NUR 265 EXAM ONE STUDY GUIDE (100% Correct) NUR 265 EXAM ONE STUDY GUIDE
Nephrotic Syndrome:
oNS is a condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted. oImmunological Kidney disorder
oThis causes massive loss of protein in the urine, edema formation, and decreased plasma albumin levels. Proteinuria- severe protein loss more than 3.5 g in 24-
hour urine sample. oKey features:
Massive proteinuria >3.5g / 24hrs
Hypoalbuminemia <3g/dL
Edema (facial and periorbital)
Lipiduria
Hyperlipidemia
Increased coagulation (renal vein thrombosis)
Reduced kidney function (↑ BUN, ↑ Cr, ↓ GFR)
oTreatment- immunosuppressant agents (if immunity based). ACE inhibitors (to decreased protein loss in urine & ↓BP)
Statins (improve blood lipid levels).
Heparin (↑ coagulation / risk of thrombosis → treat vascular effects and improve kidney function)
oDiet:
If GFR is normal- dietary intake of complete proteins is needed
If GFR is decreased- dietary protein is decreased, diuretics and sodium restriction.
Acute Kidney Injury:
oAKI is rapid reduction in kidney function resulting in a failure to maintain fluid and electrolyte balance, and acid-base balance. Can occur over a few hours or days
oSeverity of AKI is based on serum creatinine increase, and decreased urine output- an increase in specific gravity (meaning urine is more concentrated or the patient is dehydrated). oGFR isn’t used to measure acute injury or illness—only chronic kidney disease. o3 types of AKI
prerenal - conditions that reduce blood flow / oxygen to the kidney → decreased perfusion to kidneys
azotemia- nitrogenous waste/toxin build up
oeffects LOC, mood, change in personality orelated directly to reduced perfusion to the kidneys
examples of perfusion reduction:
oblood/fluid loss- (surgery, sepsis, hypovolemic shock)
oblood pressure drugs resulting in hypotension
oMI or HF → low ejection fraction → low cardiac output
oNSAIDs, ASA
oAnaphylaxis
oSevere burns
oSevere dehydration
oRenal artery stenosis
oBleeding or clotting in kidney blood vessels
oAtherosclerosis (cholesterol deposits obstructing blood flow to the kidneys)
Intra-renal failure- tissue damage to the actual kidneys
Intra-renal- reflects injury to the glomeruli, nephrons,
or tubules
Examples of intra-renal failure:
oBleeding in the kidney
oGlomerulonephritis or inflammation of the glomeruli
oPyelonephritis
oThrombi or emboli in the kidney blood vessels
oTTP → platelet disorder ↑ clotting
oSepsis or local infection
oLupus
oMultiple myeloma
oScleroderma
oChemo/ ABTs / nephrotoxic drugs
oIschemia in kidney failure, including hypoxemia
from respiratory and cardiac arrest
Post-renal failure- Urine flow obstruction
Post-renal failure examples:
oBladder cancer
oColon cancer
oProstate cancer
oCervical cancer
oEnlarged prostate
oKidney stones
oBlood clots in urinary tract
Nephrotic Syndrome:
oNS is a condition of increased glomerular permeability that allows larger molecules to pass through the membrane into the urine and then be excreted. oImmunological Kidney disorder
oThis causes massive loss of protein in the urine, edema formation, and decreased plasma albumin levels. Proteinuria- severe protein loss more than 3.5 g in 24-
hour urine sample. oKey features:
Massive proteinuria >3.5g / 24hrs
Hypoalbuminemia <3g/dL
Edema (facial and periorbital)
Lipiduria
Hyperlipidemia
Increased coagulation (renal vein thrombosis)
Reduced kidney function (↑ BUN, ↑ Cr, ↓ GFR)
oTreatment- immunosuppressant agents (if immunity based). ACE inhibitors (to decreased protein loss in urine & ↓BP)
Statins (improve blood lipid levels).
Heparin (↑ coagulation / risk of thrombosis → treat vascular effects and improve kidney function)
oDiet:
If GFR is normal- dietary intake of complete proteins is needed
If GFR is decreased- dietary protein is decreased, diuretics and sodium restriction.
Acute Kidney Injury:
oAKI is rapid reduction in kidney function resulting in a failure to maintain fluid and electrolyte balance, and acid-base balance. Can occur over a few hours or days
oSeverity of AKI is based on serum creatinine increase, and decreased urine output- an increase in specific gravity (meaning urine is more concentrated or the patient is dehydrated). oGFR isn’t used to measure acute injury or illness—only chronic kidney disease. o3 types of AKI
prerenal - conditions that reduce blood flow / oxygen to the kidney → decreased perfusion to kidneys
azotemia- nitrogenous waste/toxin build up
oeffects LOC, mood, change in personality orelated directly to reduced perfusion to the kidneys
examples of perfusion reduction:
oblood/fluid loss- (surgery, sepsis, hypovolemic shock)
oblood pressure drugs resulting in hypotension
oMI or HF → low ejection fraction → low cardiac output
oNSAIDs, ASA
oAnaphylaxis
oSevere burns
oSevere dehydration
oRenal artery stenosis
oBleeding or clotting in kidney blood vessels
oAtherosclerosis (cholesterol deposits obstructing blood flow to the kidneys)
Intra-renal failure- tissue damage to the actual kidneys
Intra-renal- reflects injury to the glomeruli, nephrons,
or tubules
Examples of intra-renal failure:
oBleeding in the kidney
oGlomerulonephritis or inflammation of the glomeruli
oPyelonephritis
oThrombi or emboli in the kidney blood vessels
oTTP → platelet disorder ↑ clotting
oSepsis or local infection
oLupus
oMultiple myeloma
oScleroderma
oChemo/ ABTs / nephrotoxic drugs
oIschemia in kidney failure, including hypoxemia
from respiratory and cardiac arrest
Post-renal failure- Urine flow obstruction
Post-renal failure examples:
oBladder cancer
oColon cancer
oProstate cancer
oCervical cancer
oEnlarged prostate
oKidney stones
oBlood clots in urinary tract
