Question 1

What key information should nurses collect during the initial assessment of a patient with acute kidney injury?

Accepted Answer

Nurses should review the patient's history for recent infections, nephrotoxic drug use, hypertension, and diabetes. During physical examination, assess for oliguria, peripheral edema, jugular vein distension, lung crackles, muscle weakness, and ECG changes like peaked T waves. These findings help identify the underlying cause and severity of acute kidney injury.

Question 2

What are the primary nursing diagnoses for patients with acute kidney injury?

Accepted Answer

Key nursing diagnoses include excess fluid volume related to impaired kidney function, evidenced by peripheral edema and weight gain; impaired gas exchange related to fluid buildup in the lungs, evidenced by dyspnea and crackles; and risk for electrolyte imbalance due to compromised renal clearance, particularly hyperkalemia. These diagnoses guide targeted interventions.

Question 3

How do nurses monitor and manage fluid balance in acute kidney injury patients?

Accepted Answer

Nurses monitor accurate intake and output and measure daily weight to track fluid status. Diuretics are administered cautiously as prescribed to reduce fluid overload. Positioning patients in semi-Fowler's position facilitates lung expansion and alleviates dyspnea, while frequent repositioning prevents atelectasis and promotes better oxygenation.

Question 4

What dietary and medication education is essential for acute kidney injury patients?

Accepted Answer

Patients should follow a low-sodium and potassium-restricted diet to control fluid retention and prevent electrolyte imbalances. Educate on medication adherence, including diuretics and electrolyte-stabilizing drugs, while avoiding nephrotoxic medications like NSAIDs. This education reduces fluid retention and minimizes further kidney damage.

Question 5

How can nurses prevent hyperkalemia in acute kidney injury patients?

Accepted Answer

Nurses monitor electrolyte levels closely, particularly potassium, to detect rising levels early. Educate patients on potassium-restricted diets and ensure medications are appropriately dosed based on renal function. Regular assessment of ECG changes and muscle weakness helps identify hyperkalemia symptoms before serious cardiac complications develop.

Question 6

What interventions improve oxygenation and gas exchange in acute kidney injury patients?

Accepted Answer

Position patients in semi-Fowler's position to facilitate lung expansion and reduce dyspnea. Encourage deep breathing exercises and frequent repositioning to prevent atelectasis. Monitor lung sounds for crackles and assess oxygen saturation regularly. These interventions address impaired gas exchange caused by pulmonary fluid buildup.

Question 7

How should nurses evaluate and adjust the care plan for acute kidney injury patients?

Accepted Answer

Regularly assess patient responses to interventions by monitoring vital signs, oxygen saturation, weight changes, and peripheral edema. Educate patients on follow-up care and lifestyle modifications including physical activity and smoking cessation. Adjust the care plan based on these evaluations to achieve therapeutic goals of improved fluid balance and oxygenation.

פגיעה חריפה בכליות VI: ניהול סיעודי

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