NUR 265 Exam 1 Questions and Answers
What is nephrotic syndrome? - ANSWER A condition of increased glomerular permeability that
allows larger molecules to pass through the membrane into the urine and then be excreted.
What are key features of nephrotic syndrome? - ANSWER -*Massive proteinuria*
-*Hypoalbuminemia*
-*Edema (facial and periorbital)*
-Lipiduria
-Hyperlipidemia
-Increased coagulation
-Reduced kidney function
In nephrotic syndrome, severe protein loss in the urine is greater than what? - ANSWER 3.5g
in 24 hours
What is nephrotic syndrome treated with? - ANSWER -immunosuppressant agents (if
immunity based).
-ACE inhibitors (decreased protein loss in urine)
-statins (improve blood lipid levels).
-Heparin (used to treat vascular effects and improve kidney function)
Describe the "risk" stage for AKI - ANSWER creatinine x 1.5 of normal, and GFR reduced by
25%
Describe the "injury" stage for AKI - ANSWER creatinine x2 & GFR reduced by 50%
Describe the "failure" stage for AKI - ANSWER creatinine x3 normal, & GFR reduced by 75%
(Cant fix)
Describe Prerenal AKI. Give examples. - ANSWER Decreased perfusion to kidneys.
-NSAIDs
-Severe dehydration
-Renal artery stenosis
,-MI or HF resulting in low ejection fraction and low cardiac output
-Blood/ fluid loss
Describe Intrarenal AKI. Give examples. - ANSWER Tissue damage to the actual kidneys.
-Glomerulonephritis or inflammation of the glomeruli
-Sepsis
-Intrarenal bleeding
-Pyelonephritis
Describe Postrenal AKI. Give examples. - ANSWER Obstruction that occurs after the
kidney.
-Enlarged prostate (BPH)
-Bladder Cancer
-Kidney stones
How do you determine the mean arterial pressure (MAP)? - ANSWER Systolic +
(Diastolic*2) /3
What is the MAP needed to perfuse the kidneys? - ANSWER 65 mmHg
What are examples of nephrotoxic drugs? - ANSWER -NSAIDS
-Metformin
-Diuretics
-Antibiotics (especially -mycin)
-Contrast dye
During the diuretic phase of AKI, what needs to be monitored? - ANSWER Watch for
dehydration and make sure output is greater than input
What are the dietary restrictions for an AKI patient? - ANSWER -Low protein
-Low sodium
-Fluid restriction: 1000-1500mL day (for anything except perfusion problem)
What are the 2 most common causes of CKD? - ANSWER -HTN
-Uncontrolled diabetes
, What is azotemia? - ANSWER Nitrogenous waste build up
What are manifestations of uremia? - ANSWER •Metallic taste in mouth
•Anorexia
•Nausea/vomiting
•Muscle cramps
•Uremic frost on skin
•Itching
•Fatigue and lethargy
•Hiccups
•Edema
•Dyspnea
•Paresthesia's
What effects can CKD have on the cardiac system - ANSWER -HTN
-Heart failure (major problem. Call the doctor)
-Pericarditis
What effects can CKD have on the Integumentary system - ANSWER -Uremic frost
What are the dietary restrictions on CKD? - ANSWER -Protein (restrict early in disease
process to preserve kidney function)
-Potassium
-Fluid
-Sodium
Describe hemodialysis - ANSWER -3x a week- 4-5 hours
-At risk for bleeding do to heparin
-Extremely fatigued post.
-Vitals and weight before and after
-Slight fever post is normal. Monitor.
What is nephrotic syndrome? - ANSWER A condition of increased glomerular permeability that
allows larger molecules to pass through the membrane into the urine and then be excreted.
What are key features of nephrotic syndrome? - ANSWER -*Massive proteinuria*
-*Hypoalbuminemia*
-*Edema (facial and periorbital)*
-Lipiduria
-Hyperlipidemia
-Increased coagulation
-Reduced kidney function
In nephrotic syndrome, severe protein loss in the urine is greater than what? - ANSWER 3.5g
in 24 hours
What is nephrotic syndrome treated with? - ANSWER -immunosuppressant agents (if
immunity based).
-ACE inhibitors (decreased protein loss in urine)
-statins (improve blood lipid levels).
-Heparin (used to treat vascular effects and improve kidney function)
Describe the "risk" stage for AKI - ANSWER creatinine x 1.5 of normal, and GFR reduced by
25%
Describe the "injury" stage for AKI - ANSWER creatinine x2 & GFR reduced by 50%
Describe the "failure" stage for AKI - ANSWER creatinine x3 normal, & GFR reduced by 75%
(Cant fix)
Describe Prerenal AKI. Give examples. - ANSWER Decreased perfusion to kidneys.
-NSAIDs
-Severe dehydration
-Renal artery stenosis
,-MI or HF resulting in low ejection fraction and low cardiac output
-Blood/ fluid loss
Describe Intrarenal AKI. Give examples. - ANSWER Tissue damage to the actual kidneys.
-Glomerulonephritis or inflammation of the glomeruli
-Sepsis
-Intrarenal bleeding
-Pyelonephritis
Describe Postrenal AKI. Give examples. - ANSWER Obstruction that occurs after the
kidney.
-Enlarged prostate (BPH)
-Bladder Cancer
-Kidney stones
How do you determine the mean arterial pressure (MAP)? - ANSWER Systolic +
(Diastolic*2) /3
What is the MAP needed to perfuse the kidneys? - ANSWER 65 mmHg
What are examples of nephrotoxic drugs? - ANSWER -NSAIDS
-Metformin
-Diuretics
-Antibiotics (especially -mycin)
-Contrast dye
During the diuretic phase of AKI, what needs to be monitored? - ANSWER Watch for
dehydration and make sure output is greater than input
What are the dietary restrictions for an AKI patient? - ANSWER -Low protein
-Low sodium
-Fluid restriction: 1000-1500mL day (for anything except perfusion problem)
What are the 2 most common causes of CKD? - ANSWER -HTN
-Uncontrolled diabetes
, What is azotemia? - ANSWER Nitrogenous waste build up
What are manifestations of uremia? - ANSWER •Metallic taste in mouth
•Anorexia
•Nausea/vomiting
•Muscle cramps
•Uremic frost on skin
•Itching
•Fatigue and lethargy
•Hiccups
•Edema
•Dyspnea
•Paresthesia's
What effects can CKD have on the cardiac system - ANSWER -HTN
-Heart failure (major problem. Call the doctor)
-Pericarditis
What effects can CKD have on the Integumentary system - ANSWER -Uremic frost
What are the dietary restrictions on CKD? - ANSWER -Protein (restrict early in disease
process to preserve kidney function)
-Potassium
-Fluid
-Sodium
Describe hemodialysis - ANSWER -3x a week- 4-5 hours
-At risk for bleeding do to heparin
-Extremely fatigued post.
-Vitals and weight before and after
-Slight fever post is normal. Monitor.
