Acute Kidney Injury Essay

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Acute Kidney Injury: How Nurses Guide the Care
Some may think that they words acute kidney injury and chronic kidney disease mean the same thing, but that is incorrect. Kidney failure results from the kidneys not being able to eliminate metabolic waste products and water, which can also disturb all other organs of the body. Acute kidney injury (AKI) is a sudden and rapid loss of kidney function that usually occurs over hours to days due to acute tubular necrosis. Acute tubular necrosis is a process where ischemia affects parts of the kidneys and disrupts the basement membrane and the tubular epithelium. Chronic kidney disease (CKD) has a gradual onset and can take place over many years. CKD is seen in many diabetic patients due to diabetic neuropathy. AKI is a much more serious issue and should be taken very seriously.
AKI is usually found when a patient’s serum creatinine is abnormally elevated or they have a sudden reduction in urine output. Due to these clinical manifestations a patient can develop azotemia, meaning that a large amount of waste products build up in the blood. AKI has a high mortality rate of 60-70%, especially if not noted quickly. AKI is sometimes reversible depending on the co-existing morbidities of the patient and how well the patient’s body reacts to treatments.
When caring for a patient with AKI the main goal is to prevent any complications and manage the complications the patient is experiencing while trying to reverse the cause. Being that urine output is the best sign that the kidneys are being perfused the bedside nurse must be strictly monitoring this patient’s fluid intake and urine output. Diuretic therapy is also started in low doses to help the kidneys along. AKI patient’s electrolyte levels...

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...use the ammonia retained in the patient’s saliva can disrupt the mucous membranes.
Anxiety is another important issue to address with AKI patients as they may be afraid related to the rapid onset of the disease and the unknown outcome of their condition. It is important to assess neurological function and any emotional needs the patient may require, such as counseling or antidepressant medications.
Overall, for an acute kidney failure patient the hope is that they are able to have complete recovery and be free of complications and electrolyte and fluid imbalances by the end of treatment. Though, this is not true for most, because many AKI patients have co-existing morbidities and need treatment until the end of life. As nurses all we can do is give the best care that we know how and make our patients feel as comfortable as possible while they’re under our care.

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