Materiały źródłowe

• #1 Acute Kidney Injury (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568593/

  Acute kidney injury (AKI), formerly known as acute renal failure (ARF), denotes a sudden and often reversible reduction in kidney function, as measured by glomerular filtration rate (GFR). […] The role of the nurse in managing patients with renal failure is emphasized. […] Initial nursing care is crucial in the detection of AKI. […] Monitor vitals including urine output. […] Weigh patient daily to determine fluid retention. […] Assess heart and lung sounds. […] Monitor mental status changes and level of consciousness. […] Assess periorbital and dependent edema. […] Review chest x-ray and laboratory parameters (BUN and creatinine). […] Insert a Foley catheter to monitor ins and outs. […] Administer diuretics as prescribed. […] Monitor blood pressure and treat accordingly.

• #2 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  Acute kidney injury (AKI), previously known as acute renal failure (ARF), is characterized by the sudden loss of the kidneys’ ability to filter waste products effectively, leading to toxin accumulation and fluid and electrolyte imbalances. It can develop rapidly, within hours or days, and poses significant morbidity and increased mortality risk. AKI affects approximately 7.5% of all hospitalized patients, with a prevalence of 20% to 40% among intensive care unit (ICU) admissions in Europe and the United States. […] A comprehensive nursing assessment is vital to detect early signs and manage AKI effectively: […] Common nursing interventions to protect kidney function include IV hydration to ensure adequate hydration, especially before procedures involving IV contrast, to maintain renal perfusion and prevent prerenal AKI.

• #3 Acute kidney injury – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-failure/symptoms-causes/syc-20369048

  Acute kidney injury happens when the kidneys suddenly can’t filter waste products from the blood. […] Acute kidney injury is most common in people who are in the hospital, mostly in people who need intensive care. […] Acute kidney injury ranges from mild to severe. If severe, ongoing and not treated, it can be fatal. But it also can be reversed. People in otherwise good health may get back typical or nearly typical use of their kidneys. […] See your healthcare professional right away or seek emergency care if you have symptoms of acute kidney injury. […] Work with your healthcare team to manage kidney and other ongoing conditions. Kidney disease, diabetes or high blood pressure increases your risk of acute kidney injury. If you have one of these, do what your healthcare team tells you to manage your condition. […] You might cut your risk of acute kidney injury by taking care of your kidneys. Try to: Get treated quickly for bad infections. […] If you have risk factors for kidney disease, check with your healthcare team to be sure that prescription medicines you take are safe for your kidneys.

• #4 Acute Kidney Injury – Symptoms, causes, treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/acute-kidney-injury-aki

  Acute kidney injury (AKI) occurs when kidneys suddenly lose their ability to filter waste from the blood, developing within hours or days. […] Acute kidney injury (AKI) is a term used to describe when your kidneys are suddenly not able to filter waste products from the blood. This can happen within a few hours or a few days. […] The signs and symptoms of AKI can differ depending on many factors like the cause, severity, and your other health conditions. […] In some cases, AKI causes no symptoms and is only found through other tests done by your healthcare professional. […] AKI can cause a build-up of waste products in your blood and make it hard to keep the right balance of fluid and minerals in your body. It can also cause permanent damage to your kidneys, leading to chronic kidney disease (CKD).

• #5 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Acute kidney injury (AKI), also known as Acute Renal Failure (ARF) occurs when the kidneys lose their filtering ability resulting in the build-up of waste products in the blood. This condition develops rapidly, in hours or days, and is common in critically ill patients. […] Assessment and monitoring play an essential role in the nursing care for patients with AKI, as subtle changes can signal progression of the disease or the development of complications. Nurses are involved in treatment by administering medications like diuretics, potassium-lowering drugs, and calcium supplements. In severe cases, dialysis is indicated to help remove toxins from the blood. Nurses may care for patients before, during, and after dialysis treatments. […] Patient education is also important to address the patients and the family members knowledge deficits related to the causes and prevention of AKI.

• #6 Acute Kidney Injury: A Nursing Challenge – CNE | ANA

  https://www.nursingworld.org/continuing-education/AN2305-Acute-Kidney/

  Nurses play a critical role in the monitoring and management of Acute Kidney Injury (AKI) and are invaluable members of the multi-disciplinary team caring for persons with AKI. It is imperative that nurses have a clear understanding of their role within AKI management to help aide in the prevention of life threatening complications from AKI. […] The monitoring of serum creatinine, estimated glomerular filtration rate, and urine output is essential in the management of AKI. Prompt treatment of AKI is essential in preventing life threatening complications. […] Describe nursing interventions in interdisciplinary collaborative management that can impact patient outcomes.

• #7 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  Acute kidney injury (AKI), previously known as acute renal failure (ARF), is characterized by the sudden loss of the kidneys’ ability to filter waste products effectively, leading to toxin accumulation and fluid and electrolyte imbalances. It can develop rapidly, within hours or days, and poses significant morbidity and increased mortality risk. AKI affects approximately 7.5% of all hospitalized patients, with a prevalence of 20% to 40% among intensive care unit (ICU) admissions in Europe and the United States. […] A comprehensive nursing assessment is vital to detect early signs and manage AKI effectively: […] Common nursing interventions to protect kidney function include IV hydration to ensure adequate hydration, especially before procedures involving IV contrast, to maintain renal perfusion and prevent prerenal AKI.

• #8 Nursing Care Plan (NCP) for Acute Kidney Injury | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-acute-kidney-injury

  Promotion of Renal Health: […] Encourage practices that promote renal health, such as maintaining adequate hydration, avoiding nephrotoxic substances, and seeking medical attention promptly for conditions that may impact kidney function. […] Nursing Assessment for Acute Kidney Injury (AKI): […] Obtain a comprehensive health history, including information on pre-existing renal conditions, recent illnesses, medication history (especially nephrotoxic drugs), and any known risk factors for AKI. […] Monitor fluid balance by assessing intake and output, changes in body weight, and signs of fluid overload or dehydration. Document urine characteristics, including color, clarity, and volume. […] Regularly assess vital signs, particularly blood pressure, heart rate, and respiratory rate, to identify signs of hypotension or other systemic issues affecting renal perfusion.

• #9 Acute Kidney Injury (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568593/

  Acute kidney injury (AKI), formerly known as acute renal failure (ARF), denotes a sudden and often reversible reduction in kidney function, as measured by glomerular filtration rate (GFR). […] The role of the nurse in managing patients with renal failure is emphasized. […] Initial nursing care is crucial in the detection of AKI. […] Monitor vitals including urine output. […] Weigh patient daily to determine fluid retention. […] Assess heart and lung sounds. […] Monitor mental status changes and level of consciousness. […] Assess periorbital and dependent edema. […] Review chest x-ray and laboratory parameters (BUN and creatinine). […] Insert a Foley catheter to monitor ins and outs. […] Administer diuretics as prescribed. […] Monitor blood pressure and treat accordingly.

• #10 Acute Kidney Injury (Renal Failure) NCLEX Review

  https://www.registerednursern.com/acute-kidney-injury-renal-failure-nclex-review/

  As a nursing student, you must be familiar with acute kidney injury along with how to care for patients who are experiencing this condition. […] Nursing Interventions […] NURSING Role: low protein diet (WHY? Remember urea is a waste product from protein break down in the liver), safety […] NURSING Role: restrict potassium-rich foods, monitor EKG for changes (tall peaked T-waves, Wide QRS and prolonged PR interval), monitor lab valuesmay be ordered to give Kayexalate orally or rectally to remove extra potassium out of the blood), place on cardiac monitor to watch rhythm. […] NURSING Role: restrict fluid intake, STRICT I and Os, daily weights every day, assess swelling, heart sounds, lung sounds (crackles), monitoring respiratory rate and oxygen saturation, neuro status […] NURSING Role: monitor respiratory and neuro status, safety […] NURSING Role: strict I and Os, daily weights, monitor for signs and symptoms of dehydration, HYPOVOLEMIA, hypotension.

• #11 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Once the nurse identifies nursing diagnoses for acute kidney injury, nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. […] Intravascular volume depletion is a risk factor for acute kidney injury. During the diuretic phase of acute kidney injury, the patients daily urine output can reach up to 5 L or more due to osmotic diuresis and the inability of the tubules to concentrate urine. […] Fluid administration in AKI is indicated to help optimize circulating volume, increase cardiac output, promote perfusion pressure, and ultimately improve renal blood flow and function. […] The placement of a urinary catheter allows for accurate measurement of urine output. Intensive monitoring of urine output is associated with improved outcomes in AKI.

• #12 Identifying and managing acute kidney injury

  https://journals.rcni.com/nursing-standard/cpd/identifying-and-managing-acute-kidney-injury-ns.2022.e11938

  Acute kidney injury, previously referred to as acute renal failure, is a common and often preventable condition that is seen in patients in acute and primary care settings. Nurses in both settings should be able to identify and assess patients at risk of acute kidney injury, and those with developing acute kidney injury, and understand the principles of clinical management. […] Early identification can assist in prevention of acute kidney injury, while supportive management and interventions can prevent further deterioration in patients diagnosed with the condition. This article describes acute kidney injury and outlines the pathophysiology, staging, and signs and symptoms. The author also describes the clinical management of patients with acute kidney injury and the long-term effects of the condition.

• #13 Acute Renal Failure Nursing Care and Management: Study Guide

  https://nurseslabs.com/acute-renal-failure/

  Learn about the nursing care management of patients with acute renal failure in this nursing study guide. […] The nurse has an important role in caring for the patient with ARF. […] Assessment usually focuses on the characteristics of the urine. […] The goals for a patient with ARF are: Improve nutritional intake. Restore fluid balance. Reduce metabolic rate. Promote pulmonary function. Prevent infection. […] Nursing interventions are aimed at restoring renal function and reducing potential causes of increased renal injury. […] A successful nursing care plan has achieved the following: Improved nutritional intake. Restored fluid balance. Reduced metabolic rate. Promoted pulmonary function. Prevented infection. […] The nurse plays an important role in teaching the patient and family with ARF.

• #14 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Once the nurse identifies nursing diagnoses for acute kidney injury, nursing care plans help prioritize assessments and interventions for both short and long-term goals of care. […] Intravascular volume depletion is a risk factor for acute kidney injury. During the diuretic phase of acute kidney injury, the patients daily urine output can reach up to 5 L or more due to osmotic diuresis and the inability of the tubules to concentrate urine. […] Fluid administration in AKI is indicated to help optimize circulating volume, increase cardiac output, promote perfusion pressure, and ultimately improve renal blood flow and function. […] The placement of a urinary catheter allows for accurate measurement of urine output. Intensive monitoring of urine output is associated with improved outcomes in AKI.

• #15 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Excess fluid volume is common in patients with AKI due to the kidneys inability to filter and get rid of excess fluid in the body. Its management will include volume status determination, fluid resuscitation, fluid overload management, nephrotoxicity prevention, and adjustment of medications based on the patients renal function. […] Diuretics are prescribed to promote urine output and reduce edema. […] AKI is associated with the imbalance of protein breakdown and production, resulting in muscle wasting, protein wasting, and weight loss. As kidney function continues to deteriorate, protein-energy wasting accelerates, appetite decreases, and malnutrition will start to develop. […] Acute kidney injury can range from slight deterioration in kidney function to severe impairment, which can alter the balance of fluid and electrolytes.

• #16 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  Medication adjustments should be made to hold nephrotoxic drugs like NSAIDs and metformin in patients with rising creatinine. […] Maintaining MAP 65 mm Hg is important, and vasopressor support should be implemented if needed to sustain renal perfusion. […] Electrolyte monitoring and management are crucial, with regular checks for hyperkalemia, hyperphosphatemia, and other imbalances; dietary restrictions and medication adjustments should be implemented as necessary. […] Patient education is essential, using clear, narrative explanations about the importance of dietary and fluid restrictions, medication adherence, and recognizing early signs of worsening kidney function. […] Dietary modifications for AKI include a high caloric intake to prevent catabolism, a low protein diet to reduce urea production and prevent further stress on the kidneys, a low potassium diet to prevent hyperkalemia, and a low sodium diet to prevent fluid overload and hypertension.

• #17 Acute Kidney Injury (Nursing) – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK568593/

  Check levels of potassium and if high, treat as clinician orders. […] Limit intake of fluids. […] Encourage a low sodium diet, limit foods with high potassium like bananas, oranges, and tomatoes. […] Keep head of bed elevated. […] The nurse should ensure that the patient is well hydrated prior to any contrast study and can produce adequate urine. […] For those who develop AKI, the nurse should educate the patient on agents to avoid worsening the renal injury. […] The outcomes for patients with AKI depend on the cause of the renal dysfunction, the presence of any underlying kidney disease, and the duration of the renal dysfunction. […] The most important issues to realize for clinicians dealing with AKI are adjusting the dose of any medications these patients are taking and avoiding nephrotoxic medications as much as possible.

• #18 Acute Kidney Injury: Inpatient Management and Treatment – Nursing CE Central

  https://nursingcecentral.com/lessons/acute-kidney-injury-inpatient-management-and-treatment/

  Nursing management of a patient with acute kidney injury can include monitoring urine output and vitals. Also, when performing a physical assessment, the heart and lungs should be auscultated. Mental status should be monitored and level of consciousness. Monitor for any signs of periorbital and dependent edema. The head of the bed should be elevated. […] Acute kidney injuries require follow-up and education to complete the recovery process. As nurses we must provide our patients with education so they can make decisions about their healthcare and to improve their recovery process. Education can cut down on readmissions and healthcare costs.

• #19 Effective Nursing Interventions for Managing Acute Renal Failure

  https://simplenursing.com/nursing-interventions-acute-renal-failure/

  Acute renal failure (ARF) is a serious condition that requires prompt and effective management. Nursing interventions for acute renal failure involve monitoring and managing the patient’s fluid and electrolyte balance. […] In cases of total volume depletion, the nurse should ensure that the patient receives adequate fluid replacement through intravenous (IV) fluids or blood products, as appropriate. And in cases where volume overload is a concern, the nurse should closely monitor the patient’s fluid intake and output and implement strategies to minimize fluid retention. […] Monitor vital signs, including blood pressure, heart rate, and respiratory rate, is essential to detect any changes that may indicate worsening of the condition. […] Administer medications such as diuretics, antihypertensives, and antibiotics that may be prescribed to manage symptoms and prevent complications.

• #20 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Excess fluid volume is common in patients with AKI due to the kidneys inability to filter and get rid of excess fluid in the body. Its management will include volume status determination, fluid resuscitation, fluid overload management, nephrotoxicity prevention, and adjustment of medications based on the patients renal function. […] Diuretics are prescribed to promote urine output and reduce edema. […] AKI is associated with the imbalance of protein breakdown and production, resulting in muscle wasting, protein wasting, and weight loss. As kidney function continues to deteriorate, protein-energy wasting accelerates, appetite decreases, and malnutrition will start to develop. […] Acute kidney injury can range from slight deterioration in kidney function to severe impairment, which can alter the balance of fluid and electrolytes.

• #21 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  Medication adjustments should be made to hold nephrotoxic drugs like NSAIDs and metformin in patients with rising creatinine. […] Maintaining MAP 65 mm Hg is important, and vasopressor support should be implemented if needed to sustain renal perfusion. […] Electrolyte monitoring and management are crucial, with regular checks for hyperkalemia, hyperphosphatemia, and other imbalances; dietary restrictions and medication adjustments should be implemented as necessary. […] Patient education is essential, using clear, narrative explanations about the importance of dietary and fluid restrictions, medication adherence, and recognizing early signs of worsening kidney function. […] Dietary modifications for AKI include a high caloric intake to prevent catabolism, a low protein diet to reduce urea production and prevent further stress on the kidneys, a low potassium diet to prevent hyperkalemia, and a low sodium diet to prevent fluid overload and hypertension.

• #22 Effective Nursing Interventions for Managing Acute Renal Failure

  https://simplenursing.com/nursing-interventions-acute-renal-failure/

  Assess for signs of infection. Patients with ARF are at increased risk for infections, especially urinary tract infections. This includes fever, chills, and increased white blood cell count, and notify the physician if necessary. […] Provide proper nutrition. Patients with ARF may require a diet limiting protein, sodium, and potassium intake. […] Educate the patient and family about the condition, treatment, and self-care strategies. This may include medication information, dietary restrictions, and complications such as hyperkalemia. […] Diuretics are given to ensure enough volume is being pushed inside the kidney to have it restarted and enter the diuretic phase. Once the patient’s kidneys are rebooted, the next goal is to achieve the recovery phase.

• #23 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Acute kidney injury (AKI), also known as Acute Renal Failure (ARF) occurs when the kidneys lose their filtering ability resulting in the build-up of waste products in the blood. This condition develops rapidly, in hours or days, and is common in critically ill patients. […] Assessment and monitoring play an essential role in the nursing care for patients with AKI, as subtle changes can signal progression of the disease or the development of complications. Nurses are involved in treatment by administering medications like diuretics, potassium-lowering drugs, and calcium supplements. In severe cases, dialysis is indicated to help remove toxins from the blood. Nurses may care for patients before, during, and after dialysis treatments. […] Patient education is also important to address the patients and the family members knowledge deficits related to the causes and prevention of AKI.

• #24 Acute kidney injury – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/kidney-failure/diagnosis-treatment/drc-20369053

  If a lack of fluids in your blood is the cause of your acute kidney injury, you may need fluids through a vein, called intravenous (IV) fluids. […] You might need medicines called potassium binders to keep potassium from building up. […] If the levels of calcium in your blood drop too low, you might need to get calcium through a vein, called an infusion. […] If wastes build up in your blood, you may need hemodialysis for a time. […] During dialysis, a machine pumps blood out of your body through an artificial kidney, called a dialyzer, that filters out waste. […] During your recovery from acute kidney injury, a special diet can help support your kidneys and limit the work they must do. […] Your dietitian may suggest that you: […] As your kidneys get better, you may no longer need a special diet. But healthy eating still is important. […] If you aren’t in the hospital and have symptoms of kidney failure, make an appointment with your family healthcare professional right away. You may be referred to a specialist in kidney disease, called a nephrologist.

• #25 Acute kidney injury (AKI) | Kidney Care UK

  https://kidneycareuk.org/kidney-disease-information/kidney-conditions/patient-info-acute-kidney-injury-aki/

  However, in severe cases, you may need to go into hospital to have dialysis. This is a treatment for severe kidney disease and uses a machine to remove the waste products and excess fluid that build up in your body when your kidneys stop working. […] Most people with AKI only need to have dialysis for a few days or weeks until their kidneys start working again. […] Most people with AKI make a full recovery and do not need any long-term treatment. […] Your GP will monitor your kidney function and blood pressure for at least three years after an episode of AKI. […] You should check with your doctor before taking any new medicine or herbal supplements in case they could damage your kidneys.

• #26 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  AKI also adversely affects immune function and is widely considered an immunosuppressed state. A wealth of data has accumulated that clients with AKI have a substantially increased risk of subsequent infection and sepsis. […] The importance of kidney care has become evident in studies showing that individuals who survive an episode of AKI are at increased risk of adverse outcomes that include both kidney and non-kidney sequelae. […] The current recommendation by KDIGO for dialysis-dependent AKI clients is to deliver a kt/v of 3.9 per week when using intermittent or extended RRT and an effluent volume of 20 to 25 mg/kg/hour when using continuous renal replacement therapy (CRRT).

• #27 Effective Nursing Interventions for Managing Acute Renal Failure

  https://simplenursing.com/nursing-interventions-acute-renal-failure/

  Assess for signs of infection. Patients with ARF are at increased risk for infections, especially urinary tract infections. This includes fever, chills, and increased white blood cell count, and notify the physician if necessary. […] Provide proper nutrition. Patients with ARF may require a diet limiting protein, sodium, and potassium intake. […] Educate the patient and family about the condition, treatment, and self-care strategies. This may include medication information, dietary restrictions, and complications such as hyperkalemia. […] Diuretics are given to ensure enough volume is being pushed inside the kidney to have it restarted and enter the diuretic phase. Once the patient’s kidneys are rebooted, the next goal is to achieve the recovery phase.

• #28 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with acute renal failure (ARF) may include: Managing Fluid Volume and Hypervolemia, Minimizing Risk of Cardiac Complications, Promoting Optimal Nutritional Balance, Promoting Infection Control and Minimizing Risk for Infection, Minimizing Risk for Hypovolemia, Initiating Health Teachings and Patient Education, Administering Medications and Pharmacologic Support, Monitoring Laboratory and Diagnostic Procedures. […] In the case of prerenal acute kidney injury (AKI), fluid resuscitation is the gold standard, but if this resuscitation continues beyond the correction of hypovolemia, then it is associated with increased morbidity, mortality, and length of hospital stay as well as increased risk of AKI. […] The prognosis for clients with AKI is directly related to the cause of the injury and, to a great extent, to the presence or absence of preexisting kidney disease, as well as to the duration of kidney dysfunction prior to therapeutic intervention.

• #29 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  AKI also adversely affects immune function and is widely considered an immunosuppressed state. A wealth of data has accumulated that clients with AKI have a substantially increased risk of subsequent infection and sepsis. […] The importance of kidney care has become evident in studies showing that individuals who survive an episode of AKI are at increased risk of adverse outcomes that include both kidney and non-kidney sequelae. […] The current recommendation by KDIGO for dialysis-dependent AKI clients is to deliver a kt/v of 3.9 per week when using intermittent or extended RRT and an effluent volume of 20 to 25 mg/kg/hour when using continuous renal replacement therapy (CRRT).

• #30 Acute Kidney Injury – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK441896/

  Acute tubular necrosis and other intrarenal causes are often slow to recover and can take weeks to months for complete recovery of renal function. […] Diuretics may be required during the oliguric phase of ATN if significant volume overload develops. […] It is also important to avoid further kidney insults, such as nephrotoxic drugs. […] In addition, many medications must be renally adjusted once a patient develops AKI. […] If hyperkalemia develops, it needs to be managed expeditiously. […] Some AKI patients tend to develop volume overload, which should be corrected as early as possible to avoid pulmonary and cardiac complications. […] Other treatments are directed at the etiology of the AKI. […] Close follow-up with a nephrologist is highly recommended in all cases of AKI. […] The patient should have a dietary consult because salt and fluid restriction are vital when managing AKI. […] Similarly, the patient should avoid a high-potassium diet when there is renal dysfunction. […] Because AKI induces a catabolic state, the patient should be encouraged to consume adequate protein.

• #31 Acute Kidney Injury: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1201/p687.html

  Management of acute kidney injury is primarily supportive, with the goals of preventing further damage and promoting recovery of renal function. […] If fluid resuscitation is indicated, isotonic crystalloids (e.g., 0.9% normal saline, lactated Ringer solution, Plasma-Lyte A) are recommended over colloids (e.g., albumin, dextran) as the initial therapy. […] A review of medications requiring discontinuation, dose adjustment, or monitoring is critical to the management of acute kidney injury. […] Early nephrology consultation (within 48 hours) appears to be beneficial for patients with acute kidney injury. […] Acute kidney injury care bundles, a specific set of guideline-based diagnostic and therapeutic interventions, are associated with improved in-hospital mortality rates and reduced risk of progression in observational studies.

• #32 Acute Kidney Injury (AKI): Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/243492-overview

  Non-targeted pharmacologic interventions for AKI have been attempted, but no large randomized controlled study has demonstrated significant benefit. […] Educating patients about the nephrotoxic potential of common therapeutic agents is always helpful. Nonsteroidal anti-inflammatory drugs (NSAIDs) provide a good example; most patients are unaware of their nephrotoxicity, and their universal availability makes them a constant concern.

• #33 Acute Kidney Injury (AKI): Nursing Diagnoses & Care Plans | NurseTogether

  https://www.nursetogether.com/acute-kidney-injury-nursing-diagnosis-care-plan/

  Acute kidney injury (AKI), also known as Acute Renal Failure (ARF) occurs when the kidneys lose their filtering ability resulting in the build-up of waste products in the blood. This condition develops rapidly, in hours or days, and is common in critically ill patients. […] Assessment and monitoring play an essential role in the nursing care for patients with AKI, as subtle changes can signal progression of the disease or the development of complications. Nurses are involved in treatment by administering medications like diuretics, potassium-lowering drugs, and calcium supplements. In severe cases, dialysis is indicated to help remove toxins from the blood. Nurses may care for patients before, during, and after dialysis treatments. […] Patient education is also important to address the patients and the family members knowledge deficits related to the causes and prevention of AKI.

• #34 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  Medication adjustments should be made to hold nephrotoxic drugs like NSAIDs and metformin in patients with rising creatinine. […] Maintaining MAP 65 mm Hg is important, and vasopressor support should be implemented if needed to sustain renal perfusion. […] Electrolyte monitoring and management are crucial, with regular checks for hyperkalemia, hyperphosphatemia, and other imbalances; dietary restrictions and medication adjustments should be implemented as necessary. […] Patient education is essential, using clear, narrative explanations about the importance of dietary and fluid restrictions, medication adherence, and recognizing early signs of worsening kidney function. […] Dietary modifications for AKI include a high caloric intake to prevent catabolism, a low protein diet to reduce urea production and prevent further stress on the kidneys, a low potassium diet to prevent hyperkalemia, and a low sodium diet to prevent fluid overload and hypertension.

• #35 Acute Kidney Injury: Care Instructions | Kaiser Permanente

  https://healthy.kaiserpermanente.org/health-wellness/health-encyclopedia/he.acute-kidney-injury-care-instructions.tw12416

  Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take. […] If you need dialysis, follow the instructions and schedule for dialysis that your doctor gives you. […] Review all of your medicines with your doctor. Do not take any medicines, including nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), unless your doctor says it is safe for you to do so. […] Make sure that anyone treating you for any health problem knows that you have had AKI. […] Watch closely for changes in your health, and be sure to contact your doctor if: You do not get better as expected.

• #36

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12416

  Acute kidney injury (AKI) is a sudden decrease in kidney function. This can happen over a period of hours, days or, in some cases, weeks. […] When AKI happens, the kidneys have trouble removing waste and excess fluids from the body as urine. The waste and fluids build up and become harmful. […] Kidney function may return to normal if the cause of AKI is treated quickly. Your chance of a full recovery depends on what caused the problem, how quickly the cause was treated, and what other medical problems you have. You may have a treatment called dialysis. It does the work of healthy kidneys to remove waste and fluids for a short time. If you are in an intensive care unit (ICU), you may get kidney dialysis in the ICU. […] Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It’s also a good idea to know your test results and keep a list of the medicines you take.

• #37

  https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=tw12416

  Talk to your doctor about how much fluid you should drink. […] If you need dialysis, follow the instructions and schedule for dialysis that your doctor gives you. […] Review all of your medicines with your doctor. Do not take any medicines, including non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Advil, Motrin) or naproxen (Aleve), unless your doctor says it is safe for you to do so. […] Make sure that anyone treating you for any health problem knows that you have had AKI. […] Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you do not get better as expected.

• #38 Acute kidney injury (AKI) | Kidney Care UK

  https://kidneycareuk.org/kidney-disease-information/kidney-conditions/patient-info-acute-kidney-injury-aki/

  However, in severe cases, you may need to go into hospital to have dialysis. This is a treatment for severe kidney disease and uses a machine to remove the waste products and excess fluid that build up in your body when your kidneys stop working. […] Most people with AKI only need to have dialysis for a few days or weeks until their kidneys start working again. […] Most people with AKI make a full recovery and do not need any long-term treatment. […] Your GP will monitor your kidney function and blood pressure for at least three years after an episode of AKI. […] You should check with your doctor before taking any new medicine or herbal supplements in case they could damage your kidneys.

• #39 Acute Kidney Injury (AKI) TOOLKIT​ – International Society of Nephrology

  https://www.theisn.org/initiatives/toolkits/acute-kidney-injury-aki-toolkit/

  Patients with AKI should be followed up within 3 months after discharge. […] Follow-up visit should include check on kidney function or damage. […] Certain categories of patient with AKI may need earlier follow-up. […] Atypical clinical course or failure to recover during follow-up: Necessitate specialist referral to ascertain the cause.

• #40 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  A nursing care plan for AKI should include monitoring vital signs for hypotension, tachycardia, fever, and respiratory rate changes, assessing fluid status for volume depletion or overload, tracking urine output, and monitoring neurological status for signs of uremia. […] The North American Nursing Diagnosis Association’s (NANDA) nursing diagnoses for AKI include ineffective renal tissue perfusion, risk for electrolyte imbalance, excess fluid volume, altered thought processes, impaired skin integrity, risk for infection, and deficient knowledge related to AKI management. […] Expected outcomes for AKI management include improved renal function with decreasing creatinine and adequate urine output, stable fluid balance, normalization of electrolytes, and patient and family understanding of AKI, its management, and the importance of follow-up care.

• #41 Acute Renal Failure Nursing Care and Management: Study Guide

  https://nurseslabs.com/acute-renal-failure/

  Learn about the nursing care management of patients with acute renal failure in this nursing study guide. […] The nurse has an important role in caring for the patient with ARF. […] Assessment usually focuses on the characteristics of the urine. […] The goals for a patient with ARF are: Improve nutritional intake. Restore fluid balance. Reduce metabolic rate. Promote pulmonary function. Prevent infection. […] Nursing interventions are aimed at restoring renal function and reducing potential causes of increased renal injury. […] A successful nursing care plan has achieved the following: Improved nutritional intake. Restored fluid balance. Reduced metabolic rate. Promoted pulmonary function. Prevented infection. […] The nurse plays an important role in teaching the patient and family with ARF.

• #42 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  Therapeutic interventions and nursing actions for patients with acute renal failure (ARF) may include: Managing Fluid Volume and Hypervolemia, Minimizing Risk of Cardiac Complications, Promoting Optimal Nutritional Balance, Promoting Infection Control and Minimizing Risk for Infection, Minimizing Risk for Hypovolemia, Initiating Health Teachings and Patient Education, Administering Medications and Pharmacologic Support, Monitoring Laboratory and Diagnostic Procedures. […] In the case of prerenal acute kidney injury (AKI), fluid resuscitation is the gold standard, but if this resuscitation continues beyond the correction of hypovolemia, then it is associated with increased morbidity, mortality, and length of hospital stay as well as increased risk of AKI. […] The prognosis for clients with AKI is directly related to the cause of the injury and, to a great extent, to the presence or absence of preexisting kidney disease, as well as to the duration of kidney dysfunction prior to therapeutic intervention.

• #43 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  A nursing care plan for AKI should include monitoring vital signs for hypotension, tachycardia, fever, and respiratory rate changes, assessing fluid status for volume depletion or overload, tracking urine output, and monitoring neurological status for signs of uremia. […] The North American Nursing Diagnosis Association’s (NANDA) nursing diagnoses for AKI include ineffective renal tissue perfusion, risk for electrolyte imbalance, excess fluid volume, altered thought processes, impaired skin integrity, risk for infection, and deficient knowledge related to AKI management. […] Expected outcomes for AKI management include improved renal function with decreasing creatinine and adequate urine output, stable fluid balance, normalization of electrolytes, and patient and family understanding of AKI, its management, and the importance of follow-up care.

• #44 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  Use this nursing care plan and management guide to help care for patients with acute renal failure. Learn about the nursing assessment, nursing interventions, goals and nursing diagnosis for acute renal failure in this guide. […] The nursing care plan and management for clients with acute renal failure are to promote renal function, correct or eliminate any reversible causes of kidney failure, and provide supportive care. Specific interventions include monitoring and managing fluid and electrolyte imbalances, optimizing nutrition, and ensuring medication safety. Nurses also work to support the patients emotional well-being and provide education on self-care and prevention of future kidney damage. […] The following are the nursing priorities for patients with acute renal failure (ARF): Assessment and monitoring of renal function, Fluid and electrolyte balance management, Identification and treatment of the underlying cause, Prevention and management of complications (e.g., electrolyte imbalances, metabolic acidosis), Monitoring and management of fluid overload or dehydration, Hemodynamic stability and blood pressure control, Education on self-care and compliance with treatment plans.

• #45 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  Following a thorough assessment, a nursing diagnosis is formulated to specifically address the challenges associated with acute renal failure based on the nurses clinical judgement and understanding of the patients unique health condition. […] Goals and expected outcomes may include: The client will display appropriate urinary output with specific gravity/laboratory studies near normal; stable weight, vital signs within the clients normal range; and absence of edema. The client will maintain cardiac output as evidenced by BP and HR/rhythm within the clients normal limits; peripheral pulses are strong and equal with adequate capillary refill time. The client will maintain/regain the weight as indicated by the individual situation, free of edema. The client will experience no signs/symptoms of infection. The client will display IO near balance; good skin turgor, moist mucous membranes, palpable peripheral pulses, stable weight, vital signs, and electrolytes within normal range.

• #46 Acute Kidney Injury: Nursing Diagnosis & Interventions | Nurse.com

  https://www.nurse.com/clinical-guides/acute-kidney-injury/?srsltid=AfmBOoppJjTSkeeGUT4WlxjP6lTlpGZwBpKbIbWtIAETIns5fPnD-Kon

  A nursing care plan for AKI should include monitoring vital signs for hypotension, tachycardia, fever, and respiratory rate changes, assessing fluid status for volume depletion or overload, tracking urine output, and monitoring neurological status for signs of uremia. […] The North American Nursing Diagnosis Association’s (NANDA) nursing diagnoses for AKI include ineffective renal tissue perfusion, risk for electrolyte imbalance, excess fluid volume, altered thought processes, impaired skin integrity, risk for infection, and deficient knowledge related to AKI management. […] Expected outcomes for AKI management include improved renal function with decreasing creatinine and adequate urine output, stable fluid balance, normalization of electrolytes, and patient and family understanding of AKI, its management, and the importance of follow-up care.

• #47 Nursing Care Plan (NCP) for Acute Kidney Injury | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-acute-kidney-injury

  Review laboratory results, including serum creatinine, blood urea nitrogen (BUN), electrolytes (potassium, sodium), and arterial blood gases to evaluate renal function and identify imbalances. […] Assess for signs and symptoms of AKI, including edema, changes in mental status, nausea, vomiting, and diminished urine output. Monitor for complications such as metabolic acidosis or hyperkalemia. […] Collaborate with specialized teams, such as nephrology and infectious disease, for a comprehensive assessment and management of underlying conditions contributing to AKI. […] Evaluation for Acute Kidney Injury (AKI) Nursing Care: […] Evaluate renal function by assessing trends in serum creatinine and blood urea nitrogen (BUN) levels. A decline in these values indicates improved kidney function.

• #48 Acute Kidney Injury: Diagnosis and Management | AAFP

  https://www.aafp.org/pubs/afp/issues/2019/1201/p687.html

  Management of acute kidney injury is primarily supportive, with the goals of preventing further damage and promoting recovery of renal function. […] If fluid resuscitation is indicated, isotonic crystalloids (e.g., 0.9% normal saline, lactated Ringer solution, Plasma-Lyte A) are recommended over colloids (e.g., albumin, dextran) as the initial therapy. […] A review of medications requiring discontinuation, dose adjustment, or monitoring is critical to the management of acute kidney injury. […] Early nephrology consultation (within 48 hours) appears to be beneficial for patients with acute kidney injury. […] Acute kidney injury care bundles, a specific set of guideline-based diagnostic and therapeutic interventions, are associated with improved in-hospital mortality rates and reduced risk of progression in observational studies.

• #49 Nursing Care Plan (NCP) for Acute Kidney Injury | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-acute-kidney-injury

  Monitor ongoing fluid and electrolyte balance, assessing for the resolution of imbalances and preventing complications associated with fluid overload or electrolyte disturbances. […] Assess for the resolution of symptoms related to AKI, such as edema, hypertension, and electrolyte abnormalities. Improvement in these symptoms indicates successful intervention. […] Evaluate the prevention or mitigation of complications associated with AKI, such as uremia, acid-base imbalances, and cardiovascular complications, ensuring optimal patient outcomes. […] Assess the patients understanding of self-management strategies, medication adherence, and adherence to lifestyle modifications. Patient empowerment and active participation in their care contribute to successful long-term outcomes.

• #50 Nursing Care Plan (NCP) for Acute Kidney Injury | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-acute-kidney-injury

  Monitor ongoing fluid and electrolyte balance, assessing for the resolution of imbalances and preventing complications associated with fluid overload or electrolyte disturbances. […] Assess for the resolution of symptoms related to AKI, such as edema, hypertension, and electrolyte abnormalities. Improvement in these symptoms indicates successful intervention. […] Evaluate the prevention or mitigation of complications associated with AKI, such as uremia, acid-base imbalances, and cardiovascular complications, ensuring optimal patient outcomes. […] Assess the patients understanding of self-management strategies, medication adherence, and adherence to lifestyle modifications. Patient empowerment and active participation in their care contribute to successful long-term outcomes.

• #51 Nursing Care Plan (NCP) for Acute Kidney Injury | Free NURSING.com Courses

  https://nursing.com/lesson/nursing-care-plan-for-acute-kidney-injury

  Monitor ongoing fluid and electrolyte balance, assessing for the resolution of imbalances and preventing complications associated with fluid overload or electrolyte disturbances. […] Assess for the resolution of symptoms related to AKI, such as edema, hypertension, and electrolyte abnormalities. Improvement in these symptoms indicates successful intervention. […] Evaluate the prevention or mitigation of complications associated with AKI, such as uremia, acid-base imbalances, and cardiovascular complications, ensuring optimal patient outcomes. […] Assess the patients understanding of self-management strategies, medication adherence, and adherence to lifestyle modifications. Patient empowerment and active participation in their care contribute to successful long-term outcomes.

• #52 8 Acute Renal Failure Nursing Care Plans – Nurseslabs

  https://nurseslabs.com/acute-renal-failure-nursing-care-plans/

  AKI also adversely affects immune function and is widely considered an immunosuppressed state. A wealth of data has accumulated that clients with AKI have a substantially increased risk of subsequent infection and sepsis. […] The importance of kidney care has become evident in studies showing that individuals who survive an episode of AKI are at increased risk of adverse outcomes that include both kidney and non-kidney sequelae. […] The current recommendation by KDIGO for dialysis-dependent AKI clients is to deliver a kt/v of 3.9 per week when using intermittent or extended RRT and an effluent volume of 20 to 25 mg/kg/hour when using continuous renal replacement therapy (CRRT).

• #53 Acute Kidney Injury – Symptoms, causes, treatment | National Kidney Foundation

  https://www.kidney.org/kidney-topics/acute-kidney-injury-aki

  If your healthcare professional suspects AKI, they will perform an assessment to identify its potential cause (or causes). […] Treatment for AKI depends on what caused it in the first place. This is why finding the cause is so important. […] Most people with AKI will need to spend some time in the hospital to be monitored while receiving treatment. […] After having AKI, you have a higher risk for other health problems, such as chronic kidney disease (CKD), heart disease, or stroke). You are also at a higher risk of getting AKI again in the future. So, it is important to have regular follow-up visits with your healthcare professional and check your kidney health, starting with two simple tests (ideally within 3 months of finishing treatment for your AKI).

• #54 Acute kidney injury

  https://www.nhs.uk/conditions/acute-kidney-injury/

  Acute kidney injury (AKI) is where your kidneys suddenly stop working properly. It can range from minor loss of kidney function to complete kidney failure. […] It’s essential that AKI is detected early and treated promptly. […] Without quick treatment, abnormal levels of salts and chemicals can build up in the body, which affects the ability of other organs to work properly. […] Even if it does not progress to complete kidney failure, AKI needs to be taken seriously. […] AKI is different from chronic kidney disease, where the kidneys gradually lose function over a long period of time. […] Treatment of AKI depends on what’s causing your illness and how severe it is. […] You may need to go to hospital for some treatments. […] Most people with AKI make a full recovery, but some people go on to develop chronic kidney disease or long-term kidney failure as a result.

• #55 Acute Kidney Injury: A Nursing Challenge – CNE | ANA

  https://www.nursingworld.org/continuing-education/AN2305-Acute-Kidney/

  Nurses play a critical role in the monitoring and management of Acute Kidney Injury (AKI) and are invaluable members of the multi-disciplinary team caring for persons with AKI. It is imperative that nurses have a clear understanding of their role within AKI management to help aide in the prevention of life threatening complications from AKI. […] The monitoring of serum creatinine, estimated glomerular filtration rate, and urine output is essential in the management of AKI. Prompt treatment of AKI is essential in preventing life threatening complications. […] Describe nursing interventions in interdisciplinary collaborative management that can impact patient outcomes.

• #56 Acute kidney injury: A nursing challenge

  https://www.myamericannurse.com/acute-kidney-injury-challenge/

  Acute kidney injury (AKI) is a common condition affecting hospitalized patients, particularly those who are critically ill. […] Monitoring serum creatinine, estimated glomerular filtration rate, and urine output is essential to AKI management. […] Prompt treatment of AKI aids in preventing life-threatening complications. […] Discuss nursing interventions in interdisciplinary collaborative management that can impact patient outcomes. […] AKI management requires interdisciplinary collaboration aimed at making renal dose adjustments, providing hemodynamic support, avoiding nephrotoxic medications, and preventing hyperglycemia. […] Nurses play a vital role in this care, as well as in managing continuous renal replacement therapy (CRRT). […] For critically ill patients with AKI, nurses should conduct daily and periodic eGFR checks to monitor disease progression and treatment response.

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