Asuhan Keperawatan Pada Pasien Dengan Gagal Ginjal Akut(GGA)

Unaiska S1 KEP 4B

29 Mar 202010:51

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

00:00

🩺 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.

05:01

🔍 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.

10:03

🏥 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

Acute Kidney Injury (AKI) is a syndrome resulting from metabolic or pathological damage to the kidneys, characterized by a sudden decrease in kidney function within a few days or weeks, with or without oliguria. In the video, AKI is described as the main topic, focusing on its causes, anatomy, physiology, pathophysiology, clinical manifestations, management, and nursing care.

💡Classification

Classification refers to the categorization of Acute Kidney Injury into different types based on specific criteria. The video mentions that AKI can be classified according to the causes, which include prerenal, renal, and postrenal factors. This classification helps in understanding the underlying causes and appropriate treatment approaches for AKI.

💡Causes

Causes of Acute Kidney Injury are varied and include factors such as decreased blood flow to the kidneys (e.g., dehydration, heart failure), direct damage to the kidneys (e.g., toxins, trauma), and obstruction of urine flow (e.g., enlarged prostate, tumors). The video discusses these causes in detail, explaining how each can lead to AKI.

💡Anatomy and Physiology

Anatomy and Physiology refer to the structure and function of the kidneys. The video explains the kidneys' location, their protective layers, and their roles in filtering blood, maintaining fluid balance, and excreting waste products. This foundational knowledge is crucial for understanding how AKI affects kidney function.

💡Pathophysiology

Pathophysiology of Acute Kidney Injury involves the study of the functional changes in the kidneys due to disease or injury. The video describes different pathophysiological mechanisms based on the cause of AKI, such as hypoperfusion, direct kidney damage, and urinary tract obstruction, which lead to impaired kidney function.

💡Clinical Manifestations

Clinical Manifestations are the signs and symptoms that indicate the presence of Acute Kidney Injury. The video lists several manifestations including reduced urine output, nausea, vomiting, loss of appetite, fatigue, high blood pressure, edema, and altered mental status. These symptoms help in diagnosing and assessing the severity of AKI.

💡Management

Management of Acute Kidney Injury involves various strategies to treat and manage the condition. The video outlines approaches such as fluid resuscitation, blood pressure management, correction of electrolyte imbalances, and supportive care. Effective management is essential to prevent further kidney damage and promote recovery.

💡Nursing Care

Nursing Care includes the specific interventions and care plans provided by nurses to patients with Acute Kidney Injury. The video highlights nursing responsibilities such as patient assessment, monitoring vital signs, assisting with activities of daily living, and collaborating with other healthcare professionals to provide comprehensive care.

💡Diagnostic Tests

Diagnostic Tests are procedures used to diagnose and monitor Acute Kidney Injury. The video mentions tests such as serum creatinine, blood urea nitrogen (BUN), electrolyte levels, urine analysis, imaging studies like ultrasound, and kidney biopsy. These tests help in assessing kidney function and identifying the underlying causes of AKI.

💡Interventions

Interventions refer to the specific actions taken to treat and manage Acute Kidney Injury. The video describes interventions such as fluid and electrolyte management, medication administration (e.g., bronchodilators), and patient education on breathing techniques and dietary modifications. These interventions aim to stabilize the patient's condition and support kidney recovery.

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.