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Illness and Patho 1 > Renal > Flashcards

Renal Flashcards

0
Q

Acute renal failure is potentially reversible in which phase?

A

Initiation phase

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1
Q

A patient’s creatinine clearance is 5 mL/min. What does this value signify?

A

Renal Dysfunction

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2
Q

Hyponatremia in renal dysfunction is the result of what?

A

Water overload

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3
Q

Signs and symptoms of acute renal failure include what?

A

Tachypnea, low pH, and low serum bicarbonate

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4
Q

What is a common complication of hemodialysis?

A

Hypotension

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5
Q

Name a medication that has the dual effect of creating a solute diuresis and augmenting renal blood flow

A

Furosemide

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6
Q

In general, maintenance of cardiovascular function and what are the two key goals in the prevention of acute tubular necrosis?

A

Adequate intravascular volume

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7
Q

One of the most useful noninvasive diagnostic tools available for clinicians to monitor fluid volume status is what?

A

Monitoring daily weights

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8
Q

A study that delineates the size, shape, and position of the kidneys and also demonstrates abnormalities, such as calculi, hydronephrosis, cysts, or tumors is what?

A

KUB x-ray

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9
Q

While undergoing his first ever hemodialysis treatment, the patient suddenly becomes confused, complains of a headache, begins to twitch, and proceeds to have a seizure. The nurse realizes that this is most likely due to what?

A

Cerebral edema

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10
Q

Name the indications for hemodialysis.

A

Acid-base imbalances, electrolyte imbalances, and fluid overload

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11
Q

Name the principles that are the basis for dialysis.

A

Diffusion and ultrafiltration

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12
Q

After a patient has an arteriovenous fistula placed, what differences will occur in that arm?

A

The vein will dilate and the pulse distal to the fistula will need to be evaluated

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13
Q

Name the common complications of hemodialysis.

A

Dysrhythmias, hypotension, infection, and muscle cramps

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14
Q

In a patient undergoing peritoneal dialysis, what signs and symptoms should a nurse be looking for?

A

Abdominal pain and fever, cloudy return fluid, and poor drainage from the abdominal cavity

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15
Q

What might exposure to aminoglycoside antibiotics result in?

A

Acute tubular necrosis

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16
Q

What medications should be withheld for 4-6 hours before hemodialysis?

A

Antihypertensives

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17
Q

What is the most common intrarenal condition resulting from prolonged ischemia?

A

Acute tubular necrosis

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18
Q

How long after an aminoglycoside is administered is a peak level taken?

A

1-2 hours

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19
Q

What contributes to prerenal failure?

A

Hypovolemia and cardiogenic shock

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20
Q

Urine output of less than 400 mL in 24 hours

A

Oliguria

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21
Q

The sudden deterioration of renal function, resulting in retention of nitrogenous waste products

A

Acute renal failure

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22
Q

Conditions that produce acute renal failure by interfering with renal perfusion

A

Prerenal

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23
Q

Acute renal failure resulting from obstruction of the flow of urine

A

Postrenal

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24
Q

Conditions that produce produce acute renal by directly acting on functioning kidney tissues

A

Intrarenal

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25
Q

Particularly useful for patients in the critical care unit whose cardiovascular status is too unstable to tolerate rapid fluid removal

A

Continuous renal replacement therapy

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26
Q

Manifested by abdominal pain, cloudy peritoneal fluid, fever and chills, nausea and vomiting, and difficulty in draining fluid from the peritoneal cavity

A

Peritonitis

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27
Q

Commonly used to treat the anemia of chronic renal failure

A

Epogen

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28
Q

Controversial treatment of acute renal failure

A

Dopamine

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29
Q

Primarily used for controlling fluid volume

A

Ultrafiltration

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30
Q

Separation of solute by differential diffusion

A

Dialysis

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31
Q

The normal BUN/Creatinine ratio

A

10:1 to 20:1

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32
Q

What should normal urine production be?

A

1 mL/kg/hr

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33
Q

What is the absolute minimum amount of urine production to sustain life?

A

30 mL/hr

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34
Q

Normal specific gravity or urine values

A

1.005-1.030

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35
Q

What does a urine specific gravity of greater than 1.030 indicate?

A

Dehydration

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36
Q

What do RBCs in the urine indicate?

A

Infection, damage, or a break in a membrane

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37
Q

What do WBCs in urine indicate?

A

Infection

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38
Q

Lack of control of voiding

A

Incotinence

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39
Q

Voiding at frequent intervals

A

Frequency

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40
Q

Difficulty in initiating voiding

A

Hesitancy

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41
Q

Need to void immediately

A

Urgency

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42
Q

Urine output <100 mL/day

A

Anuria

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43
Q

Urine remaining in the bladder post voiding

A

Residual urine

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44
Q

What is the normal residual volume of urine?

A

50 mL or less

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45
Q

Awakening at night to void

A

Nocturia

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46
Q

Painful urination

A

Dysuria

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47
Q

Presence of blood in the urine

A

Hematuria

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48
Q

Urine output of more that 2500 mL/day

A

Polyuria

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49
Q

What disease is polyuria indicative of?

A

Diabetes

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50
Q

What is the normal creatinine level?

A

0.5-1.2 mg/dL

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51
Q

Specifically indicates renal function, this value increases when glomerular filtration is impaired

A

Creatinine

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52
Q

How man nephrons must be lost before there is a change in creatinine levels?

A

25%

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53
Q

What is a normal BUN level?

A

5-25 mg/dL

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54
Q

Increases with excessive protein intake or trauma, but may be falsely elevated in many cases

A

BUN

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55
Q

What can falsely elevate BUN levels?

A

Lots of protein, blood, diet, and poor liver function

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56
Q

Direct visualization of the inner lining of the bladder

A

Cystoscopy

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57
Q

Abdominal x-ray of the kidney, ureters,and bladder

A

KUB x-ray

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58
Q

Visualizes the urinary tract

A

Intravenous pyelogram

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59
Q

What is important to evaluate before administering an IVP?

A

Normal creatinine levels in order to clear dye

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60
Q

What is the most common nosocomial infection?

A

UTI

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61
Q

What is done to diagnose a UTI?

A

Symptoms, urinalysis, urine culture and sensitivity, IVP, and an abdominal ultrasound

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62
Q

Why is a urine culture and sensitivity done on suspected UTIs?

A

It is necessary for definitive identification of the infecting organism and the most effective antibiotic

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63
Q

Which drug is prescribe for palliative reasons in a UTI patient?

A

Pyridium

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64
Q

Why is an anticholinergic prescribed to a UTI patient?

A

To decrease the spasms of the bladder

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65
Q

If a patient has a UTI, how much fluid should the take in?

A

An extra 2000-3000 mL/day

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66
Q

How can urine be acidified?

A

Intake of cranberry juice

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67
Q

Presence of stones in the urinary tract

A

Urolithiasis

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68
Q

Stones formed in renal parenchyma

A

Nephrolithiasis

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69
Q

Formation of stones in the ureter

A

Ureterolithiasis

70
Q

What are predisposing factors for renal calculi?

A

Heredity, UTI, foley, IMMOBILITY, dehydration, pH of urine, hyperparathyroidism, GOUT, excess vitamin D

71
Q

Who is most susceptible for renal calculi?

A

Young males

72
Q

What are the types of renal calculi?

A

Calcium oxalate, calcium phosphate, uric acid, struvite, and cystine

73
Q

Which type of renal calculi is the biggest and has sharp edges?

A

Struvite

74
Q

Which type of renal calculi is influenced by heredity?

A

Cystine

75
Q

What are the emergency treatments for renal calculi?

A

IV Dilaudid or Morphine, IV Fluid, Torodol, and Ditropan

76
Q

Why is Torodol given to renal calculi patients?

A

To decrease inflammation

77
Q

Why is Ditropan given to renal calculi patients?

A

To depress the smooth muscle of the ureter

78
Q

What are the signs and symptoms of renal calculi?

A

Pain, hematuria, changes in urine output, urgency and frequency, and pyuria

79
Q

How are renal calculi diagnosed?

A

Lab findings, x-rays, KUB, IVP, renal ultrasounds, spiral CT scan

80
Q

What nursing interventions can be taken for a patient with renal calculi?

A

Strain all urine, force fluids, walk, narcotics, spasmolytic agents, check vitals, back rubs, PIV dye

81
Q

Rapid deterioration of renal function associated with an accumulation of nitrogenous wastes of the body that is not due to extrarenal factors

A

Acute Renal Failure

82
Q

Accumulation of nitrogenous wastes of the body

A

Azotemia

83
Q

Renal failure caused by poor blood flow to the kidneys

A

Prerenal azotemia

84
Q

Trauma causes what kind of renal failure?

A

Prerenal

85
Q

What is the most common and most curable type of renal failure?

A

Prerenal

86
Q

Acute renal failure resulting from damage to the kidney itself

A

Intrarenal failure

87
Q

What are the causes of intrarenal failure?

A

Inflammation, Immunologic, and ATN

88
Q

What can cause ATN?

A

Damage to the nephrons, antibiotics, and rhybdomylosis

89
Q

Obstruction of the urinary collecting system

A

Postrenal Acute Renal Failure

90
Q

What are the phases of ARF?

A

Onset, Oliguric, Diuretic, and Recovery

91
Q

What signs and symptoms will a patient in ARF exhibit?

A

SOB, lots of backed up fluid, and increased BUN and Creatinine

92
Q

What nursing interventions should be done for a patient in ARF?

A

Decrease fluid intake, give Lasix, assess for pulmonary edema, and daily weights

93
Q

Why should patients in ARF be on a low protein, high CHO and calorie diet?

A

Because they can’t break proteins down and they are in a high metabolic state

94
Q

What happens to the urine of a patient in ARF?

A

The specific gravity decreases because they lose the ability to concentrate it

95
Q

What are the signs of Dig Toxicity?

A

Halo vision and bradycardia

96
Q

Why is low does dopamine used in ARF patients?

A

To restore renal perfusion and help increase blood pressure

97
Q

What does Vitamin K combat in ARF patients?

A

Increased BUN that interferes with platelet aggregation

98
Q

What should the diet of a patient in ARF look like?

A

High CHO, high calorie, low protein, low sodium, low fluid, low magnesium, low phosphorous, and low potassium

99
Q

How is fluid replaced in a ARF patient?

A

With output from previous 24 hours + 400 mL for insensible loss

100
Q

A standard treatment with dialysate solution that uses vascular access for continuous arteriovenous and venovenous hemofiltrations

A

Continuous Renal Replacement Therapy

101
Q

Remove plasma water and dissolved contents from the clients’ blood across a membrane

A

Dialysis

102
Q

What is the pH problem of all patients in ARF?

A

Metabolic Acidosis

103
Q

How does dialysis decrease the BUN and Creatinine levels?

A

By removing water and waste

104
Q

Progressive, irreversible kidney injury where kidney function does not recover

A

Chronic Kidney Disease

105
Q

How do patients with CRF survive?

A

By using artificial means of replacing kidney function

106
Q

Inflammatory process involving both kidneys’ immune response of glomerular membrane to the protein beta hemolytic streptococcus

A

Chronic Glomerulonephritis

107
Q

Inherited disorder in which nephrons form cysts and are non-functional

A

Polycystic Kidney Disease

108
Q

Which antibiotics are nephrotoxic?

A

Mycins

109
Q

What is the leading cause of CRF?

A

Diabetes Mellitus

110
Q

What is the second leading cause of CRF?

A

Hypertension

111
Q

Why does hypertension cause CRF?

A

Shrinks and scars the kidneys

112
Q

What are the stages of CRF?

A

Reduced renal reserve, renal insufficiency, renal failure, end-stage renal disease

113
Q

In which stage does the healthier kidney compensate for the more diseased kidney?

A

Reduced Renal Reserve

114
Q

In which phase of CRF does metabolic waste being to accumulate?

A

Renal Insufficiency

115
Q

In which stage of CRF does anemia occur?

A

Renal Insufficiency

116
Q

Condition in which nephrons cannot reabsorb Bicarb and are unable to excrete hydrogen ions

A

Acidosis

117
Q

How does the body attempt to compensate for acidosis?

A

Increased respirations to blow off CO2

118
Q

Why are patients in CRF anemic?

A

Because of decrease in Erythropoietin

119
Q

In which phase of CRF do patients become acidotic?

A

Renal Failure

120
Q

In which phase of CRF are there excessive amounts of nitrogenous wastes accumulating in the blood to an extent that the patient is unable to maintain homeostasis?

A

End Stage Renal Disease

121
Q

Why are patients in End Stage Renal Disease hard to resuscitate after a cardiac event?

A

Because they are acidotic

122
Q

What symptom to only patients in ENRD exhibit?

A

Paroxysmal Nocturnal Dyspnea

123
Q

What is the classic indicator of renal failure?

A

Azotemia

124
Q

What are the signs and symptoms of CRF?

A

Nausea, vomiting, anorexia, diarrhea, constipation, increased nitrogenous wastes, restlessness, muscle spasms, peaked T waves, arrhythmias, AMS, halitosis, pale, uremic frost, RLS

125
Q

Rate at which the kidneys remove creatinine from plasm

A

Creatinine Clearance

126
Q

Why does sodium-hyponatremia occur in early renal failure?

A

Increase in urine output and less nephrons to reabsorb the sodium

127
Q

What symptoms of CRF are caused by a increase in potassium levels?

A

Peaked T waves, arrhythmias, bradycardia, and cardiac arrest

128
Q

What will be increased in the urine of a CRF patient?

A

Protein

129
Q

Why is the calcium of a patient with CRF decreased?

A

Because the kidneys cannot excrete phosphorus and when phosphorous increase, calcium decreases

130
Q

Besides the kidneys, what other organ hypertrophies in a patient with CRF?

A

The parathyroid

131
Q

What is the end result of the kidneys’ inability to excrete phosphorous?

A

Brittle bones

132
Q

What is the sign of severe CRF?

A

Anemia

133
Q

What are the side effects of Epogen?

A

Pain and hypertension

134
Q

Why do patients with CRF also have hypertension?

A

The renin-angiotensin aldosterone system fails to recognize the increased renal blood flow so it increases renin production, which increases blood pressure

135
Q

Why do CRF patients have pericarditis?

A

From the uremic toxins

136
Q

How much does 1 liter of excess fluid weigh?

A

2.2 lb

137
Q

What cardiac conditions will a CRF patient exhibit?

A

Hypertension, hyperlipidemia, heart failure, and pericarditis

138
Q

What will the urine of a patient in ESRF look like?

A

Dilute and clear

139
Q

What laboratory assessments should be done to diagnose CRF?

A

BUN, Creatinine, Electrolyte, CBC, ABG

140
Q

What is the test of choice to diagnosis CRF?

A

MRI

141
Q

When should the nurse administer vitamin and mineral supplements to a patient in CRF?

A

After dialysis

142
Q

What drugs are used to treat CRF?

A

Digoxin, Antacids, Amphojel, Stool Softeners, Narcotics, Antihypertensives, Diuretics, Insulin, and Erythropoietin

143
Q

What tests are used to diagnose CRF?

A

KUB, IVP, Aortorenal angiography, Ultrasounds, MRI, Renal Biopsy

144
Q

How can a CRF patient decrease their risk for infections?

A

Meticulous skin care, preventive skin care, inspection of vascular access site for dialysis, and monitoring of vital signs

145
Q

How can a nurse prevent a patient with CRF from feeling fatigued?

A

Give vitamin and mineral supplements, give epogen, and give iron

146
Q

What types of vascular access devices are used to administer hemodialysis?

A

Arteriovenous fistula or graft long term or catheter or shunt for short term

147
Q

What complications can arise from the vascular access devices used for hemodialysis?

A

Thrombosis or stenosis, infection, aneurysm formation, ischemia, heart failure

148
Q

What causes post dialysis disequilibrium syndrome?

A

Lots of fluid taken up quickly

149
Q

Procedure involves siliconized rubber catheter placed into the abdominal cavity for infusion of dialysate

A

Peritoneal dialysis

150
Q

Why is the peritoneum used for dialysis?

A

Because it is a semipermeable membrane

151
Q

What is the nurse’s responsibility when administering peritoneal dialysis?

A

Observe the outflow amount and pattern of the fluid

152
Q

If a kidney is going to be transplanted, what needs to be matched between the donor and recipient?

A

Blood type and HLA

153
Q

How is a kidney transplanted?

A

The old kidney is left in and the new kidney is placed in front of it

154
Q

What does the nurse look for after a kidney transplant?

A

Golden Nectar

155
Q

What is the nurse’s responsibility in a patient that just had a kidney transplant?

A

Keep the kidney very hydrated

156
Q

Inflammation of the bladder caused by irritation or, more commonly, by infectioin

A

Cystitis

157
Q

An inflammation of the urethra that causes symptoms similar to UTIs

A

Urethritis

158
Q

For a patient with renal calculi, what do nursing interventions focus on?

A

Pain management and prevention of infection and urinary obstruction

159
Q

The use of sound, laser or dry shock waves to break the renal calculi into small fragments

A

Lithotripsy

160
Q

How much fluid should a normal person drink?

A

1.5-2.5 L/day

161
Q

What exercises can women with incontinence do to reverse the condition?

A

Pelvic floor strengthening exercises

162
Q

What is the kidney’s role in the human body?

A

Filtering wastes and balancing fluids, electrolytes, acids and bases

163
Q

Involves an active bacterial infection and tissue inflammation, tubular cell necrosis, and possible abscess formation anywhere in the kidney

A

Acute pyelonephritis

164
Q

Occurs with a lower urinary tract defect, obstruction, kidney stones, or, most commonly, when urine reflexes from the bladder back into the ureters

A

Chronic pyelonephritis

165
Q

Why do ARF patients need a high calorie diet?

A

Because there is a high rate of catabolism

166
Q

What types of dialysis are used in emergency situations?

A

Continuous renal replacement therapy, continuous arteriovenous hemofiltration, continuous arteriovenous hemodialysis and filtration

167
Q

Which systemic diseases put patients at higher risk for CRF?

A

Diabetes Mellitus, hypertension, lupus, and sickle cell disease

168
Q

What is urea the end product of?

A

Protein metabolism

169
Q

What type of dialysis is the least disruptive to a normal lifestyle?

A

Continuous Ambulatory Peritoneal Dialysis

170
Q

What does protein in a urinalysis indicate?

A

Kidney injury and muscle wasting

171
Q

What would cause a BUN to be elevated?

A

Excessive protein intake or trauma

172
Q

What is the most common cause of renal calculi?

A

Dehydration

173
Q

Why does Diabetes Mellitus cause CRF?

A

The fluctuations between high and low sugars does constant damage

Illness and Patho 1 (12 decks)

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