Question

QSEN for Acute Kidney Injury ( pt. in ICU)

Answer 1

Ans) QSEN for Acute Kidney Injury ( pt. in ICU):

Nursing Priorities - Prevent volume depletion & provide intervention early!

Reduced perfusion from volume depletion is a common cause of AKI

Recognize manifestations of volume depletion
- Low urine output
- Decreased SBP
- Decreased pulse pressure
- Orthostatic hypotension
- Thirst
- Rising blood osmolality

Intervene early with oral fluids or **REQUEST AN INCREASE IN IVF rate from health care provider (MD, DO, NP, PA) to prevent damage to the kidneys

A clinically significant increase in creatinine especially when the increase occurs over hours or a few days is a concern and should be reported urgently to health care providers

Question any...:
- Prescription for potentially nephrotoxic medications & validate dose
- Combination of 2 or more nephrotoxic medications [this increases the risk of AKI (NSAIDs + many antibiotics)]
- If pt must receive nephrotoxic medications closely monitor labs including BUN, creatinine, peak & trough levels
- Recommend pretreatment with oral or IV bolus of fluids (Push - Pull Effect).