Azotemia (Eng/Kor) for NCLEX

Azotemia

 

1. Definition (정의)

English:
Azotemia is a condition where nitrogenous waste products (BUN, creatinine) build up in the blood due to impaired kidney function.

→ It means early kidney failure or decreased filtration.

Korean:
Azotemia(아조테미아)는 신장 기능 저하로 인해 BUN, 크레아티닌 같은 질소 노폐물이 혈액에 증가하는 상태입니다.
→ 즉, 초기 신부전 또는 여과율 감소를 의미합니다.

2. Types of Azotemia (종류)

1) Prerenal Azotemia (신전성)

Cause: decreased blood flow to kidneys

• Dehydration
• Heart failure
• Shock
• Hemorrhage

Korean:
신장으로 가는 혈류 감소

• 탈수
• 심부전
• 쇼크
• 출혈

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

2) Intrarenal (Renal) Azotemia (신성)

Cause: direct damage to kidney tissues

• Acute Tubular Necrosis (ATN)
• Nephrotoxic drugs (NSAIDs, aminoglycosides)
• Glomerulonephritis

Korean:
신장 자체 손상

• 급성 세뇨관 괴사
• 신독성 약물
• 사구체신염

3) Postrenal Azotemia (신후성)

Cause: obstruction of urine flow

• Kidney stones
• Enlarged prostate
• Tumors
• Urethral obstruction

Korean:
요로 폐쇄(막힘)

• 신장 결석
• 전립선 비대
• 종양
• 요도 폐색

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

3. Signs & Symptoms (증상)

English:

• Elevated BUN & creatinine
• Decreased urine output (oliguria)
• Fluid retention, edema
• Fatigue
• Nausea
• Confusion (severe)

Korean:

• BUN, 크레아티닌 상승
• 소변량 감소(핍뇨)
• 체액저류, 부종
• 피로
• 오심
• 심한 경우 혼돈

4. Diagnosis (진단)

• BUN ↑
• Creatinine ↑
• BUN/Creatinine ratio (helps differentiate type)
  • Prerenal: >20:1
  • Intrarenal: <15:1
• Urinalysis
• Renal ultrasound (obstruction)
• Electrolytes: ↑K+, ↑phosphate, ↓Ca+

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

5. Treatment (치료)

Depends on type (원인에 따라 다름)

 Prerenal

• IV fluids
• Treat dehydration
• Improve cardiac output
• Stop nephrotoxic drugs

 Renal (intrarenal)

• Treat ATN or glomerulonephritis
• Manage electrolytes
• Dialysis if needed

 Postrenal

• Remove obstruction
• Catheterization
• Treat stones or prostate enlargement

6. Nursing Considerations (간호)

• Strict I&O
• Monitor BUN/Cr trends
• Daily weights
• Assess for edema and lung sounds
• Monitor potassium (risk of hyperkalemia → dysrhythmias)
• Avoid nephrotoxic drugs
• Adjust medication doses for kidney function

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7. Complications (합병증)

• Acute kidney injury (AKI)
• Hyperkalemia
• Metabolic acidosis
• Uremia
• Cardiac arrhythmias
• Death if untreated

8. NCLEX Key Points (핵심 요약)

• Azotemia = ↑BUN & creatinine due to ↓kidney function
• Prerenal = low perfusion
• Intrarenal = kidney damage
• Postrenal = obstruction
• Monitor electrolytes, fluids, I&O
• Treat the underlying cause
• Watch for hyperkalemia