NURS 302 Pre-Exam 5 Homework Spring 2019
Directions: Urinalysis can provide information about kidney functioning, as well as systemic conditions.
For each value below, discuss what it means and associated conditions. The first
finding is completed as an example.
UA Finding Meaning/Cause
Glucosuria Elevated glucose in urine
Seen in DM when glucose exceeds threshold of
what the renal tubule can absorb
Hematuria Blood in the urine
Often present in pt w/ renal failure or w/ kidney
stones *Renal Calculi or infection
Ketonuria Ketones in the urine
Often present in Hyperglycemia (DM1) Fasting
Starvation
Uncontrolled DM
Leukocyte esterase WBCs in the urine ; A positive leukocyte esterase
measures the amount of enzyme secreted by
WBCs; a high amount is indicative of either a
bladder or kidney infection.
Nitrites Bacteria in the urine
UTI or ASB
Bilirubin Bilirubin in urine
Liver disorders
Excessive hemolysis
Lower than normal pH Acidosis
Elevated specific gravity Dehydration? Highly concentrated urine
Urobilinogen Can indicate liver disease
Bacteriuria Bacteria in the urine that can be visualized on
microscopy
UTI or asymptomatic bacteriuria (ASB)
Urinary casts Cylindrical mucoprotein structures produced by
the nephron tubules that appear in the urine.
Various casts found in urine sediment include
hyaline, waxy, granular, fatty, crystal, RBC, WBC,
bacterial, and epithelial.
Nephrotic syndrome
Dehydration
Vigorous exercise
Diuretics
Tubular necrosis
Autoimmune disorders
Pyelonephritis
Other kidney diseases
Proteinuria *AKA Microalbuminuria A condition in which urine contains an abnormal
,NURS 302 Pre-Exam 5 Homework Spring 2019
amount of protein.
Normally urine should contain no more than 200
mg of protein per liter.
Glomerular injury
Kidney dysfunction caused by diabetes
Kidney dysfunction caused by high blood pressure
Inflammation of the kidneys
Directions: Complete the table below.
Renal Failure Causes Lab changes and/or
signs/symptoms
Prerenal caused by decreased blood flow Decrease GFR; hypovolemia;
and perfusion to the kidney hypercalcemia; weight loss,
orthostatic hypotension; poor
skin turgor, tachycardia, ascites,
spider angiomas
Intrarenal develops secondary to actual WBC can elevate; muscle
injuries to the kidney itself; This tenderness, edema, abdominal
is most commonly caused by bruits
nephrotoxic medications, renal
infections, or systemic illnesses
that affect the kidney. Common
examples include nephrotoxicity
caused by nonsteroidal anti-
inflammatory drugs (NSAIDs)
and poststreptococcal
glomerulonephritis.
Postrenal related to obstruction of urine BPH, neurogenic bladder;
outflow from the kidneys; A few bladder distention, pelvic mass
conditions can cause this
obstruction, including kidney
stone or prostate gland
hyperplasia.
, NURS 302 Pre-Exam 5 Homework Spring 2019
Directions: Read the case study and complete the questions.
Kyle, age 72 years, recently suffered a heart attack, damaging his left ventricle. He appears to be
suffering from left-side heart failure. Stroke volume, blood pressure, and cardiac output are all reduced.
Kyle’s renal function may be impaired. Serum BUN and Cr levels are increasing and GFR is significantly
reduced. Oliguria is present, as are edema of the face and extremities. Kyle seems to be becoming more
and more confused and disoriented. Further blood laboratory values reveal hypocalcemia, hyperkalemia,
and anemia.
1. Based on the information provided, which type of renal dysfunction is most likely in Kyle’s case:
prerenal, intrarenal, or postrenal?
Prerenal
2. What information leads you to your conclusion?
Prerenal dysfunction of the kidney describes pathophysiologic processes that affect GFR and are directly
related to blood flow and renal perfusion. Any condition that directly or indirectly decreases renal
perfusion may lead to prerenal dysfunction. His GFR is reduced. His stroke volume, CO, and BP are all
reduced.
3. Why are Kyle’s serum BUN and Cr levels increasing?
An elevated BUN can occur when there is a decrease in the GFR, which leads to accumulation of
nitrogenous waste products in the blood. Accumulation of serum creatinine indicates decreased filtering
of creatinine at the glomerulus.
4. Why may Kyle be experiencing oliguria?
The decrease in glomerular filtration of the blood causes a decrease, or diminished, urine production.
The kidneys are not effectively filtering out wastes.
5. Explain Kyle’s blood test results.
Nitrogenous waste builds up in the blood and signs and symptoms of uremia occur, such as
encephalopathy, anemia, hyperkalemia, metabolic acidosis, thrombocytopenia, and neuromuscular
irritability.
6. What are some treatment options for Kyle’s condition?
With prerenal AKI, fluid administration is indicated. Once the patient develops oliguria, diuretics such as
furosemide (Lasix) may be used cautiously. Electrolytes are monitored; with hyperkalemia, cardiac
monitoring is necessary. In patients who do not have rapid resolution of the AKI, continuous renal
replacement treatment (CRRT) or hemodialysis may be indicated.
Directions: Urinalysis can provide information about kidney functioning, as well as systemic conditions.
For each value below, discuss what it means and associated conditions. The first
finding is completed as an example.
UA Finding Meaning/Cause
Glucosuria Elevated glucose in urine
Seen in DM when glucose exceeds threshold of
what the renal tubule can absorb
Hematuria Blood in the urine
Often present in pt w/ renal failure or w/ kidney
stones *Renal Calculi or infection
Ketonuria Ketones in the urine
Often present in Hyperglycemia (DM1) Fasting
Starvation
Uncontrolled DM
Leukocyte esterase WBCs in the urine ; A positive leukocyte esterase
measures the amount of enzyme secreted by
WBCs; a high amount is indicative of either a
bladder or kidney infection.
Nitrites Bacteria in the urine
UTI or ASB
Bilirubin Bilirubin in urine
Liver disorders
Excessive hemolysis
Lower than normal pH Acidosis
Elevated specific gravity Dehydration? Highly concentrated urine
Urobilinogen Can indicate liver disease
Bacteriuria Bacteria in the urine that can be visualized on
microscopy
UTI or asymptomatic bacteriuria (ASB)
Urinary casts Cylindrical mucoprotein structures produced by
the nephron tubules that appear in the urine.
Various casts found in urine sediment include
hyaline, waxy, granular, fatty, crystal, RBC, WBC,
bacterial, and epithelial.
Nephrotic syndrome
Dehydration
Vigorous exercise
Diuretics
Tubular necrosis
Autoimmune disorders
Pyelonephritis
Other kidney diseases
Proteinuria *AKA Microalbuminuria A condition in which urine contains an abnormal
,NURS 302 Pre-Exam 5 Homework Spring 2019
amount of protein.
Normally urine should contain no more than 200
mg of protein per liter.
Glomerular injury
Kidney dysfunction caused by diabetes
Kidney dysfunction caused by high blood pressure
Inflammation of the kidneys
Directions: Complete the table below.
Renal Failure Causes Lab changes and/or
signs/symptoms
Prerenal caused by decreased blood flow Decrease GFR; hypovolemia;
and perfusion to the kidney hypercalcemia; weight loss,
orthostatic hypotension; poor
skin turgor, tachycardia, ascites,
spider angiomas
Intrarenal develops secondary to actual WBC can elevate; muscle
injuries to the kidney itself; This tenderness, edema, abdominal
is most commonly caused by bruits
nephrotoxic medications, renal
infections, or systemic illnesses
that affect the kidney. Common
examples include nephrotoxicity
caused by nonsteroidal anti-
inflammatory drugs (NSAIDs)
and poststreptococcal
glomerulonephritis.
Postrenal related to obstruction of urine BPH, neurogenic bladder;
outflow from the kidneys; A few bladder distention, pelvic mass
conditions can cause this
obstruction, including kidney
stone or prostate gland
hyperplasia.
, NURS 302 Pre-Exam 5 Homework Spring 2019
Directions: Read the case study and complete the questions.
Kyle, age 72 years, recently suffered a heart attack, damaging his left ventricle. He appears to be
suffering from left-side heart failure. Stroke volume, blood pressure, and cardiac output are all reduced.
Kyle’s renal function may be impaired. Serum BUN and Cr levels are increasing and GFR is significantly
reduced. Oliguria is present, as are edema of the face and extremities. Kyle seems to be becoming more
and more confused and disoriented. Further blood laboratory values reveal hypocalcemia, hyperkalemia,
and anemia.
1. Based on the information provided, which type of renal dysfunction is most likely in Kyle’s case:
prerenal, intrarenal, or postrenal?
Prerenal
2. What information leads you to your conclusion?
Prerenal dysfunction of the kidney describes pathophysiologic processes that affect GFR and are directly
related to blood flow and renal perfusion. Any condition that directly or indirectly decreases renal
perfusion may lead to prerenal dysfunction. His GFR is reduced. His stroke volume, CO, and BP are all
reduced.
3. Why are Kyle’s serum BUN and Cr levels increasing?
An elevated BUN can occur when there is a decrease in the GFR, which leads to accumulation of
nitrogenous waste products in the blood. Accumulation of serum creatinine indicates decreased filtering
of creatinine at the glomerulus.
4. Why may Kyle be experiencing oliguria?
The decrease in glomerular filtration of the blood causes a decrease, or diminished, urine production.
The kidneys are not effectively filtering out wastes.
5. Explain Kyle’s blood test results.
Nitrogenous waste builds up in the blood and signs and symptoms of uremia occur, such as
encephalopathy, anemia, hyperkalemia, metabolic acidosis, thrombocytopenia, and neuromuscular
irritability.
6. What are some treatment options for Kyle’s condition?
With prerenal AKI, fluid administration is indicated. Once the patient develops oliguria, diuretics such as
furosemide (Lasix) may be used cautiously. Electrolytes are monitored; with hyperkalemia, cardiac
monitoring is necessary. In patients who do not have rapid resolution of the AKI, continuous renal
replacement treatment (CRRT) or hemodialysis may be indicated.
