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    This document discusses acute kidney injury (AKI), also known as acute renal failure. It begins by defining AKI as a condition where the kidneys suddenly cannot excrete urine in sufficient volume or concentration to maintain homeostasis. It then describes the potential causes of AKI as being pre-renal, renal, or post-renal in nature. Specifically, it notes pre-renal causes include reduced blood volume or cardiac output leading to decreased kidney perfusion and function. Renal causes involve direct damage to the structure or function of the kidney tissues. Post-renal causes relate to physical obstruction of urine flow from the kidneys.

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    WOC GGA

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    This document discusses acute kidney injury (AKI), also known as acute renal failure. It begins by defining AKI as a condition where the kidneys suddenly cannot excrete urine in sufficient volume or concentration to maintain homeostasis. It then describes the potential causes of AKI as being pre-renal, renal, or post-renal in nature. Specifically, it notes pre-renal causes include reduced blood volume or cardiac output leading to decreased kidney perfusion and function. Renal causes involve direct damage to the structure or function of the kidney tissues. Post-renal causes relate to physical obstruction of urine flow from the kidneys.

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    19 views2 pages

    Woc Gga

    Uploaded by

    Winitaruri 94
    This document discusses acute kidney injury (AKI), also known as acute renal failure. It begins by defining AKI as a condition where the kidneys suddenly cannot excrete urine in sufficient volume or concentration to maintain homeostasis. It then describes the potential causes of AKI as being pre-renal, renal, or post-renal in nature. Specifically, it notes pre-renal causes include reduced blood volume or cardiac output leading to decreased kidney perfusion and function. Renal causes involve direct damage to the structure or function of the kidney tissues. Post-renal causes relate to physical obstruction of urine flow from the kidneys.

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    of 2

    Web of Causation: Acute Kidney

    Injury
    Definisi: Gagal ginjal akut adalah kondisi yang terjadi bila ginjal tiba-tiba tidak mampu mengekskresikan urin dengan volume cukup atau konsentrasi adekuat untuk mempertahankan keseimban

    Pra-renal Renal Pasca-renal

    Cardiac output Glomerular Obstruksi


    Hipotensi Hipovolemia Interstitial Vascular
    menurun (Glomerulonephritis) (Autoimmune, toxic, infectious)
    Tubular Large vessel
    (Renovascular disease,
    Volume atheroembolic) Intrinsik Ekstrinsik
    Total loss redistribution Ischemic Small vessel
    GI Loss Toxic Surrounding
    (Extreme pre renal, (Vasculitis, HRS, renovascular, or infiltrating
    (Vomiting, diarrhoea, Batu
    sepsis, pancreatitis) malignant hypertension) tumour
    surgical fistule)
    Intrinsic toxins Large
    Reduced effective circulating volume
    Haemorrhage (Ascites, oedema, ‘3rd spacing’, (Rhabdomyolysis, massive inflammatory
    Tumor
    (Visible and occult) congestive cardiac failure) haemolysis, tumour lysis, myeloma) abdominal aortic
    aneurysms
    Altered vascular capacitance
    Renal loss
    (Sepsis, shunting, vasodilatation,
    (Diuretics, polyuria) Extrinsic toxins
    Hepatorenal syndrome HRS)
    (Radio contrast, drugs, antibiotics)
    Skin loss
    (Excessive sweating,
    burns)

    Aliran urine dari


    ginjal
    Gangguan fungsi dan struktur jaringan ginjal
    Penurunan Penumpukan zat toksin di
    sirkulasi ginjal
    Kerja ginjal terganggu
    Merusak jaringan ginjal

    Acutekidney injury
    Acutekidney injury

    B B2 B B B
    B
    Renin-angiotensin-system (RAS)-
    acting agents
    Gangguan fungsi ginjal Penurunan produksi
    Mual-muntah
    Gg. Asam basa Glumerulus Filtration eritropoitin

    Ginjal tidak mampu mengeliminasi Asidosis metabolik Retensi urine Anoreksia Penurunan Hemoglobim (Hb)
    Vasokontriksi pembuluh darah
    ureum dalam tubuh

     Anthropometric measurement
    Penumpukan ureum dalam darah Penurunan perfusi jaringan perifer Penumpukan cairan di paru Odem (Tinggi badan, berat badan, Kelemahan otot
    tebal lipatan kulit, lingkar tubuh)
     Biochemical data (Hemoglobin,
    Gangguan pertukaran gas Hipervolemia hematokrit, albumin)
    Masuk jaringan otak Intoleransi aktivitas
     Clinical sign of nutrional
    status (Rambut kulit, mata,
    cardiovasculer, otot-otot,
    Afterload jantuang gastrointestinal, aktifitas,
    neurologi)
    Koma uremikum Defisit Nutrisi  Dietery history (Pola diet/makan,
    Manajemen Nutrisi: kebiasaan makan, makanan
    Gagal jantung Observasi: kesukaan, pemasukan cairan,
    problem diet, tingkat aktivitas,
    Penurunan kesadaran 1. Identifikasi Nutrisi  riwayat kesehatan/konsumsi

    2. Identifikasi alergi makanan


    Hipervolemia : Defisit nutrisi
    3. Identifikasi kebutuhan kalori dan jenis
    Manajemen Cairan
    nutrient obat.
    1. Periksa tanda dan gejala
    hypervolemia Resiko Infeksi
    Gangguan Pertukaran Gas 4. Identifikasi perlunya penggunaan
    2. Identifikasi penyebab hypervolemia Manajemen infeksi
    Pemantauan Respirasi
    3. Monitor status hemodinamik, tekanan 1. Monitor frekuensi, irama, kedalaman selang nasogastrik 1. Pantau TTV
    darah, MAP, CVP, PAP, PCWP, CO jika 2. Kaji tanda-tanda infeksi (suhu tubuh, nyeri, dan
    dan upaya napas 5. Monitor asupan ASI
    tersedia perdarahan)
    2. Monitor pola napas
    4. Timbang berat bada setiap hari pada 6. Monitor BB
    3. Berikan posisi semifowler atau fwler 3. Monitor tanda infeksi sistemik dan local
    waktu yang sama 4. Kolaborasi pemberian oksigen 4. Hand hygiene
    5. Batasi asupan cairan dan garam 7. Monitor hasil pemeriksaan fisik
    6. Rencana Insersi CDL 5. Rawat luka
    8. Kolaborasi dengan ahli gizi untuk
    6. Kolaborasi pemberian antibiotik
    menentukan jumlah ASI yang

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