A nursing student is studying for a test and asks you to explain to her the difference between acute and chronic renal failure. She states, "Isn't it all the same, I mean don't they all go on dialysis?"
a. How would you explain to her the difference between acute and chronic?
b. What are the signs and symptoms of each?
Students' answers should include the following:
a. Acute renal failure is a sudden onset; rapid and sudden decrease in renal function, usually irreversible, may be reversible if aggressive treatment started early
Chronic renal failure is progressively slower and is also irreversible but may take months to years to develop.
b. Starts with conditions that disrupt the urine flow
The prerenal stage contains nonurologic conditions, which interrupt the renal blood flow and thus affect filtering ability.
Prerenal influences can be hemorrhage, cardiac insufficiency, injury, or sepsis.
In intrarenal, the kidneys destroy the nephrons.
Postrenal are usually obstructive issues below the kidneys.
In initial phase, there is reduced blood flow to the nephrons and tubular necrosis.
In oliguric phase, there is less than adequate amount of urine with azotemia (uric acid, creatinine, and other waste in the blood).
Diuretic phase is where the nephrons start to recover.
Recovery phase function is restored, this may take 3 to 12 months; there may be some sort of permanent dysfunction, however.
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