUN/Creatinine and ↓ Glomerular Filtration Rate (GFR)
c. Diuretic→ Beginning to recover, there is a gradual increase in urine output followed by diuresis
d. Recovery→ has decreased edema, electrolytes normalize, and GFR increases
1. Oliguric Phase
a. Restrict fluid intake because there is volume overload, give diuretics for volume overload, and identify & treat the cause
2. Diuretic Phase
a. Replace fluids and electrolytes and especially watch potassium & sodium levels
3. If not recovering, may need dialysis
Medical History:
Mr. Smith had a history of hypertension and diabetes, which may have contributed to his acute kidney injury
Diagnosis:
Mr. Smith was diagnosed with acute kidney injury, a sudden decrease in kidney function, resulting in impaired filtration and waste-elimination
Treatment Plan:
Outcome:
With diligent nursing care and medical management, Mr. Smith’s kidney function showed signs of improvement. His urine output increased, and his blood pressure was stabilized. Gradually, his serum creatinine and BUN levels began to decline.
This Acute Kidney Injury (AKI) review provides essential knowledge for confidently approaching the NCLEX. Understanding its prevention, management, and interventions empowers nurses to provide effective care and save lives.
Looking for more must-know NCLEX review topics? Download our free eBook, "NCLEX Flash Notes: 77 Must-Know Nursing Topics for the NCLEX," by simply providing your email address below. I'll send you a complimentary copy straight to your inbox!
You CAN Do This
Happy Nursing!