NUR 265 Exam 1 Questions and Answers Latest Updated 2024/2025 (Graded)

NUR 265 Exam 1 Questions and Answers Latest Updated 2024/2025 (Graded) 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 NUR 265 Exam 1 Questions and Answers Latest Updated 2024/2025 (Graded) -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: mL 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. Describe peritoneal dialysis - ANSWER -Sterile procedure at home where catheter is placed into the abdomen -Wear a mask -Solution may be warmed using a heating bag or blanket, not microwave! -Make sure patient turns and repositions to mix solution in the cavity Describe nursing care for an AV fistula. - ANSWER -Palpate and auscultate- bruit and thrill -Distal pulses -ROM- helps form the fistula -Monitor for infection -No heavy lifting or carrying -No pressure -Aneurysm can form at AV fistula site Describe dialysis disequilibrium syndrome - ANSWER -Life threatening! (occurs if fluid is pulled off too fast) -S/S: restless, headache, decreased LOC, seizures, coma -Call a rapid immediately -Give barbiturates and anticonvulsants What is cirrhosis? - ANSWER An extensive, irreversible scarring of the liver. What are common causes of cirrhosis? - ANSWER -ETOH -Viral hepatitis (HEP C) - Autoimmune hepatitis -Drugs and chemicals (aetaminophen or anything else hepatotoxic) What are early S/S of cirrhosis? - ANSWER -Enlarged liver -Fatigue -Weight loss -Anorexia -N/V -Abdominal pain What are end stage S/S of cirrhosis? - ANSWER -Ascites -Small liver -clotting disorder (bruising, GI bleed) -Jaundice -Elevated ammonia levels (give Lactulose) -Hepatic encephalopathy -Decreased bile production What are the stages of hepatic encephalopathy? - ANSWER -Stage 1: personality changes, subtle things that may not be recognized -Stage 2: Continuing mental changes, mental confusion, disorientation to time, place, and person -Stage 3: Marked mental confusion, progressive deterioration -Stage 4: metabolic acidosis, unresponsiveness leading to death in most patients, unarousable What causes hepatic encephalopathy? - ANSWER The buildup of ammonia in the body Describe the physical assessment of an end stage cirrhosis patient. - ANSWER -Ascites -Jaundice -Coagulation problems -Fatigue -Spider angiomas -Petechiae -Liver flaps (asterixis)