Page 1828 - Saunders Comprehensive Review For NCLEX-RN

diuretics, as prescribed to increase
renal blood flow and diuresis of
retained fluid and electrolytes.
3. Diuretic phase

a. Urine output rises slowly,

followed by diuresis (4 to 5 L/day).
b. Excessive urine output indicates that
damaged nephrons are recovering
their ability to excrete wastes.
c. Dehydration, hypovolemia,
hypotension, and tachycardia can
occur.
d. Level of consciousness improves.
e. Laboratory analysis (see Box 54-4)
f. Administer IV fluids as prescribed,
which may contain electrolytes to
replace losses.
4. Recovery phase (convalescent)
a. Recovery is a slow process; complete
recovery may take 1 to 2 years.
b. Urine volume returns to normal.
c. Memory improves.
d. Strength increases.
e. The older adult is less likely than a
younger adult to regain full kidney
function.
f. Laboratory analysis (see Box 54-4)
g. AKI can progress to chronic kidney
disease (CKD).

The signs and symptoms of AKI are

primarily caused by the retention of nitrogenous
wastes, the retention of fluids, and the inability of the
kidneys to regulate electrolytes.
D. Assessment: Assess objective and subjective data noted in the
phases of AKI (see Box 54-4).
E. Other interventions
1. Monitor vital signs, especially for signs of
hypertension, tachycardia, tachypnea, and an
irregular heart rate.

2. Monitor urine and intake and output hourly

and urine color and characteristics.

3. Monitor daily weight (same scale, same

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