Renal NCLEX practice review question on acute kidney injury stages (also called acute renal failure stages).

This NCLEX renal review question will test your nursing knowledge about the four stages of acute renal failure (initiation, oliguric, diuresis, recovery). You will be required to select all the options that may present in the specific stage asked in the question.

What is acute kidney injury (AKI)? It is the SUDDEN decrease in renal function that will lead to the buildup of waste in the blood, fluid overload, and electrolyte imbalances. AKI can be reversible.

There are four stages of acute renal failure. The first stage is called the initiation stage. This stage occurs when a cause (prerenal, intrarenal, or postrenal) creates injury to the kidney. Then signs and symptoms start to appear, which leads to the next stage. This stage is known as the oliguric (some patients skip this stage and go straight into the diuresis stage). The hallmark finding in this stage is the patient's urinary output, which will be less than 400 ml/day.

The third stage is known as the diuresis stage. The patient will be voiding an excessive amount of urine (3-6 liters/day) due to osmotic diuresis. The nephrons can't concentrate the urine yet but can filter out waste.

The last stage is called the recovery stage and not all patients will enter this stage but may progress to chronic kidney disease. This stage is where everything has returned to normal (GFR, BUN, creatinine, electrolytes etc.) and the body is able to maintain homeostasis.

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