Asuhan Keperawatan Pada Pasien Dengan Gagal Ginjal Akut(GGA)
Summary
TLDRThe video explains acute kidney failure, starting with its definition as a sudden decline in kidney function over days or weeks. It covers classification, causes such as reduced blood flow, trauma, and urinary blockages, and the kidney's anatomy and physiology. The pathophysiology is detailed into prerenal, renal, and postrenal categories. Clinical manifestations include reduced urine output, nausea, and high blood pressure. Treatment involves fluid and blood pressure management, while nursing care includes patient assessment, diagnosis, and interventions to address respiratory issues, activity intolerance, and nutritional imbalances.
Takeaways
- 🔍 Acute kidney failure is a syndrome characterized by a sudden decrease in kidney function within a few days or weeks, which can lead to the loss of the kidney's ability to maintain body homeostasis.
- 📊 Classification of acute kidney failure includes prerenal, renal, and postrenal causes.
- 💡 Causes of acute kidney failure can be due to decreased blood flow to the kidneys, trauma, toxic substances, or blockages in the urinary tract.
- 🔬 The kidneys are anatomically located with the right kidney lower than the left due to the liver's size and are encased in three layers of tissue: renal capsule, adipose tissue, and renal fascia.
- 🧠 Kidney functions include toxin removal, fluid balance, acid-base balance, and elimination of metabolic waste such as urea, creatinine, and ammonia.
- 🚰 Urine formation occurs in three stages: glomerular filtration, tubular reabsorption, and tubular secretion.
- 🧪 Pathophysiology of acute kidney failure is categorized into prerenal (reduced kidney perfusion), renal (damage within the kidneys), and postrenal (obstruction of urine flow).
- 📉 Clinical manifestations of acute kidney failure include reduced urine output, nausea, vomiting, decreased appetite, foul breath, high blood pressure, fatigue, edema, decreased consciousness, dehydration, seizures, and back pain.
- 💉 Management of acute kidney failure involves fluid status correction, blood pressure regulation, electrolyte and acid-base balance correction.
- 📝 Nursing care includes assessment (biodata, health history, physical examination, and laboratory tests), diagnosis (e.g., ineffective breathing pattern, activity intolerance, nutritional imbalance), and interventions (e.g., respiratory support, activity assistance, nutritional support).
Q & A
What is acute kidney failure?
-Acute kidney failure is a syndrome resulting from metabolic or pathological damage to kidney tissues, characterized by a sudden decline in kidney function within a few days or weeks, with or without oliguria, leading to the inability of the kidneys to maintain body homeostasis.
What are the primary classifications of acute kidney failure?
-Acute kidney failure can be classified into three main types: prerenal (due to decreased blood flow to the kidneys), renal (due to damage within the kidneys), and postrenal (due to obstruction of urine flow after it leaves the kidneys).
What are the common causes of prerenal acute kidney failure?
-Common causes include dehydration, blood vessel blockage, reduced heart pumping capacity, heart failure, and severe low blood pressure or shock.
How does trauma affect the kidneys and lead to acute kidney failure?
-Trauma to the kidneys can cause allergic reactions, exposure to toxins, and conditions that affect the kidney's filtering units, leading to acute kidney failure.
What are the physiological functions of the kidneys?
-The kidneys play crucial roles in excreting toxins, maintaining fluid balance, regulating acid-base balance, and eliminating waste products of protein metabolism such as urea, creatinine, and ammonia.
What are the three stages of urine formation in the kidneys?
-The three stages are glomerular filtration in the glomerulus and Bowman's capsule, reabsorption in the proximal tubules, and secretion or augmentation in the distal tubules.
What are the clinical manifestations of acute kidney failure?
-Clinical manifestations include decreased urine output, nausea and vomiting, loss of appetite, foul breath, difficulty breathing, high blood pressure, fatigue, edema, decreased consciousness, dehydration, seizures, and back pain below the ribs.
How is the fluid status of a patient with acute kidney failure managed?
-Fluid status is managed by resuscitation with isotonic crystalloid fluids like normal saline or Ringer's lactate to correct fluid deficiency.
What diagnostic tests are used to assess kidney function in acute kidney failure?
-Diagnostic tests include measuring creatinine and blood urea nitrogen (BUN) levels, creatinine clearance, serum electrolyte levels, urine tests, blood tests to monitor creatinine, urea, and electrolytes, glomerular filtration rate (GFR) measurement, and imaging studies like kidney ultrasound or biopsy if necessary.
What nursing interventions are recommended for a patient with ineffective breathing patterns due to acute kidney failure?
-Nursing interventions include assessing airway needs, monitoring for pallor and cyanosis, observing respiratory rate, rhythm, depth, and effort, consulting with a respiratory therapist, collaborating with a doctor for medication administration like bronchodilators, providing nebulizer therapy, teaching effective coughing techniques, and encouraging deep abdominal breathing.
Outlines
🩺 Introduction to Acute Kidney Failure
This paragraph provides an overview of acute kidney failure, explaining its definition as a syndrome caused by metabolic or pathological damage leading to a sudden decrease in kidney function over days or weeks, with or without oliguria, resulting in the loss of the kidneys' ability to maintain body homeostasis.
🔍 Causes of Acute Kidney Failure
This paragraph outlines the various causes of acute kidney failure, which include reduced blood flow to the kidneys, heart failure, very low blood pressure, kidney trauma, allergic reactions, toxins, conditions affecting kidney filtration units, and urinary flow obstructions like prostate enlargement and tumors.
🏥 Kidney Anatomy and Physiology
This paragraph discusses kidney anatomy and physiology, noting that the right kidney is lower than the left due to liver size. The kidneys are encased in three layers: the innermost renal capsule, the middle adipose tissue, and the outermost renal fascia. It also covers kidney functions such as toxin elimination, fluid balance, acid-base balance, and excretion of metabolic waste products.
🧪 Pathophysiology of Acute Kidney Failure
This paragraph explains the pathophysiology of acute kidney failure, classified by etiology into prerenal (decreased kidney perfusion), renal (damage within the kidney), and postrenal (obstruction in the urinary tract). It describes the mechanisms leading to kidney damage in each category, such as hypoperfusion, toxic damage, and increased pressure due to urinary tract obstruction.
🚑 Clinical Manifestations
This paragraph lists the clinical manifestations of acute kidney failure, which include decreased urine output, nausea, vomiting, loss of appetite, bad breath, shortness of breath, high blood pressure, fatigue, edema, decreased consciousness, dehydration, seizures, and lower back pain.
📝 Management and Nursing Care
This paragraph covers the management and nursing care for acute kidney failure, including fluid status correction, blood pressure improvement, and electrolyte and acid-base balance management. It also details nursing assessments, physical examinations, and diagnostic tests like creatinine, blood urea nitrogen, electrolyte levels, urine tests, imaging, and kidney biopsy.
🩺 Nursing Diagnoses and Interventions
This paragraph outlines nursing diagnoses and interventions for patients with acute kidney failure, including ineffective breathing patterns, activity intolerance, and nutritional imbalances. It details goals, criteria for success, and specific nursing interventions, such as respiratory assessment, monitoring oxygen response, providing nutritional support, and collaborating with specialists.
Mindmap
Keywords
💡Acute Kidney Injury
💡Classification
💡Causes
💡Anatomy and Physiology
💡Pathophysiology
💡Clinical Manifestations
💡Management
💡Nursing Care
💡Diagnostic Tests
💡Interventions
Highlights
Definition of acute kidney failure: a syndrome due to metabolic or pathological damage characterized by sudden loss of kidney function within a few days or weeks, with or without oliguria, leading to the inability to maintain body homeostasis.
Classification table of acute kidney failure is presented.
Causes of acute kidney failure include reduced blood flow to the kidneys causing dehydration or blockage of blood vessels, decreased heart pumping ability or heart failure, very low blood pressure (shock), and kidney failure or final stage renal disease.
Trauma to the kidneys causing allergic reactions, toxic substances, conditions affecting the kidney's filtering units, and blockage of kidney arteries or veins.
Post-renal causes include urinary flow obstruction after leaving the kidneys, prostate enlargement, and tumors compressing the urinary tract.
Anatomy of the kidney: the right kidney is positioned lower than the left due to the size of the liver lobe, wrapped by three layers of tissue.
Physiology of the kidney: important roles include excretion of toxins, maintaining fluid balance, acid-base balance, and eliminating metabolic waste products such as urea, creatinine, and ammonia.
Stages of urine formation: glomerular filtration in the glomerulus and Bowman’s capsule, reabsorption in the proximal tubule, and secretion.
Pathophysiology of acute kidney failure is categorized into prerenal, renal, and postrenal causes, each with specific mechanisms such as hypoperfusion, tubular cell damage, and urinary tract obstruction.
Clinical manifestations of acute kidney failure include reduced urine production, nausea and vomiting, loss of appetite, bad breath, shortness of breath, high blood pressure, fatigue, edema, decreased consciousness, dehydration, seizures, and lower back pain.
Management of acute kidney failure: fluid status improvement with isotonic crystalloids, blood pressure improvement with a target mean arterial pressure of at least 65 mmHg, and correction of electrolyte and acid-base imbalances.
Nursing care assessment includes biodata, health history, daily habits, psychological, social, and spiritual history, physical examination, and supporting examinations such as creatinine and BUN levels, urine tests, blood tests, glomerular filtration rate measurement, imaging diagnostics, and kidney biopsy.
Nursing diagnoses include ineffective breathing pattern related to hyperventilation, activity intolerance related to imbalance between oxygen supply and demand, and nutritional imbalance less than body requirements related to nausea and vomiting.
Nursing interventions for ineffective breathing pattern: assess airway needs, monitor for pallor and cyanosis, observe respiratory rate, rhythm, depth, and effort, consult with respiratory therapists, collaborate with doctors for bronchodilator administration, provide nebulizer therapy, and teach effective coughing and deep breathing techniques.
Nursing interventions for activity intolerance: assess patient's ability to transfer, stand, and ambulate, monitor respiratory response to activity, teach controlled breathing techniques during activity, instruct on the use of oxygen equipment during activity, encourage alternating periods of rest and activity, and collaborate with occupational and physical therapists.
Nursing interventions for nutritional imbalance: assess nutritional status, provide easily digestible warm food, assist with feeding if needed, measure food intake and weight, encourage small frequent meals, collaborate with nutritionists for appropriate diet planning, monitor blood glucose, electrolytes, albumin, and hemoglobin levels, and instruct the patient on breathing techniques to reduce nausea and vomiting.
Transcripts
Hai yang gagal ginjal akut di sini nanti
saya akan menjelaskan tentang pertama
ada definisi kedua klasifikasi ketiga
penyebab keempat anatomi dan fisiologi
ginjal yang kelima patofisiologi dan
pathway yang keenam ada manifestasi
klinis yang ketujuh penatalaksanaan dan
yang terakhir asuhan keperawatan
hai Sebelumnya apa sih gagal ginjal akut
itu gagal ginjal akut adalah suatu
sindrom Akibat kerusakan metabolik atau
patologis pada sizzle yang ditandai
dengan penurunan fungsi ginjal yang
mendadak dalam waktu beberapa hari atau
beberapa minggu dengan atau tanpa
oliguria sehingga mengakibatkan
hilangnya kemampuan hijau untuk
mempertahankan homeostasis tubuh di sini
ada tabel klasifikasinya selanjutnya ada
Penyebab gagal ginjal akut merupakan
akibat dari berbagai keadaan yang
menyebabkan pertama berkurangnya aliran
darah ke ginjal menyebabkan dehidrasi
atau tidak David yang menyebabkan
tersumbatnya pembuluh darah selanjutnya
daya pompa jantung menurun atau
kegagalan jantung yang ketiga tekanan
darah yang sangat rendah apa sok yang
terakhir kegagalan ginjal atau film
akhir patoren alis
Hai penyebab kedua yaitu trauma pada
ginjal yang menyebabkan reaksi alergi
zat-zat racun selanjutnya keadaan yang
mempengaruhi unit penyaringan ginjal
atau n yang keempat ada penyumbatan
Arteri atau vena ginjal yang terakhir
kristal protein atau bahan lainnya dalam
ginjal penyebab ketiga yaitu penyumbatan
aliran kemih setelah meninggalkan ginjal
yang pertama menyebabkan pembesaran
prostat di kedua tumor yang menekan
saluran kemih Nah di sini ada anatomi
biar teman-teman
ini dia kanan terletak lebih rendah dari
yang kiri karena besarnya lobus hepar
ginjal dibungkus oleh tiga lapisan
jaringan-jaringan yang terdalam adalah
kapsula renalis jaringan pada lapisan
kedua adalah adiposa dan jaringan
terluar adalah pos ya renault-nissan
Hai selanjutnya fisiologi ginjal yang
pertama fungsi ginjal fungsi ginjal
pertama yaitu memegang peranan penting
dalam pengeluaran zat-zat toksis atau
racun yang kedua mempertahankan
Keseimbangan cairan tubuh yang ketiga
mempertahankan keseimbangan kadar asam
dan basa dari cairan tubuh yang keempat
mengeluarkan zat sisa metabolisme akhir
dari protein ureum Kreatinin dan amonia
Hai selanjutnya ada tahap pembentukan
urine tahap pembentukan urine ada tiga
tahap yang pertama filtrasi glomerular
di glomerulus dan kapsul Bowman yang
kedua reabsorpsi di tubulus proksimal
yang ketiga ada augmentasi atau sekresi
features
Hai selanjutnya Anda patofisiologi
Patofisiologi dari gagal ginjal akut
dibedakan berdasarkan etiologinya ada
tiga yang pertama prerenal yang kedua
ada Rhenald yang ketiga ada pasca Renal
yang pertama prerenal hipoperfusi ke
ginjal yang menyebabkan penurunan laju
filtrasi glomerulus seperti pada
hipovolemia gangguan fungsi jantung
vasodilatasi sistem fix dan peningkatan
resistensi vaskuler yang kedua ada
Rhenald gangguan terjadi dalam sehingga
seperti tubulus glomerulus interstitial
dalam pembuluh darah infrared hal
perusakan dan kematian sel tubulus siapa
disebabkan karena ikhwan toksik yang
terakhir ada pasca Renal adanya
obstruksi pada traktus urinarius dimulai
dari tubulus ginjal hingga uretra dimana
terjadi peningkatan tekanan intra bulet
Hai hadits ini ada pathway tentang gagal
ginjal teman-teman
Hai selanjutnya ada manifestasi klinis
yang pertama berkurangnya produksi urine
ada mual dan muntah nafsu makan
berkurang bernafas menjadi tidak sedap
sesak tingginya tekanan darah mudah
lelah edema penurunan kesadaran
dehidrasi kejang nyeri punggung di bawah
tulang rusuk yang
Hai selanjutnya dia penatalaksanaan
pertama perbaikan status cairan Bila
terdapat kekurangan cairan pada pasien
dengan resiko atau tidak mengalami gagal
ginjal akut sebaiknya resusitasi
dilakukan dengan cairan kristaloid
isotonik seperti cairan sel normal dan
finger rests dan kedua ada perbaikan
tekanan darah perbaikan tekanan darah
dilakukan dengan target mint arterial
pressure minimal 65 mmhg
Hai selanjutnya perbaikan kadar
elektrolit dan keseimbangan asam dan
basa
Hai Tuhan keperawatan pertama ada
pengajian yang berupa biodata crewet
kesehatan pola kebiasaan sehari-hari
riwayat psikologis riwayat sosial
riwayat spiritual pemeriksaan fisik
pemeriksaan head susu pemeriksaan
penunjang pengkajian pemeriksaan
penunjang meliputi high pertama
Kreatinin dan BUMD Perum keduanya tinggi
karena beratnya gagal ginjal kedua
clearance creatinin menunjukkan penyakit
ginjal tahap akhir bila berkurang sampai
dengan 90% yang ketidak yang ketiga
elektrolit serum menunjukkan peningkatan
kalium fosfor kalsium magnesium dan
produk fosfor kalsium dengan natrium
serum rendah yang keempat ada tes urine
dan tes darah Tes darah bertujuan
memantau kadar Kreatinin Urea dan
elektrolit dalam darah hasilnya akan
menggambarkan fungsi ginjal
Hai selanjutnya pengukuran laju filtrasi
darah terus mengukur jumlah pengeluaran
urine pencitraan diagnostik pencitraan
yang paling Umum dilakukan ada USG
ginjal melalui pemeriksaan ini dokter
video dapat dilihat oleh dokter bila USG
saja tidak cukup dokter juga bisa
menghancurkan metode pencitraan lain
selanjutnya biopsi ginjal biopsi adalah
prosedur pengambilan jaringan dalam
kasus tertentu langkah ini dapat
membantu dokter dalam memastikan
diagnosis
Hai selanjutnya ada diagnosis ada data
fokus problem ideologi yang pertama DS
pasien mengatakan kesulitan dalam
bernafas beo pasien tampak sesak dan
sulit bernafas er lebih dari 16 kali
permenit problemnya ketidakefektifan
pola nafas etiologi hiperventilasi ya
kedua DS pasien mengatakan sesak nafas
salah berjalan dan beraktivitas beo
spacenya tengah-tengah setelah berjalan
problem intolerance intoleransi
aktivitas etiologi ketidakseimbangan
antara suplai dan kebutuhan oksigen
Hai selanjutnya BS semangat pasien
mengatakan tidak nafsu makan dan merasa
mual di operasi yang terlihat tidak
menghabiskan makanan pasien terlihat
mual-mual dan muntah-muntah problem
ketidakseimbangan nutrisi kurang dari
kebutuhan tubuh etiologi mual dan muntah
Hai adiknya ada diagnosa keperawatan
pertama ketidak efek efektifan pola
nafas berhubungan dengan hiperventilasi
intoleransi aktivitas berhubungan dengan
ketidakseimbangan antara suplai dan
kebutuhan oksigen ketidakseimbangan
nutrisi kurang dari kebutuhan tubuh
berhubungan dengan mual dan selanjutnya
ada intervensi yang pertama tujuan warna
fast kembali efektif setelah dilakukan
tindakan keperawatan selama tiga kali 24
jam dengan kriteria hasil yang berupa
pertama kecepatan respirasi 12-16 kali
permenit tidak ada kau hanya tak nafas
intervensi pertama yaitu kaji kebutuhan
inversi jalan nafas yang kedua pantau
adanya pucat dan sianosis yang ketiga
pantai kecepatan Irama kedalaman dan
upaya pernafasan yang keempat konsultasi
dengan ahli terapi pernafasan yang
kelima kolaborasi dengan dokter untuk
pemberian obat seperti bronkodilator
yang keenam berikan terapi Nebulizer
yang ketujuh ajarkan teknik batuk
efektif
slepan akhirnya napas dalam melalui
abdomen selama periode batin seks
selanjutnya berternak si terhadap
aktivitas yang biasa dilakukan setelah
dilakukan tindakan keperawatan selama
dua kali 24 jam dengan kriteria hasil
pertama tidak mengalami sesak nafas
setelah berjalan dan beraktivitas mampu
melakukan aktivitas secara mandiri
intervensi-intervensi pertama yaitu kaji
Tingkat kemampuan pasien untuk berpindah
dari tempat tidur berdiri dan ambulasi
yang kedua pantau respon despire
trattori terhadap aktivitas yang ketiga
pantau respon Oksigen yang keempat
intruksikan kepada pasien untuk
menggunakan teknik nafas terkontrol
selama aktivitas level 5 instruksikan
untuk penggunaan peralatan seperti
oksigen sama aktivitas yang keenam
anjurkan periode ini untuk sirah head
yang anak dan aktivitas secara
bergantian yang ketujuh kolaborasikan
dengan ahli terapi okupasi fisik
Hai selanjutnya ketidakseimbangan
nutrisi kurang dari kebutuhan tubuh
dapat teratasi setelah dilakukan
tindakan keperawatan setelah tiga kali
24 jam dengan kriteria hasil pertama
pasien tidak mengeluh mual pasien tidak
lemas tidak terjadi penurunan berat
badan secara drastis dengan intervensi
pertama kaji status nutrisi pasien
meliputi meliputi abcd tanda-tanda vital
sensori dan bising usus yang kedua
sajikan makanan yang mudah dicerna dalam
keadaan hangat dan tertutup yang ketiga
bantu pasien makan jika tidak mampu yang
keempat ukur intake makanan dan timbang
berat badan yang kelima anjurkan pasien
untuk makan sedikit-sedikit tapi sering
yang keenam kolaborasi dengan ahli gizi
untuk menentukan diet yang tepat bagi
ASEAN yang ke-7 monitor highlights
seperti glukosa elektrolit albumin dan
hemoglobin yang ke-8 instruksikan pasien
agar menarik nafas film perlahan dan
menolak secara sekber untuk mengurangi
mual dan muntah
hai hai
Hai terima kasih Cukup sekian saya yang
ditabrak saya jelaskan kurang lebihnya
saya mohon maaf Wassalamualaikum
warahmatullahi wabarakatuh
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