Week 7- AKI-CKD-Dialysis

AKI Dietary Needs

High carbohydrate and protein intake should be maintained.

AKI Dietary Restrictions

Restrict potassium (K), phosphorus (Phos), magnesium (Mg), and sodium (Na).

CKD Dietary Restrictions

Restrict sodium (Na), potassium (K), phosphorus (Phos), magnesium (Mg).

CKD Dietary Maintenance

High carbohydrate intake and protein maintenance.

CKD Dietary Focus with Fluid Retention

Low sodium, low potassium, low phosphorus, high carbohydrates, protein maintenance.

PD Complications

Common complications include peritonitis, leakage, bleeding, and skin infection at the site.

PD Lab Disturbances

Electrolyte imbalances may occur.

Creatinine in Kidney Injury

Increased (normal: 0.6–1.2 mg/dL).

BUN in Kidney Injury

Increased (normal: 10–20 mg/dL).

GFR in Kidney Injury

Decreased (normal: 90–120 mL/min).

Potassium in Kidney Injury

Increased (normal: 3.5–5 mEq/L).

Erythropoietin Function

Stimulates production of red blood cells (RBCs).

AKI Expected Findings

Hypertension, edema, dysrhythmias, hyperkalemia, crackles, shortness of breath, decreased O₂, fluid retention.

CKD Expected Findings

Decreased GFR, elevated creatinine, decreased sodium, increased BUN, anemia, fluid retention, metabolic acidosis, hypertension.

ESRD Expected Complications

Peripheral neuropathy, pain, pruritis, electrolyte imbalances.

HD Medication Precautions

Hold all prescription medications (especially blood pressure medications) before hemodialysis; confirm with provider.

HD Nurse Monitoring

Monitor for hypovolemia, muscle cramps, bleeding, and disequilibrium syndrome.

HD Access Arm Precautions

No lab draws, IVs, or blood pressure measurements on the access arm.

AV Fistula Bruit

A swooshing sound heard over an AV fistula indicating patency.

AV Fistula Thrill

A vibration felt over an AV fistula indicating patency.

AV Fistula Assessment

Fistula should be assessed every shift.

Fluid Overload Signs

Weight gain, edema, shortness of breath, crackles, jugular vein distention (JVD), hypertension, bounding pulse.