CH. 22 Flashcards
Which of the following statements regarding postrenal acute kidney injury is correct?
- Postrenal acute kidney injury involves damage to the renal parenchyma or tubules.
- Postrenal acute kidney injury typically results in decreased pressure on the nephrons.
- Postrenal acute kidney injury is caused by obstruction of urine flow from the kidneys.
- Patients with postrenal acute kidney injury typically develop severe hypokalemia.
Postrenal acute kidney injury is caused by obstruction of urine flow from the kidneys.
You are dispatched to a residence for an elderly man with an altered mental status. As you are assessing the patient, his wife tells you that he goes to dialysis several times a week, but has missed his last three treatments because their car broke down. The patient’s skin is yellow, his blood pressure is 98/60 mm Hg, and his pulse rate is 118 beats/min. The ECG reveals sinus tachycardia with peaked T waves. You should be concerned with the potential for:
- acute bradycardia or heart block.
- severe hypovolemia.
- hypokalemia-induced cardiac arrest.
- lethal ventricular dysrhythmias.
lethal ventricular dysrhythmias.
Which of the following is the most important therapy the paramedic can administer to a patient with an isolated renal calculus?
- An antiemetic
- Analgesia
- Oxygen
- Rehydration
Analgesia
A patient with prerenal acute kidney injury would most likely present with:
- peripheral edema and hematuria.
- hypotension and tachycardia.
- joint pain and bladder distention.
- confusion and hypertension.
hypotension and tachycardia
End-stage renal disease occurs when:
- the kidneys have lost all ability to function.
- urine output falls to less than 500 mL/day.
- the glomerular filtration rate is increased.
- the initial signs of azotemia are present.
the kidneys have lost all ability to function.
Which of the following is an internal region of the kidney?
- Urethra
- Cortex
- Hilum
- Ureter
Cortex
In contrast to the male urethra, the female urethra:
- is approximately 20 cm long.
- is significantly shorter in length.
- is divided into three regions.
- consists of a prostatic urethra.
Is significantly shorter in length
A 20-year-old male presents with an acute onset of severe testicular pain. He denies any trauma to the genital region. He is conscious and alert, his blood pressure is 144/84 mm Hg, his heart rate is 120 beats/min, and his respirations are 24 breaths/min with adequate depth. The most important aspect in the care of this patient involves:
- narcotic analgesia.
- high-flow oxygen.
- IV fluid therapy.
- prompt transport.
Prompt transport
A 50-year-old man presents with a painful penile erection that has persisted for the past several hours. He is conscious, but restless, and his vital signs are stable. Which of the following conditions could cause his clinical presentation?
- Head trauma
- Renal failure
- Nitroglycerin use
- Antidepressant use
Antidepressant use.
It is important for the paramedic to consult with medical control prior to administering analgesia to a patient with severe flank pain and suspected acute kidney injury because:
- patients with renal failure often require high doses of analgesia.
- analgesia will mask the patient’s pain and skew further examination.
- most patients who are given analgesia will experience hypotension.
- renal failure may cause analgesics to accumulate to toxic levels.
Renal failure may cause analgesics to accumulate to toxic levels.
A renal calculus that has become lodged in a lower ureter would likely produce which of the following signs and symptoms?
- Overflow incontinence
- Hematuria
- Fever
- Seizure
Hematuria
Immediately following a dialysis treatment, a middle-aged woman complains of generalized weakness and nausea. Her blood pressure is 80/50 mm Hg, pulse rate is 40 beats/min and weak, and respirations are 22 breaths/min and regular. She is receiving supplemental oxygen, and an IV line has been established in the extremity opposite the shunt. The ECG reveals sinus bradycardia in lead II. Your next action should be to:
- obtain a 12-lead ECG tracing.
- administer 0.5 mg of atropine sulfate.
- administer calcium and bicarbonate.
- administer a 20-mL/kg fluid bolus.
Administer 0.5 mg of atropine sulfate.
If a patient missed a dialysis treatment, you would expect them to present with:
- hypokalemia.
- hypocalcemia.
- edema.
- dehydration.
Edema
Which of the following common signs and symptoms would you expect with a of a lower urinary tract infection?
- Decreased urinary frequency
- Painful urination
- Gross hematuria
- Localized pain in the right upper quadrant
Painful urination
Any time a patient with end-stage renal disease is found in cardiac arrest, the paramedic should strongly consider which of the following as the cause?
- Hypokalemia
- Hypocalcemia
- Hyperkalemia
- Hypercalcemia
Hyperkalemia
A 40-year-old man presents with difficulty urinating, fever, and tremors. Which of the following should you suspect?
- Prostatitis
- Prostate cancer
- Benign prostatic hypertrophy
- Testicular torsion
Prostatitis
Which of the following conditions may cause urinary retention?
- Polynephritis
- Urinary tract infections
- Chronic kidney disease
- Testicular torsion
Urinary tract infections
A 59-year-old woman with chronic kidney disease presents with an acute onset of dyspnea while undergoing a hemodialysis treatment. She is conscious but in obvious respiratory distress. Further assessment reveals perioral cyanosis and a blood pressure of 96/56 mm Hg. Based on this patient’s medical history and clinical presentation, which of the following interventions is likely indicated?
- Narcotic analgesia
- Rapid transport to the hospital
- IV crystalloid fluid boluses
- Administration of calcium and bicarbonate
Rapid transport to the hospital.
Patients requiring chronic dialysis:
- are typically not able to ambulate.
- are usually dialyzed every 2 or 3 days.
- are almost always inpatients in a hospital.
- stay on the dialysis machine for 6 to 8 hours.
Are usually dialyzed every 2 or 3 days
Which of the following is a clinical manifestation of chronic kidney disease?
- Hyperkalemia
- Hypertension
- Bradycardia
- Dehydration
Hyperkalemia
