Patho Patho #88
The nurse is caring for a client with congestive heart failure. The client’s blood pressure has been trending down with the most recent result being 78/48. The nurse will take action to improve the blood pressure in order to prevent:
- 1. intra-renal failure.
This answer choice is not correct because hypotension is considered a pre-renal cause for acute kidney injury. Examples of intra-renal injury etiologies include nephrotoxic drugs and intra-renal ischemia.
- 2. pre-renal failure.
This answer is correct because hypotension and congestive heart failure prevent adequate renal perfusion and are thus considered pre-renal etiologies for renal injury.
- 3. post-renal failure.
This answer choice is not correct because hypotension and congestive heart failure prevent adequate perfusion which could lead to renal injury due to pre-renal causes.
- 4. chronic renal failure.
This answer choice is not correct because hypotension/ hypotension are considered pre-renal etiologies for acute kidney injury. Interventions should be aimed at improving the clients blood pressure in order to prevent acute kidney injury.
The focus of this question is asking the nurse to identify which type of renal injury client with congestive heart failure is at risk for. Pre-renal failure results from a decrease in renal perfusion due to decreased cardiac output or hypotension. A client with a history of congestive heart failure and a current blood pressure of 78/48 is at risk for developing pre-renal failure.
Pre-renal causes of acute kidney injury comprise the most common etiologies for renal injury. Most often, renal injury can be prevented with specific interventions at reversing the underlying pre-renal cause such as hypotension. A client with congestive heart failure and a blood pressure of 78/48 requires interventions aimed at increasing blood pressure and thus renal perfusion, in order to prevent renal injury.
Test Taking Tip
Make sure to learn the most common etiologies associated with each type of renal failure. Pre-renal: congestive heart failure, hypotension; Intrarenal: nephrotoxic drugs/ contrast dye; Post-renal: BPH, kidney stones.