Advanced Pathophysiology for the Advanced Practice Nurse
Dr. Deana Batross & Dr. Shivani Bhatnagar
Acute Kidney Injury, Perioperative Considerations, Serum Creatinine, Fluid Management, Prevention/Treatment, Risk Factors
Medicine and Health Sciences | Nursing
In the surgical setting, caring for a patient in the operative and postoperative phases require perioperative care providers to be attentive to risk factors that can lead to potential harm. Of all the possible complications of surgical cases, acute kidney injury is more common than others. Acute kidney injury (AKI) is kidney function that abruptly declines over a few hours or days, increases serum creatinine, causes a period of oliguria, and has three levels of severity (Zarbock et al., 2018, p.1236-1237). Risk factors predispose patients to AKI, including age, diabetes, cardiac failure, previous history of AKI, sepsis, and many more. The kidneys can autoregulate blood pressures to maintain kidney perfusion until a certain point when renal tubular ischemia and reduced glomerular filtration rate occur (Gumbert et al., 2020, p.183). There are scoring systems available to help diagnose AKI based on specific lab values that can be limited by factors like the reliability of serum creatinine and the criteria used to define AKI. The mortality rate of AKI is about 23%, topping out at 36% for patients with the highest stage and diagnosis (Elghazali et al., 2021, p. 671). Pre-surgical assessment by the perioperative care providers can help identify patients at risk for AKI and enact preventative strategies before, during, and after surgery. Creating successful treatments for AKI has proven difficult, with different modalities researched consistently, including fluid restriction, fluid replacement, pharmacological agents, and renal replacement therapy (Gumbert et al., 2020, p. 196). Patients present their own set of challenges during the phases of surgery, with concern for patients at high risk for AKI. This poster serves to educate perioperative care providers about AKI and the pathophysiology, signs and symptoms, and nursing implications during surgical interventions.
Copyright, all rights reserved. Fair Use
Hall, Matthew, "Acute Kidney Injury in Perioperative Patients" (2022). Nursing Student Class Projects (Formerly MSN). 514.