Renal Content Flashcards
What are possible causes of a urinary obstruction? SATA
A. Tumor
B. Stones
C. BPH
D. Hematuria
Answer: A, B, C
Which Glomerular Dysfunction is associated with capsule damage leading to a massive loss of proteins?
A. Glomerulonephritis
B. Nephrotic Syndrome
C. CKD
D. Acute Tubular Necrosis
Answer: B
Rationale: nephrotic syndrome occurs when there is damage to Bowmans capsule leading to increased permeability and the leakage of proteins in the urine
What CM would you expect to see with Nephrotic Syndrome? SATA
A. Extreme weight loss
B. Increased Urinary Frequency
C. Low serum protein
D. Edema
E. Proteinuria
Answers: C, D, E
Define the etiology of Polycystic Kidney Disease
A. Cancerous growth on the Kidney
B. Masses of Crystals formed in the Kidneys
C. Inherited disorder
D. Damage to the Kidney related to drug use
Answer: C
Rationale: This is the most common inherited Kidney disease
BPH would be classified as which type of Acute Kidney Injury?
A. Pre Renal
B. Intra Renal
C. Post Renal
Answer: C
Rationale: The cause of damage occurs AFTER the Kidney
The damage of the Kidney from toxin buildup such as Lactic Acid is classified as which type of Acute Kidney Injury?
A. Pre Renal
B. Intra Renal
C. Post Renal
Answer: B
Rationale: This is direct injury to the Kidney
A pt suffering from severe burns has an Acute Kidney Injury due to the dehydration. How would this be classified?
A. Pre Renal
B. Intra Renal
C. Post Renal
Answer: A
Rationale: Ischemic injury related to hypovolemia
T/F: The oliguric pathway of Acute Tubular Necrosis has a better prognosis than non-oliguric.
False: No urine production - buildup of toxic wastes and fluid retention
What happens in the recovery phase of Acute Tubular Necrosis? SATA
A. Decreased Urine Output
B. Increased Urine Output
C. Decreased Serum Creatinine
D. Increased Serum Creatinine
Answers: B, C
What is our primary concern with the diuresis seen during this phase?
Which of the following are true regarding CKD? SATA
A. Rapid decrease of Kidney function
B. Gradual decrease of Kidney function
C. Reversible
D. Non-Reversible
Answer: B, D
Rationale: This is a progressive and irreversible disorder
What is our main treatment goal with CKD?
What is the key marker for Kidney damage in a CKD patient?
A. Polyuria
B. Albuminuria
C. Oliguria
D. Dysuria
Answer: B
Why do we see this?
Which of the following are compensatory mechanisms of the Kidney seen in CKD? SATA
A. Nephron atrophy
B. RAAS System Activates
C. Functioning nephrons hypertrophy and hyperfiltrate
D. GFR Increases
Answer: B, C
Slide 20
What is the word that defines the accumulation of nitrogen waste?
A. Oliguria
B. Uremia
C. Azotemia
D. Anemia
Answer: C
Define Uremia
When reviewing the labs of a patient with CKD you note a serum potassium level of 6.2. As the nurse you know which of the following is true?
A. Hyperkalemia is an early indicator of Kidney Failure
B. Hypokalemia is a late indicator of Kidney Failure
C. This patient is in the late stages of Kidney Failure
D. This patient’s serum potassium is in the normal range
Answer: C
Rationale: HYPERkalemia does not develop until the Kidneys are severely compromised - late stages of CKD
How are HTN and CKD related?
A. There is no relation between these two conditions
B. CKD can cause HTN
C. HTN can lead to CKD
D. Both B and C are correct
Answer: D
What manifestations of CKD lead to HTN? SATA
A. Hypervolemia
B. Increased RAAS system activation
C. Decreased PVR
D. Increased prostaglandins that promoted vasodilation
Answer: A, B
Slides 23-38 * Know these CM well
What is the major concern in a CKD patient specifically regarding the decreased Calcitrol?
A. Pathologic Fractures
B. Hypercalcemia
C. Osteomyelitis
D. Cancer
Answer: A
Kidneys activate Vit D - Calcitrol
Kidney Dysfuntion:
Low Vit D activation = Low Calcitrol = Increased PTH = Weakened bone matrix = Increased RF fractures
What will be seen in a CKD diagnosis? SATA
A. Proteinuria
B. Increased GFR
C. Decreased Serum Creatnine
D. Increased BUN
Answer: A, D
A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury?
A. Post-renal
B. Intra-renal
C. Pre-renal
Answer: C
Rationale: decreased perfusion to the kidneys due to a secondary cause
A 36 year old male patient is diagnosed with acute kidney injury. The patient is voiding 4 L/day of urine. What complication can arise based on the stage of AKI this patient is in? Select all that apply:
A. Water intoxication
B. Hypotension
C. Hypokalemia
D. Normal GFR
Answer: B, C
Rationale: This is the diuresis stage where we are concerned for water and electrolyte loss!
A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for related to this lab finding?
A. Hypercalcemia
B. Anemia
C. Blood clots
D. Hyperkalemia
Answer: B
Rationale: Erythropoietin is responsible for RBC formation and is produced in the Kidneys.
Kidney damage - decreased eryhro - decreased RBCs
The kidneys are responsible for performing all the following functions EXCEPT?
A. Activating Vitamin D
B. Secreting Renin
C. Secreting Erythropoietin
D. Maintaining cortisol production
Answer: D
Rationale: The adrenal glands are responsible for maintaining cortisol production not the kidneys.
Which of the following statements made by a client with polycystic kidney disease indicates that the desired outcome has been met?
A. “I know these drugs will make the cysts disappear and I won’t have to deal with this anymore.”
B. “The development of renal failure with this disease is very rare.”
C. “I will have my family seek genetic counseling and screening.”
D. “I sure am glad that hemodialysis will shrink the cysts and cure me.”
Answer: C
Rationale: This is a genetic disorder with no cure, it will progress to CKD
You’re providing an in-service to a group of nurses about the different types of kidney stones. You explain to the attendees that the most common type of kidney stone is made up of:
A. Cholesterol
B. Calcium and oxalate
C. Calcium and phosphate
D. Uric acid
Answer: B
What is normal urine output?
A. 300mL/hr
B. 40mL/hr
C. 30mL/hr
D. 100mL/day
C
A patient with CKD has a low erythropoietin (EPO) level. The patient is at risk for?
A. Hypercalcemia
B. Anemia
C. Blood clots
D. Hyperkalemia
B
Rationale: erythropoietin (EPO) helps create red blood cells in the bone marrow. The kidneys produce EPO and when the kidneys are damaged in CKD they can decrease in the production of EPO. Therefore, the patient is at risk for anemia.
A patient with CKD is experiencing extreme pruritus and has several areas of crystallized white deposits on the skin. As the nurse, you know this is due to excessive amounts of what substance found in the blood?
A. Calcium
B. Urea
C. Phosphate
D. Erythropoietin
B
Rationale: This patient is experiencing uremic frost that occurs in severe chronic kidney disease. This is due to high amounts of urea in the blood being secreted via the sweat glands onto the skin, which will appear as white deposits on the skin. The patient will experience itching with this.
While assessing morning labs on your patient with CKD. You note the patient’s phosphate level is elevated. As the nurse, you expect to find the calcium level to be?
A. Elevated
B. Low
C. Normal
D. Same as the phosphate level
B
Rationale: Calcium and phosphate have an inverse relationship
The kidneys are responsible for performing all the following functions EXCEPT?
A. Activating Vitamin D
B. Regulate blood pressure
C. Secreting Erythropoietin
D. Maintaining cortisol production
E. Maintaining electrolyte balance
D
A patient with acute renal injury has a low GFR (glomerular filtration rate). Which signs and symptoms below may this patient present with? SATA
A. Hypervolemia
B. Hypokalemia
C. Increased BUN level
D. Decreased Creatinine level
A, C
During which phase of acute tubular necrosis will there be NO urine output?
A. initiation
B. oliguric
C. non oliguric
D. recovery
B
Which has a better prognosis?
A. Oliguric
B. Non-Oliguric
B
No urine output! Wast and fluid retention
