Medical Surgical Nursing II Professor Ventura’s Notes EXAM #3

Acute Kidney Injury (AKI) ● The old terminology was Acute Renal Failure (ARF) ● Sudden and sometimes temporary “death” → kidney can recover ○ Decrease in perfusion (blood flow) ●Three Types of Acute Kidney Injury: ○ Pre-Renal → away from and above the kidney ○ Examples of Pre-Renal: ■ The Heart → Myocardial Infarction/Heart Failure ■ The Brain → Stroke ■ Dehydration or Blood Loss ○Intra-Renal (Intrinsic) → inside the kidney ■ Acute Glomerulonephritis: ● The glomerulus is responsible for kidney filtration. ● Autoimmune → the body produces antibodies after infection (staph infection caused by staphylococcus bacteria OR strep infection caused by streptococcus bacteria) that will attack the glomerulus. ●○ Sore throat or skin infection* → Post-Streptococcal Kidney Failure Manifestations of Acute Glomerulonephritis: ○ Coca-Colored Urine → Dark, Dusky, and Brown ■ Caused by hematuria (RBC’s in the urine) ○ Hypertension ○ Edema → Facial Edema and Periorbital Edema ○ Proteinuria ■Nephrotic●●Syndrome: Excreting too much protein and albumin in the urine leading to an excessive loss of protein and albumin Manifestations of Nephrotic Syndrome: ○ Urine will be a foamy white color→ “Vanilla Ice Cream” ○ Hypoalbuminemia ■ Albumin → Normal level is 3.5 - 5.5 mg/dL ■ Albumin maintains oncotic pressure ■ Low albumin can cause ascites, which is a buildup of fluid in the abdominal cavity ○ Hypoproteinemia ■ Total Protein → Normal level is 4 - 6 mg/dL ■ Excreting too much protein in urine will cause the body to signal the liver to produce lipoproteins (lipids) causing an increase in cholesterol → cardiac problems. ○ Edema → Peripheral Edema, Facial Edema and Periorbital Edema ○ Anasarca → Generalized Edema ○ Clot formation → due to excretion of clotting factors ■Examples of Intra-Renal: ● Nephrotoxic Agents → NSAIDS, Aminoglycosides, Contrast Agents, Chemotherapy (Cisplatin), and Amphotericin B ● Autoimmune Disorders → Systemic Lupus Erythematosus (SLE) ● Kidney Cancer ● Kidney Trauma