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NUR 420 CRITICAL CARE: ACUTE AND CHRONIC
RENAL FAILURE 2025| BRAND NEW ACTUAL EXAM
WITH 100% VERIFIED QUESTIONS AND CORRECT
SOLUTIONS| GUARANTEED VALUE PACK| ACE YOUR
GRADES.
What are the functions of the kidneys? - (answers)1. Regulate the volume and
composition of extracellular fluid
2. exrete waste products from the body (high BUN and itchy b/c waste is coming
out of the skin)
3. Other: produces erythropoietin, produces & secretes renin and activates Vit D
(anemic, brittle bones)
What is involved with regulating the volume and composition of the extracellular
fluid in kidneys? - (answers)• Exchanges Na for K ions (hyperkalemia in kideney
failure)
• Conserves HCO3 and secretes H (kidneys not working= get rid of HCO3 and keep
H making acidotic)
• Reabsorbs Ca and excretes phosphates (P keeps climbing which makes the Ca go
down in kidney failure)
abrupt loss of kidney function - (answers)acute renal failure (ARF)
- If treated promptly is reversible (kidneys will keep working with significant
amount of damage)
build up of nitrogenous wastes in the blood - elevated BUN/creatinine -
(answers)azotemia
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What are the hallmarks of ARF? - (answers)- Dec glomerular filtration rate (GFR)
reflected by
- Inc *BUN and creatinine* (more specific creatinine b/c BUN can be effected by
dehydration) *AZOTEMIA*
- Serum creatinine is a better marker b/c it is relatively unaffected by metabolic
factors
What is there to know about serum creatinine in ARF? - (answers)• Inc of 0.5
mg/dL or doubling from baseline when baseline is 2.5 mg/dL
• Inc in more than 20% if baseline is >2.5 mg/dL
• A 50% dec in the measured creatinine clearance or calculated GFR.
What are the urine CM of ARF? - (answers)• Oliguria (<400 mL/day) (more often)
(worry when <17mL/hr): associated with higher morbidity/mortality rates
• Nonoliguria (>400 mL/day)
• Anuria (<100 mL/day)
What does anuria suggest in ARF? - (answers)Rare and suggests obstruction,
vascular catastrophe, severe acute tubular necrosis (ATN), or severe
glomerulonephritis
What are the three stages of ARF? - (answers)1. prerenal (30%)
2. intrarenal: drugs (mycins) and toxins (60%)
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3. postrenal: ob of ureter on both sides, issues in bladder and BPH (10%)
What is there to know about prerenal ARF? - (answers)• Accounts for 35-40% of
inpt and 70% of outpt cases
• Any event that causes *RENAL HYPOPERFUSION*
Common causes:
- Hypovolemia (can be caused by sepsis and shock)
- Cardiovascular failure
The ability to *REVERSE* prerenal ARF is the *KEY* to its diagnosis
- *give fluids then function goes up= dealing with ARF and not chronic*
What is the beginning of prerenal patho? - (answers)• Kidney's response to
inadequate perfusion
• The kidney releases renin= renin-angiotension-aldosterone cascade
• Vasoconstriction and Na/H2O retention result (Preserves renal perfusion over a
wide range of arterial pressures)
• if renal perfusion is severely compromised= autoregulation is overwhelmed and
GFR dec
What is there to know about autoregulation in prerenal ? - (answers)• Mod
hypovolemia, CHF, ACE inhib, and NSAIDS can overwhelm the autoregulation
NUR 420 CRITICAL CARE: ACUTE AND CHRONIC
RENAL FAILURE 2025| BRAND NEW ACTUAL EXAM
WITH 100% VERIFIED QUESTIONS AND CORRECT
SOLUTIONS| GUARANTEED VALUE PACK| ACE YOUR
GRADES.
What are the functions of the kidneys? - (answers)1. Regulate the volume and
composition of extracellular fluid
2. exrete waste products from the body (high BUN and itchy b/c waste is coming
out of the skin)
3. Other: produces erythropoietin, produces & secretes renin and activates Vit D
(anemic, brittle bones)
What is involved with regulating the volume and composition of the extracellular
fluid in kidneys? - (answers)• Exchanges Na for K ions (hyperkalemia in kideney
failure)
• Conserves HCO3 and secretes H (kidneys not working= get rid of HCO3 and keep
H making acidotic)
• Reabsorbs Ca and excretes phosphates (P keeps climbing which makes the Ca go
down in kidney failure)
abrupt loss of kidney function - (answers)acute renal failure (ARF)
- If treated promptly is reversible (kidneys will keep working with significant
amount of damage)
build up of nitrogenous wastes in the blood - elevated BUN/creatinine -
(answers)azotemia
,2|Page
What are the hallmarks of ARF? - (answers)- Dec glomerular filtration rate (GFR)
reflected by
- Inc *BUN and creatinine* (more specific creatinine b/c BUN can be effected by
dehydration) *AZOTEMIA*
- Serum creatinine is a better marker b/c it is relatively unaffected by metabolic
factors
What is there to know about serum creatinine in ARF? - (answers)• Inc of 0.5
mg/dL or doubling from baseline when baseline is 2.5 mg/dL
• Inc in more than 20% if baseline is >2.5 mg/dL
• A 50% dec in the measured creatinine clearance or calculated GFR.
What are the urine CM of ARF? - (answers)• Oliguria (<400 mL/day) (more often)
(worry when <17mL/hr): associated with higher morbidity/mortality rates
• Nonoliguria (>400 mL/day)
• Anuria (<100 mL/day)
What does anuria suggest in ARF? - (answers)Rare and suggests obstruction,
vascular catastrophe, severe acute tubular necrosis (ATN), or severe
glomerulonephritis
What are the three stages of ARF? - (answers)1. prerenal (30%)
2. intrarenal: drugs (mycins) and toxins (60%)
, 3|Page
3. postrenal: ob of ureter on both sides, issues in bladder and BPH (10%)
What is there to know about prerenal ARF? - (answers)• Accounts for 35-40% of
inpt and 70% of outpt cases
• Any event that causes *RENAL HYPOPERFUSION*
Common causes:
- Hypovolemia (can be caused by sepsis and shock)
- Cardiovascular failure
The ability to *REVERSE* prerenal ARF is the *KEY* to its diagnosis
- *give fluids then function goes up= dealing with ARF and not chronic*
What is the beginning of prerenal patho? - (answers)• Kidney's response to
inadequate perfusion
• The kidney releases renin= renin-angiotension-aldosterone cascade
• Vasoconstriction and Na/H2O retention result (Preserves renal perfusion over a
wide range of arterial pressures)
• if renal perfusion is severely compromised= autoregulation is overwhelmed and
GFR dec
What is there to know about autoregulation in prerenal ? - (answers)• Mod
hypovolemia, CHF, ACE inhib, and NSAIDS can overwhelm the autoregulation
