Renal

Question 1

Renal disease - Systemic changes are not evident until overall renal function is _________% of normal.

Answer 1

20-25%

Question 2

What 2 things change with the first stage of renal failure? Also, name this stage.

Answer 2

50% nephron loss, creatinine doubles. Diminished Renal Reserve

Question 3

Name the 2nd stage of renal failure, and name 2 values/things that are evident.

Answer 3

Renal Insufficiency. 75% nephron loss and mild azotemia present.

Question 4

What is the last stage of renal failure? Name 3 physiological conditions that are present.

Answer 4

End Stage Renal Disease. 90% nephrons lost, azotemia, metabolic alterations/changes

Question 5

What is the normal serum creatinine to BUN ratio?

Answer 5

1:10

Question 6

Name the most common cause of INTRArenal failure (also called intrinsic renal failure).

Answer 6

Nephrotoxic agents

Question 7

What diet instruction is very important to tell chronic renal failure patients?

Answer 7

Keep intake of protein less than 40 g/day.

Question 8

Diagnostic Test Table (p. 86): List values for Prerenal, Intrarenal, and Postrenal Disease for the Serum BUN: Creatinine ratio.

Answer 8

Prerenal: > than 10:1
Intrarenal: 10:1
Postrenal: 10:1

Question 9

Diagnostic Test Table (p. 86): List values for Prerenal, Intrarenal, and Postrenal Disease for the Urine Sodium.

Answer 9

Prerenal: 40 mmol/dL
Postrenal: Usually > 40 mmol/dL

Question 10

Diagnostic Test Table (p. 86): List values for Prerenal, Intrarenal, and Postrenal Disease for the Specific Gravity.

Answer 10

Prerenal: > 1.015**
Intrarenal:

Question 11

Diagnostic Test Table (p. 86): List descriptions for Prerenal, Intrarenal, and Postrenal Disease for Urinary Sediment.

Answer 11

Prerenal: Normal/few hyaline casts
Intrarenal: Granular/White casts
Postrenal: Normal

Question 12

Diagnostic Test Table (p. 86): List values for Prerenal, Intrarenal, and Postrenal Disease for the Fractional excretion of Sodium? (FEna)

Answer 12

Prerenal: 3
Postrenal: Usually > 3

Question 13

BPH affects ___ % of men by age 50, and it affects greater than 80% of men by age ____.

Answer 13

50, 80

Question 14

What pain does the patient experience when a renal stone has passed to the lower third of the ureter? 2 possible answers.

Answer 14

Radiation downward to the groin and testicular pain

Question 15

How would you manage prerenal disease? 2 answers.

Answer 15

Expand intravascular volume, consider dopamine.

Question 16

How would you manage intrarenal disease? 3 answers.

Answer 16

1. Maintain renal perfusion
2. Stop nephrotoxic drugs
3. Renal replacement therapies as needed

Question 17

How would you manage postrenal disease? 4 answers.

Answer 17

1. Remove source of obstruction
2. Check foley
3. CT
4. Renal ultrasound

Question 18

Where is the pain when a patient is passing a stone from the kidney to the ureter?

Answer 18

In the belly or lower back

Question 19

Does GFR change with age? If so, how?

Answer 19

Yes. It decreases with age naturally.