Med Surg Lewis Chapter 47: Acute Kidney Injury
and Chronic Kidney Disease | QUESTIONS AND
ANSWERS | LATEST VERSION
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Terms in this set (284)
What are intrarenal causes of acute d, e, f. Intrarenal causes of acute kidney injury (AKI)
kidney injury (AKI) (select all that include conditions that cause direct damage to the
apply)? kidney tissue, including nephrotoxic drugs, acute
a. Anaphylaxis glomerulonephritis, and tubular obstruction by
b. Renal stones myoglobin, or prolonged ischemia. Anaphylaxis
c. Bladder cancer and other prerenal problems are frequently the
d. Nephrotoxic drugs initial cause of AKI. Renal stones and bladder
e. Acute glomerulonephritis cancer are among the postrenal causes of AKI.
f. Tubular obstruction by myoglobin
,An 83-year-old female patient was c, e. Because the patient has had nothing to eat or
found lying on the bathroom floor. drink
She said she fell 2 days ago and has for 2 days, she is probably dehydrated and
not been hypovolemic.
able to take her heart medicine or Decreased cardiac output (CO) is most likely
eat or drink anything since then. What because she is older and takes heart medicine,
conditions could be causing prerenal which is probably for heart failure or hypertension.
AKI in Both hypovolemia and decreased CO cause
this patient (select all that apply)? prerenal AKI. Anaphylaxis is also a cause of
a. Anaphylaxis prerenal AKI but is not likely in this situation.
b. Renal calculi Nephrotoxic drugs would contribute to intrarenal
c. Hypovolemia causes of AKI and renal calculi would be a
d. Nephrotoxic drugs postrenal cause of AKI.
e. Decreased cardiac output
Acute tubular necrosis (ATN) is the d. Acute tubular necrosis (ATN) is primarily the
most common cause of intrarenal result
AKI. Which patient is most likely to of ischemia, nephrotoxins, or sepsis. Major surgery
develop ATN? is most likely to cause severe kidney ischemia in the
a. Patient with diabetes mellitus patient requiring a blood transfusion. A blood
b. Patient with hypertensive crisis transfusion
c. Patient who tried to overdose on hemolytic reaction produces nephrotoxic injury if it
acetaminophen occurs.
d. Patient with major surgery who Diabetes mellitus, hypertension, and
required a blood transfusion acetaminophen
overdose will not contribute to ATN.
,Priority Decision: A dehydrated b. Injury is the stage of RIFLE classification when
patient is in the Injury stage of the urine
RIFLE staging of AKI. What would the output is less than 0.5 mL/kg/hr for 12 hours, the
nurse serum
first anticipate in the treatment of this creatinine is increased times two or the glomerular
patient? filtration rate (GFR) is decreased by 50%. This stage
a. Assess daily weight may
b. IV administration of fluid and be reversible by treating the cause or, in this patient,
furosemide (Lasix) the
c. IV administration of insulin and dehydration by administering IV fluid and a low
sodium bicarbonate dose of
d. Urinalysis to check for sediment, a loop diuretic, furosemide (Lasix). Assessing the
osmolality, sodium, and specific daily
gravity weight will be done to monitor fluid changes but it
is
not the first treatment the nurse should anticipate.
IV
administration of insulin and sodium bicarbonate
would
be used for hyperkalemia. Checking the urinalysis
will
help to determine if the AKI has a prerenal,
intrarenal, or
postrenal cause by what is seen in the urine but with
this
patient's dehydration, it is thought to be prerenal to
begin
treatment.
, What indicates to the nurse that a d. In prerenal oliguria, the oliguria is caused by a
patient with oliguria has prerenal decrease
oliguria? in circulating blood volume and there is no
a. Urine testing reveals a low specific damage
gravity. yet to the renal tissue. It can be reversed by
b. Causative factor is malignant correcting
hypertension. the precipitating factor, such as fluid replacement
c. Urine testing reveals a high sodium for
concentration. hypovolemia. Prerenal oliguria is characterized by
d. Reversal of oliguria occurs with urine
fluid replacement. with a high specific gravity and a low sodium
concentration,
whereas oliguria of intrarenal failure is
characterized
by urine with a low specific gravity and a high
sodium
concentration. Malignant hypertension causes
damage to
renal tissue and intrarenal oliguria.
In a patient with AKI, which b. A urine specific gravity that is consistently 1.010
laboratory urinalysis result indicates and a
tubular damage? urine osmolality of about 300 mOsm/kg is the same
a. Hematuria specific gravity and osmolality as plasma. This
b. Specific gravity fixed at 1.010 indicates that tubules are damaged and unable to
c. Urine sodium of 12 mEq/L (12 concentrate urine. Hematuria is more common with
mmol/L) postrenal damage. Tubular damage is associated
d. Osmolality of 1000 mOsm/kg (1000 with a high sodium concentration (greater than 40
mmol/kg) mEq/L).
and Chronic Kidney Disease | QUESTIONS AND
ANSWERS | LATEST VERSION
Save
Terms in this set (284)
What are intrarenal causes of acute d, e, f. Intrarenal causes of acute kidney injury (AKI)
kidney injury (AKI) (select all that include conditions that cause direct damage to the
apply)? kidney tissue, including nephrotoxic drugs, acute
a. Anaphylaxis glomerulonephritis, and tubular obstruction by
b. Renal stones myoglobin, or prolonged ischemia. Anaphylaxis
c. Bladder cancer and other prerenal problems are frequently the
d. Nephrotoxic drugs initial cause of AKI. Renal stones and bladder
e. Acute glomerulonephritis cancer are among the postrenal causes of AKI.
f. Tubular obstruction by myoglobin
,An 83-year-old female patient was c, e. Because the patient has had nothing to eat or
found lying on the bathroom floor. drink
She said she fell 2 days ago and has for 2 days, she is probably dehydrated and
not been hypovolemic.
able to take her heart medicine or Decreased cardiac output (CO) is most likely
eat or drink anything since then. What because she is older and takes heart medicine,
conditions could be causing prerenal which is probably for heart failure or hypertension.
AKI in Both hypovolemia and decreased CO cause
this patient (select all that apply)? prerenal AKI. Anaphylaxis is also a cause of
a. Anaphylaxis prerenal AKI but is not likely in this situation.
b. Renal calculi Nephrotoxic drugs would contribute to intrarenal
c. Hypovolemia causes of AKI and renal calculi would be a
d. Nephrotoxic drugs postrenal cause of AKI.
e. Decreased cardiac output
Acute tubular necrosis (ATN) is the d. Acute tubular necrosis (ATN) is primarily the
most common cause of intrarenal result
AKI. Which patient is most likely to of ischemia, nephrotoxins, or sepsis. Major surgery
develop ATN? is most likely to cause severe kidney ischemia in the
a. Patient with diabetes mellitus patient requiring a blood transfusion. A blood
b. Patient with hypertensive crisis transfusion
c. Patient who tried to overdose on hemolytic reaction produces nephrotoxic injury if it
acetaminophen occurs.
d. Patient with major surgery who Diabetes mellitus, hypertension, and
required a blood transfusion acetaminophen
overdose will not contribute to ATN.
,Priority Decision: A dehydrated b. Injury is the stage of RIFLE classification when
patient is in the Injury stage of the urine
RIFLE staging of AKI. What would the output is less than 0.5 mL/kg/hr for 12 hours, the
nurse serum
first anticipate in the treatment of this creatinine is increased times two or the glomerular
patient? filtration rate (GFR) is decreased by 50%. This stage
a. Assess daily weight may
b. IV administration of fluid and be reversible by treating the cause or, in this patient,
furosemide (Lasix) the
c. IV administration of insulin and dehydration by administering IV fluid and a low
sodium bicarbonate dose of
d. Urinalysis to check for sediment, a loop diuretic, furosemide (Lasix). Assessing the
osmolality, sodium, and specific daily
gravity weight will be done to monitor fluid changes but it
is
not the first treatment the nurse should anticipate.
IV
administration of insulin and sodium bicarbonate
would
be used for hyperkalemia. Checking the urinalysis
will
help to determine if the AKI has a prerenal,
intrarenal, or
postrenal cause by what is seen in the urine but with
this
patient's dehydration, it is thought to be prerenal to
begin
treatment.
, What indicates to the nurse that a d. In prerenal oliguria, the oliguria is caused by a
patient with oliguria has prerenal decrease
oliguria? in circulating blood volume and there is no
a. Urine testing reveals a low specific damage
gravity. yet to the renal tissue. It can be reversed by
b. Causative factor is malignant correcting
hypertension. the precipitating factor, such as fluid replacement
c. Urine testing reveals a high sodium for
concentration. hypovolemia. Prerenal oliguria is characterized by
d. Reversal of oliguria occurs with urine
fluid replacement. with a high specific gravity and a low sodium
concentration,
whereas oliguria of intrarenal failure is
characterized
by urine with a low specific gravity and a high
sodium
concentration. Malignant hypertension causes
damage to
renal tissue and intrarenal oliguria.
In a patient with AKI, which b. A urine specific gravity that is consistently 1.010
laboratory urinalysis result indicates and a
tubular damage? urine osmolality of about 300 mOsm/kg is the same
a. Hematuria specific gravity and osmolality as plasma. This
b. Specific gravity fixed at 1.010 indicates that tubules are damaged and unable to
c. Urine sodium of 12 mEq/L (12 concentrate urine. Hematuria is more common with
mmol/L) postrenal damage. Tubular damage is associated
d. Osmolality of 1000 mOsm/kg (1000 with a high sodium concentration (greater than 40
mmol/kg) mEq/L).
