NU 407 FINAL EXAM WITH 320+ QUESTIONS &
CORRECT ANSWERS
What is acute kidney injury?
The rapid loss of kidney function that is typically reversible
What are two common manifestations of acute kidney injury?
Reduced GFR and oliguria
What is chronic kidney disease?
progressive, irreversible loss of kidney function
What stage of chronic kidney disease are symptoms unremarkable?
Stage 1
What GFR rate is dialysis required?
15
What is a common symptom of chronic kidney disease?
Azotemia
(nitrogen-containing wastes and urea presence in blood)
What are the three causes of acute kidney failure?
Prerenal, intrarenal, and postrenal
Describe the prerenal cause of acute kidney failure.
Sudden and severe drop in BP (shock) or interruption of blood flow to kidneys
Describe the intrarenal cause of acute kidney failure.
direct damage to kidneys by inflammation, toxins, drugs, etc.
What is the hallmark sign of nephrotic syndrome?
Periorbital edema (must be diagnosed with biopsy)
,Describe the postrenal cause of acute kidney injury.
Sudden obstruction of urine flow (due to enlarged prostate, kidney stones, bladder
tumors, etc.)
S/s of AKI include (4)
N/V, ascites, pulmonary edema, hyperkalemia, etc.
(essentially a backup of fluids and an inability to filter electrolytes like potassium)
What are the three phases of acute kidney injury?
Oliguric (<400mL/day, metabolic acidosis ), diuretic, and recovery
What acid base balance are patients in AKI typically experiencing?
Metabolic acidosis (bicarb becomes depleted)
What is the earliest sign that the kidneys are struggling?
Microalbuminuria
What conditions put a pt at risk for chronic kidney failure (3)?
DM, HTN, pyelonephritis, etc
What access site is typically used for hemodialysis?
AV graft, or fistula
What should you educate a patient with an AV fistula?
Avoid tight clothing on arm with fistula
What is hemodialysis indicated for?
Used for both AKI and CKD
What are expected findings for an AV graft?
Hearing a bruit and feeling a thrill
What is the benefit of doing peritoneal dialysis over hemodialysis?
Can be performed at home
What is the indication for peritoneal dialysis?
,Patients with CKD or renal failure
What is a major complication of peritoneal dialysis that is not shared with
hemodialysis?
Peritonitis
What is the expected finding for a pt utilizing peritoneal dialysis looking at the
drainage bag?
Clear to yellow-tinged drainage
A patient is undergoing peritoneal dialysis and notices that the drainage is cloudy
and red-tinged, and the patient is reporting severe abdominal distension what
condition may this indicate?
Peritonitis
How often must peritoneal dialysis be done?
3-5 times a day
A nurse is monitoring a patient undergoing peritoneal dialysis, they notice that the
dialysate is infusing however there is no drainage. What should the nurse do first?
Check the line for any kinks by repositioning them
What electrolytes should be avoided in kidney disease (3)?
Potassium, phosphorus, protein, etc.
A recommended food for patients in AKI is chocolate (T/F).
False
(chocolate contains phosphorus, also avoid dark sodas in AKI)
What notable symptom does hyperphosphatemia cause?
Pruritus
What are common abnormal urinalysis findings in a patient with a UTI?
Elevated WBC, Elevated bacteria, Elevated RBC
What are common S/S of a UTI (4)?
burning with urination, frequency, urgency, hematuria
, What is a very common symptom of geriatric patients with a UTI?
Confusion
What serious condition are patients with cystitis at risk for?
Sepsis
(caused by infection traveling to kidneys then bloodstream)
What are primary interventions in treating a urinary tract infection (4)?
relieve pain, antibiotics, increase fluid intake, frequent voiding
How often should a patient void to prevent a UTI?
every 2-3 hours during the day
What are common S/S of kidney stones (nephrolithiasis) (4)?
frequent urination, and blood in urine, pulsing flank pain, difficulty voiding
What is common patient education to provide for prevention of kidney stones?
Avoid protein intake, avoid intake of oxalate-containing foods, drink fluids (water)
every 1-2 hours, avoid dehydration
(Low calcium diets are NOT recommended)
What are examples of oxalate containing foods (4)?
Spinach, strawberries, tea, peanuts, etc.
What supplements can help with prevention of kidney stones?
Magnesium and vitamin B6
Mucus seen in an ileal conduit is a normal finding (T/F).
True
What are healthy colors for a stoma (2)?
Pink, beefy red
Why would mucus be seen in the output of an ileal conduit?
This urinary diversion method runs through a section of the small intestines.
CORRECT ANSWERS
What is acute kidney injury?
The rapid loss of kidney function that is typically reversible
What are two common manifestations of acute kidney injury?
Reduced GFR and oliguria
What is chronic kidney disease?
progressive, irreversible loss of kidney function
What stage of chronic kidney disease are symptoms unremarkable?
Stage 1
What GFR rate is dialysis required?
15
What is a common symptom of chronic kidney disease?
Azotemia
(nitrogen-containing wastes and urea presence in blood)
What are the three causes of acute kidney failure?
Prerenal, intrarenal, and postrenal
Describe the prerenal cause of acute kidney failure.
Sudden and severe drop in BP (shock) or interruption of blood flow to kidneys
Describe the intrarenal cause of acute kidney failure.
direct damage to kidneys by inflammation, toxins, drugs, etc.
What is the hallmark sign of nephrotic syndrome?
Periorbital edema (must be diagnosed with biopsy)
,Describe the postrenal cause of acute kidney injury.
Sudden obstruction of urine flow (due to enlarged prostate, kidney stones, bladder
tumors, etc.)
S/s of AKI include (4)
N/V, ascites, pulmonary edema, hyperkalemia, etc.
(essentially a backup of fluids and an inability to filter electrolytes like potassium)
What are the three phases of acute kidney injury?
Oliguric (<400mL/day, metabolic acidosis ), diuretic, and recovery
What acid base balance are patients in AKI typically experiencing?
Metabolic acidosis (bicarb becomes depleted)
What is the earliest sign that the kidneys are struggling?
Microalbuminuria
What conditions put a pt at risk for chronic kidney failure (3)?
DM, HTN, pyelonephritis, etc
What access site is typically used for hemodialysis?
AV graft, or fistula
What should you educate a patient with an AV fistula?
Avoid tight clothing on arm with fistula
What is hemodialysis indicated for?
Used for both AKI and CKD
What are expected findings for an AV graft?
Hearing a bruit and feeling a thrill
What is the benefit of doing peritoneal dialysis over hemodialysis?
Can be performed at home
What is the indication for peritoneal dialysis?
,Patients with CKD or renal failure
What is a major complication of peritoneal dialysis that is not shared with
hemodialysis?
Peritonitis
What is the expected finding for a pt utilizing peritoneal dialysis looking at the
drainage bag?
Clear to yellow-tinged drainage
A patient is undergoing peritoneal dialysis and notices that the drainage is cloudy
and red-tinged, and the patient is reporting severe abdominal distension what
condition may this indicate?
Peritonitis
How often must peritoneal dialysis be done?
3-5 times a day
A nurse is monitoring a patient undergoing peritoneal dialysis, they notice that the
dialysate is infusing however there is no drainage. What should the nurse do first?
Check the line for any kinks by repositioning them
What electrolytes should be avoided in kidney disease (3)?
Potassium, phosphorus, protein, etc.
A recommended food for patients in AKI is chocolate (T/F).
False
(chocolate contains phosphorus, also avoid dark sodas in AKI)
What notable symptom does hyperphosphatemia cause?
Pruritus
What are common abnormal urinalysis findings in a patient with a UTI?
Elevated WBC, Elevated bacteria, Elevated RBC
What are common S/S of a UTI (4)?
burning with urination, frequency, urgency, hematuria
, What is a very common symptom of geriatric patients with a UTI?
Confusion
What serious condition are patients with cystitis at risk for?
Sepsis
(caused by infection traveling to kidneys then bloodstream)
What are primary interventions in treating a urinary tract infection (4)?
relieve pain, antibiotics, increase fluid intake, frequent voiding
How often should a patient void to prevent a UTI?
every 2-3 hours during the day
What are common S/S of kidney stones (nephrolithiasis) (4)?
frequent urination, and blood in urine, pulsing flank pain, difficulty voiding
What is common patient education to provide for prevention of kidney stones?
Avoid protein intake, avoid intake of oxalate-containing foods, drink fluids (water)
every 1-2 hours, avoid dehydration
(Low calcium diets are NOT recommended)
What are examples of oxalate containing foods (4)?
Spinach, strawberries, tea, peanuts, etc.
What supplements can help with prevention of kidney stones?
Magnesium and vitamin B6
Mucus seen in an ileal conduit is a normal finding (T/F).
True
What are healthy colors for a stoma (2)?
Pink, beefy red
Why would mucus be seen in the output of an ileal conduit?
This urinary diversion method runs through a section of the small intestines.
