Acute Kidney Injury (AKI) occurs when there is a sudden loss of renal function resulting in the bodies inability to maintain homeostasis. AKI is common in clients who are in the hospital, in intensive care units, and especially in older adults (“Acute Kidney Injury” (AKI), 2017). The following is an evolving case study regarding a client who presented to the emergency department after experiencing nausea, vomiting and diarrhea for the past week. This evolving case study will evaluate the client’s signs and symptoms, diagnostic and laboratory tests and medical diagnoses to establish a priority nursing diagnosis and the interventions needed to care for this client during hospital stay.
Clinical Presentation
On March 19, 2018 K.C. presented to …show more content…
AKI is characterized by a sudden loss of function in the renal system. This disease can be 1. prerenal, meaning the issue lies somewhere before the kidneys (i.e. volume loss), a perfusion issue; 2. intrarenal, meaning the problem is within the kidneys (i.e. nephrotoxic agents); or 3. post-renal, meaning the kidneys have a problem with excreting urine. The kidneys can have atherosclerosis, an infection in the kidneys, inflammation in the kidneys, or a toxic injury where the kidneys are having difficulty filtering them out (Story, …show more content…
It is manifested by the kidneys ability to maintain proper fluid balance. This can cause electrolyte imbalance as well as acid base balance which could occur in a few hours or over days with a healing period of a few months (Ignatavicius & Workman, 2016).
The acronym “RIFLE” helps classify and describe the stages and outcomes based on GFR and urine output. The first three letters classify the stages. R stands for risk and is manifested with a decreased GFR by >25%; I stands for injury, and GFR has decreased >50%; The F is for final and there is a 75% decrease in GFR. The last two letters describe the outcomes. The L is for loss, which is indicated when clients require renal replacement therapy for > four weeks; and finally, E represents the end stage where a client requires dialysis for more than three months (Ignatavicius & Workman, 2016).
Left-Sided Heart Failure (LHF), or CHF is essentially the inability of the heart to pump in a manner that meets the needs of the body. The hearts inadequacy to pump leads to decreased cardiac output (CO), increased preload and afterload, which leads to the hearts decreased contractility and decreased stroke volume (SV). This disease process can be acute or chronic (Story,
Clinical Presentation
On March 19, 2018 K.C. presented to …show more content…
AKI is characterized by a sudden loss of function in the renal system. This disease can be 1. prerenal, meaning the issue lies somewhere before the kidneys (i.e. volume loss), a perfusion issue; 2. intrarenal, meaning the problem is within the kidneys (i.e. nephrotoxic agents); or 3. post-renal, meaning the kidneys have a problem with excreting urine. The kidneys can have atherosclerosis, an infection in the kidneys, inflammation in the kidneys, or a toxic injury where the kidneys are having difficulty filtering them out (Story, …show more content…
It is manifested by the kidneys ability to maintain proper fluid balance. This can cause electrolyte imbalance as well as acid base balance which could occur in a few hours or over days with a healing period of a few months (Ignatavicius & Workman, 2016).
The acronym “RIFLE” helps classify and describe the stages and outcomes based on GFR and urine output. The first three letters classify the stages. R stands for risk and is manifested with a decreased GFR by >25%; I stands for injury, and GFR has decreased >50%; The F is for final and there is a 75% decrease in GFR. The last two letters describe the outcomes. The L is for loss, which is indicated when clients require renal replacement therapy for > four weeks; and finally, E represents the end stage where a client requires dialysis for more than three months (Ignatavicius & Workman, 2016).
Left-Sided Heart Failure (LHF), or CHF is essentially the inability of the heart to pump in a manner that meets the needs of the body. The hearts inadequacy to pump leads to decreased cardiac output (CO), increased preload and afterload, which leads to the hearts decreased contractility and decreased stroke volume (SV). This disease process can be acute or chronic (Story,