NUR 265
EXAM 1 STUDY GUIDE
Medical-Surgical Nursing
Galen College of Nursing
,NUR 265 EXAM ONE STUDY GUIDE
Nephrotic Syndrome:
o NS is a condition of increased glomerular permeability that
allows larger molecules to pass through the membrane into the
urine and then be excreted.
o Immunological Kidney disorder
o This causes massive loss of protein in the urine, edema
formation, and decreased plasma albumin levels.
Proteinuria- severe protein loss more than 3.5 g in 24-
hour urine sample.
o Key features:
Massive proteinuria >3.5g / 24hrs
Hypoalbuminemia <3g/dL
Edema (facial and periorbital)
Lipiduria
Hyperlipidemia
Increased coagulation (renal vein thrombosis)
Reduced kidney function (↑ BUN, ↑ Cr, ↓ GFR)
o Treatment- immunosuppressant agents (if immunity based).
ACE inhibitors (to decreased protein loss in urine & ↓BP)
Statins (improve blood lipid levels).
Heparin (↑ coagulation / risk of thrombosis → treat
vascular effects and improve kidney function)
o Diet:
If GFR is normal- dietary intake of complete proteins is
needed
If GFR is decreased- dietary protein is decreased, diuretics
and sodium restriction.
Acute Kidney Injury:
o AKI is rapid reduction in kidney function resulting in a failure to
maintain fluid and electrolyte balance, and acid-base balance.
Can occur over a few hours or days
o Severity of AKI is based on serum creatinine increase, and
decreased urine output- an increase in specific gravity (meaning
urine is more concentrated or the patient is dehydrated).
o GFR isn’t used to measure acute injury or illness—only chronic
kidney disease.
o 3 types of AKI
prerenal - conditions that reduce blood flow / oxygen to
the kidney → decreased perfusion to kidneys
azotemia- nitrogenous waste/toxin build up
o effects LOC, mood, change in personality
, o related directly to reduced perfusion to the
kidneys
examples of perfusion reduction:
o blood/fluid loss- (surgery, sepsis, hypovolemic
shock)
o blood pressure drugs resulting in hypotension
o MI or HF → low ejection fraction → low cardiac
output
o NSAIDs, ASA
o Anaphylaxis
o Severe burns
o Severe dehydration
o Renal artery stenosis
o Bleeding or clotting in kidney blood vessels
o Atherosclerosis (cholesterol deposits
obstructing blood flow to the kidneys)
Intra-renal failure- tissue damage to the actual kidneys
Intra-renal- reflects injury to the glomeruli, nephrons,
or tubules
Examples of intra-renal failure:
o Bleeding in the kidney
o Glomerulonephritis or inflammation of the
glomeruli
o Pyelonephritis
o Thrombi or emboli in the kidney blood vessels
o TTP → platelet disorder ↑ clotting
o Sepsis or local infection
o Lupus
o Multiple myeloma
o Scleroderma
o Chemo/ ABTs / nephrotoxic drugs
o Ischemia in kidney failure, including hypoxemia
from respiratory and cardiac arrest
Post-renal failure- Urine flow obstruction
Post-renal failure examples:
o Bladder cancer
o Colon cancer
o Prostate cancer
o Cervical cancer
o Enlarged prostate
o Kidney stones
o Blood clots in urinary tract
EXAM 1 STUDY GUIDE
Medical-Surgical Nursing
Galen College of Nursing
,NUR 265 EXAM ONE STUDY GUIDE
Nephrotic Syndrome:
o NS is a condition of increased glomerular permeability that
allows larger molecules to pass through the membrane into the
urine and then be excreted.
o Immunological Kidney disorder
o This causes massive loss of protein in the urine, edema
formation, and decreased plasma albumin levels.
Proteinuria- severe protein loss more than 3.5 g in 24-
hour urine sample.
o Key features:
Massive proteinuria >3.5g / 24hrs
Hypoalbuminemia <3g/dL
Edema (facial and periorbital)
Lipiduria
Hyperlipidemia
Increased coagulation (renal vein thrombosis)
Reduced kidney function (↑ BUN, ↑ Cr, ↓ GFR)
o Treatment- immunosuppressant agents (if immunity based).
ACE inhibitors (to decreased protein loss in urine & ↓BP)
Statins (improve blood lipid levels).
Heparin (↑ coagulation / risk of thrombosis → treat
vascular effects and improve kidney function)
o Diet:
If GFR is normal- dietary intake of complete proteins is
needed
If GFR is decreased- dietary protein is decreased, diuretics
and sodium restriction.
Acute Kidney Injury:
o AKI is rapid reduction in kidney function resulting in a failure to
maintain fluid and electrolyte balance, and acid-base balance.
Can occur over a few hours or days
o Severity of AKI is based on serum creatinine increase, and
decreased urine output- an increase in specific gravity (meaning
urine is more concentrated or the patient is dehydrated).
o GFR isn’t used to measure acute injury or illness—only chronic
kidney disease.
o 3 types of AKI
prerenal - conditions that reduce blood flow / oxygen to
the kidney → decreased perfusion to kidneys
azotemia- nitrogenous waste/toxin build up
o effects LOC, mood, change in personality
, o related directly to reduced perfusion to the
kidneys
examples of perfusion reduction:
o blood/fluid loss- (surgery, sepsis, hypovolemic
shock)
o blood pressure drugs resulting in hypotension
o MI or HF → low ejection fraction → low cardiac
output
o NSAIDs, ASA
o Anaphylaxis
o Severe burns
o Severe dehydration
o Renal artery stenosis
o Bleeding or clotting in kidney blood vessels
o Atherosclerosis (cholesterol deposits
obstructing blood flow to the kidneys)
Intra-renal failure- tissue damage to the actual kidneys
Intra-renal- reflects injury to the glomeruli, nephrons,
or tubules
Examples of intra-renal failure:
o Bleeding in the kidney
o Glomerulonephritis or inflammation of the
glomeruli
o Pyelonephritis
o Thrombi or emboli in the kidney blood vessels
o TTP → platelet disorder ↑ clotting
o Sepsis or local infection
o Lupus
o Multiple myeloma
o Scleroderma
o Chemo/ ABTs / nephrotoxic drugs
o Ischemia in kidney failure, including hypoxemia
from respiratory and cardiac arrest
Post-renal failure- Urine flow obstruction
Post-renal failure examples:
o Bladder cancer
o Colon cancer
o Prostate cancer
o Cervical cancer
o Enlarged prostate
o Kidney stones
o Blood clots in urinary tract
