Acute Kidney Failure Research Paper

Acute kidney failure occurs when your kidneys become inadequate to filter waste products that form in your blood. Chemicals start to build up in your blood that could be fatal. If you catch it soon enough you can reverse the effect and come back to regular kidney functions.

Prerenal failure its common to have a decrease in urine output but not always. Fluid retention which commonly causes swelling in distal extremedies,slumberous, dyspnea, chronic fatigue and nausea. The man who arrived into the clinic had complained about almost all symptoms of acute renal failure. Intrinsic renal failure is when the direct damge causes the kidney to lose its function. Most common intrinsic renal failure is acute tubular necrosis where the small filtering

tubes are damaged.

This mainly happens patients who are already hospitalized. Acute glomerulonephritis is where the blood vessels in kidney becomes inflamed and unable to filter blood properly. Postrenal would include a urinary tract obstruction. Kidney stones or renal malignancy. Next we would need to perform a bladder scan to make sure its not just renal retention, monitor for 50-100mls for neurogenic bladder. To be sure it is an acute renal failure diagnoses test will be performed. A serum creatinine level you compare the patient creatinine level with previous levels to determine the duration and how long the kidneys have been failing, its usually a rise in creatinine has occurred in the first 48 hours. A complete blood count will show if there is acute hemolytic anemia with the peripheral smear showing schistocytes in the setting of acute kidney injury should raise the possibility of hemolytic uremic

syndrome or thrombotic thrombocytopenic purpura. Stage one is more of a warning sign you should not ignore, there is a chance to reverse it in this stage but most people but things off and next thing you are in the second stage and before you know it you are in end stage renal disease.
Subjective and objective signs and symptoms of acute renal failure, subjective would be the patient complaining of less urination, dizziness, nausea, shortness of breath, confusion, fatigue, chest pain or pressure, fluid retention causing swelling in legs, ankles and feet. Objective signs would be anuria the patient has nonpassage of urine less than <100ML a day. The patient will also show signs of asthenia which is muscle weakness, which the patient would not be able to ambulate. Oliguria the patient also like anuria would be low output of urine but in this case it would be more than 100 but less than 400. Positive for uremia which is high amount of protein and amino acids found in urine would show. Azotemia is elevated of blood urea nitrogen and serum creatinine levels. The reference range for BUN is 10-20 mg/dL, and the normal range for serum creatinine is 0.7-1.4 mg/dL.
A dietary modification the nurse should teach a client who has renal insufficiency and chronic renal failure, you need develop a healthy meal plan that includes limited protein, and limits salt, sugar, phosphorus and potassium also limiting their fluid intake to safe levels each day this also includes a high intake or vitamin B, Calcium and Iron.

In the early stages of kidney failure, you do not need to limit the fluid you drink. But, as your condition gets worse, or when you are on dialysis, you will need to watch the amount of liquid you take in. While reciving dialysis sessions, fluid can build up in the body. Too much fluid will lead to shortness of breath, and edema or an emergency that needs immediate medical attention. Your doctor or nusee will let you know how much you should drink every day depending on each individual. Do not eat too much of foods that contain a lot of water, such as soups, Jell-O, Popsicles, ice cream, grapes, melons, lettuce, tomatoes, and celery because they have a lot of

water.
Medical management of acute renal failure is two things one is dialysis, dialysis is when your kidney no longer can function as a kidney. Dialysis does it for you. There is also two types of dialysis you can receive one is hemodialysis, an artificial kidney which is used to remove waste and extra chemicals and fluid from your blood. It helps to get the blood into the artificial kidney, the doctor needs to make an enterance into your blood vessels which is done by minor surgery to your arm or leg. Most of the time they make an access by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula, but if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin which is called a graft. Sometimes, an opening is made by a narrow plastic tube, which is called a catheter and is inserted into a large vein in your neck. This type can be temporary, but sometimes used for long-term treatment. Also there is peritoneal dialysis, which your blood is cleaned inside your body. Surgery is done to place a plastic tube called a catheter into your abdomen to make an access. During the treatment, your abdominal area is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. All the extra fluid and waste products are drawn out of your blood and into the dialysate. Also you can receive a transplant which is very common in US. You can receive a kidney from a living donor which can be like related person, living unrelated donor like a friend or your spouse also a deceased donor like a person who has recently died and has good kidneys. The kidney can be preserved for 48 hours and that gives us enough time to perform test to ensure the tissue will match.
A short term goal for patients with acute renal failure The patient will exhibit signs of adequate perfusion by having a normal MAP 70 or greater
, urine output of 30 ML/HR, heart rate of 60-100 bpm, the patient will exhibit signs of optimal fluid volume status of normal MAP (70-100)
, also would be lungs clear to auscultation
. The Long term goals the patient will experience adequate renal perfusion as evidenced by urine output of at least 30 ML/HR, also the patient will experience normal fluid volume status as evidenced by balanced intake and output, weight loss, stable vital signs, normal breath sounds.