Nurses caring for patients with acute kidney injury should be aware of common nursing diagnoses such as fluid volume excess, risk of reduced cardiac output, imbalanced nutrition, risk for infection, and risk for electrolyte imbalance.
Your doctor will start with a physical exam. Then, they’ll order tests of your blood, urine, and kidneys.
Blood tests. These measure substances in your blood, including:
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Creatinine is a waste product in your blood that’s made by muscle activity. Normally, it’s removed from your blood by your kidneys. But if your kidneys stop working, your creatinine level rises.
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Urea nitrogen is another waste product in your blood. It’s created when protein from food is broken down. Like creatinine, your kidneys remove this from your blood. When your kidneys stop working, your urea nitrogen levels rise.
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Potassium is an electrolyte found in your blood that balances water levels in your bloodstream. Kidney disease can cause either high or low potassium levels.
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Sodium is an electrolyte that helps with fluid balance in your body. High sodium levels can mean that your kidneys aren’t working properly because your body can’t get rid of the right amount of sodium.
Urine tests. Your doctor will check your pee for blood and protein. They’ll also look for certain electrolytes. The results help your doctor understand what’s causing your kidney failure.
Kidney biopsy (renal biopsy). A kidney biopsy is a procedure where the doctor pushes a thin needle through your skin and takes a small piece of your kidney to look at under a microscope. It can show if there is any damage or disease in your kidney and often helps determine the cause as well. This is typically done only in cases where it is unclear what is causing the kidney failure.
Imaging tests. Some tests, such as ultrasonography or a CT scan, can show whether your kidneys are enlarged or there’s a blockage in your urine flow. They can also tell your doctor if there is any problem with arteries or veins going in and out of your kidneys. An MRI can show this, too. By closely monitoring the patient's condition, administering appropriate treatments, and providing patient education, nurses can help prevent complications and promote recovery from acute kidney injury treatment.
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