Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Nursing Science 3 > WEEK 3 - Renal Injury > Flashcards

WEEK 3 - Renal Injury Flashcards

1
Q

What is the primary function of the renal system?

A

To regulate blood volume and composition of body fluids and to excrete wastes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the three additional functions of the kidneys?

A
  1. Synthesis of the active form of vitamin D
  2. Blood pressure regulation via the RAAS
  3. Erythropoietin synthesis for blood cell production via the bone marrow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where are the kidneys located anatomically?

A

They lie in the retroperitoneal space, posterior to the abdominal wall, outside of the abdominal sac

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which kidney is located lower than the other?

A

The right is lower than the left (due to the presence of the liver)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How do the kidneys regulate pH?

A

Via the excretion of protons or the retention of bicarbonate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How do the kidneys regulate BGLs?

A

Via gluconeogenesis - conversion of amino acids to glucose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

How much cardiac output do the kidneys receive? Via which artery?

A

20-25% via the renal artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Major vessels, nerves and the ureters enter and exit the kidneys via which structure?

A

The hilum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What does the renal cortex contain?

A

85% of nephrons (outer region of the kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What does the renal medulla contain?

A

15% of nephrons and the renal pyramids (inner region of the kidney)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How is the renal pelvis formed?

A

Minor calyces join to form the major calyces, major calyces join to form the renal pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the structural and functional unit of the kidney?

A

The nephron

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which area of the nephron is responsible for filtration?

A

The glomerulus and Bowman’s capsule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which areas of the nephron are responsible for reabsorption?

A
  • Proximal convoluted tubule

- Distal convoluted tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Which area of the nephron is responsible for concentration?

A

The loop of Henle (via the peritubular capillaries)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which area of the nephron is responsible for secretion?

A

The distal convoluted tubule

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

By what means substances reabsorbed via the nephron?

A

Water and urea = passive transport (descending LoH)

Ions and salts = active transport (ascending LoH)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

There are three ions that are resorbed or excreted depending on hormonal influences. Which ions are these?

A

Na+
Ca2+
Mg2+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Define GFR (not just what the letters stand for)

A

Glomerular Filtration Rate

The quantity of glomerular filtrate produced each minute by ALL NEPHRONS in BOTH KIDNEYS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Normal GFR?

A

125mL/min OR

180L/hour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What proportion of filtrate is resorbed by the kidneys?

A

99%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

When are you no longer considered to have a healthy GFR and why?

A

After the age of 30 due to age-dependent loss of nephrons

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What three factors is GFR reliant on?

A
  1. Net filtration pressure
  2. Filtration membrane permeability
  3. Total surface area available
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Renal injury is characterised by?

A

A sustained decline in GFR

25
Acute renal injury is characterised by?
A decline in GFR over a period of minutes-days, leading to elevated BUN and decreased urinary output
26
How long can acute renal failure last for and what does it become after this period?
Can last for up to 12 months | After 12 months, if ARF has not resolved, this becomes chronic kidney disease or end stage kidney disease (ESKD)
27
What are some causes of acute renal failure?
- Hypotension (decreased CO to kidneys) - Tubular injury - Interstitial injury (caused by E Coli) - Glomerular injury (caused by strep infection) - Obstruction eg. PCa, renal calculi, neoplasms
28
What are the three forms of renal failure?
1. Pre-renal 2. Intrinsic or Intra-renal 3. Post-renal
29
What is the primary cause of pre-renal failure?
Impaired blood flow May be due to - Hypotension - Renal hypo-perfusion - Renal vasoconstriction - Hypovolaemia
30
Clinical manifestations of pre-renal failure depend on?
Pt age, health status, increased HR, variable BP (low or normotensive), decreased urinary output
31
What test is used in the diagnosis for pre-renal failure? Is this test accurate in all groups?
Creatinine test Not accurate in older populations due to age dependent changes in skeletal muscle mass - creatinine is a byproduct of skeletal muscle activity
32
Creatinine clearance depends on which three factors?
- Age - Gender - Weight
33
Primary cause of intra-renal failure
Damaged nephron components - glomerulus, interstitium and tubules May be due to: - Glomerulonephritis - Acute tubular necrosis - Inflammation - Renal trauma - Transfusion reaction
34
Clinical manifestations of intra-renal failure?
- Oligouria and fluid overload - Uremia, nausea and vomiting - Decreased EPO production = anaemia, decreased blood cell count - Decreased production of vit. D = hypocalcaemia, hyperparathroidism
35
How is intra-renal failure diagnosed?
- Imaging to exclude pre-/post-renal failure | - Urine microscopy for RBCs and casts
36
Post-renal failure is associated with?
Urinary tract obstruction | Caused by neoplasms, PCa, renal calculi
37
Clinical manifestations of post-renal failure?
Fluid retention (or anuria (no peeing)), pain, electrolyte changes
38
Diagnostic criteria of post-renal failure?
- An abrupt reduction in renal function (in less 48 hours) | - An increase in creatinine (>50%) or anuria for at least 12 hours
39
First line pharmacological therapy for acute renal failure?
Thiazide diuretics eg. Hydrochlorothiazide
40
What characterises chronic renal failure?
The progressive destruction of renal parenchyma wit irreversible sclerosis, loss of nephrons and decline in glomerular function.
41
Primary clinical manifestation of chronic renal failure?
Extracellular fluid expansion and total body volume overload as a result of a failure in the kidneys' abilities to excrete Na+ and H2O
42
What are the biochemical markers tested in the diagnosis of chronic renal failure?
1. Urea 2. Creatinine 3. Sodium 4. Potassium, phosphate and calcium
43
What are the three imaging studies used in the diagnosis of chronic renal failure?
1. Plain film X-ray 2. CT/MRI 3. Voiding Cystoutererogram (VCUG)
44
Why is creatinine a better marker for chronic renal failure than urea?
As creatinine is not influenced by non-renal factors such as a high protein diet and steroids
45
Management for chronic renal failure is aimed at?
Delaying or halting renal failure (no cure)
46
When does end stage kidney failure occur?
When GFR is less than 15%
47
What must happen in end stage kidney failure for symptoms to be exhibited?
The loss of at least 80% of nephrons
48
Characteristics of STAGE 1 of ESKD?
- Asymptomatic | - Normal BUN and creatinine
49
Characteristics of STAGES 2-4 of ESKD?
- Increased BUN and creatinine - Polyuria - Nocturia
50
Characteristics of STAGE 5 of ESKD?
- Marked BUN and creatinine - Anaemia - Hypocalcaemia - Oliguria - Uremic syndrome
51
What is the mechanism of action of hydrochlorothiazide?
Decreases reabsorption of Na+/Cl- in the proximal segment of the distal convoluted tubule - stimulates Na+/K+ and H2o excretion
52
What are the adverse effects of hydrochlorothiazide?
- Hypokalaemia/natraemia - Hyperuricaemia - Hypotension - Dizziness, weakness, muscle cramps (due to low K) - Increased plasma glucose
53
What is the mechanism of action of frusemide?
Inhibits the absorption of Na+ and Cl- in the ascending limb of the Loop of Henle, short acting, causes a rapid decrease in blood volume
54
What are the adverse effects of frusemide?
- Dose-dependent disturbances in electrolytes Na+ and K+ - Dehydration - Syncope - Postural hypotension
55
What is the mechanism of action of mannitol?
Increases osmolality of blood = osmotic diuresis
56
What are the adverse effects of mannitol?
- Electrolyte loss - Thirst, dehydration - Headache, blurred vision, fluid shifts (pulmonary congestion)
57
What is the mechanism of action of Spironolactone?
Inhibits Na+ reabsorption in the distal convoluted tubule by blocking Na+ channels and aldosterone = increased Na+ and decreased K+ excretion
58
What are the adverse effects of Spironolactone?
- Gynaecomastia in men - Post-menopasual bleeding in women - Hyperkalaemia

Nursing Science 3 (21 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions