NSG 241 Renal Disease Study Questions with 100%
Correct Answers
Normal BUN
`8-20
Normal Creatinine
0.6-1.2
Once they have flu like symptoms...
they are even more uremic
Renal Failure
occurs when kidneys cannot remove wastes or perform regulatory functions can be acute or
chronic, systemic disease
What does renal failure result in?
azotemia, metabolic disturbances
Acute on Chronic
have CKD but having acute exacerbation
Acute Kidney Injury
typically reversible, 5-7% of hospitalized clients, 20% of critically ill clients, mortality rate of 40-
60% clients, 5-20% may develop chronic renal failure
Goal of Treatment for AKI
identify and treat cause quickly
Patho of AKI
idiopathic
,Clinical Manifestations of AKI
azotemia, acidemia, fluid excess, altered calcium and phosphate balance, loss of BP regulation,
anemia
Azotemia
increased creatinine, increased BUN, increased wastes
Acidemia
metabolic acidosis- increased RR, SOB, kussmaul's respirations
Loss of BP regulation
related to RAS
Anemia
impact RBC production, decreased H&H, need to watch oxygen saturation
Oliguria
less than 500 mL/day
Anuria
absence of urine
Pre-Renal AKI
azotemia resulting from poor perfusion, 60% of ARF cases, decreased blood supply to kidneys,
decreased GFR & UOP
Causes of Pre-Renal AKI
dehydration, blood loss, GI loss, decreased CO, states of vasodilation, medications
Decreased CO
related to HF, arrhythmias, MI
, States of Vasodilation
sepsis, anaphylaxis
Medications
nitroglycerin, hydralazine
What MAP must we need to maintain renal perfusion?
60-65
if BUN is high but creatinine is normal...
good sign, we can correct fluids quickly
Intra-Renal AKI
the renal parenchyma or nephron is damaged
What is the most common cause of intra-renal AKI?
acute tubular necrosis
How many causes of ATN are caused by nephrotoxic agents?
12%
Nephrotoxic Agents
aminoglycosides- tobramycin, gentamycin
radiocontrast dyes
heavy metals- lead, mercury
solvents & chemicals
NSAIDs & ACE inhibitors
What do NSAIDs & ACEs do to the kidney?
interfere with normal auto-regulatory mechanisms, can cause ischemia
Pre-Renal AKI can cause...
Correct Answers
Normal BUN
`8-20
Normal Creatinine
0.6-1.2
Once they have flu like symptoms...
they are even more uremic
Renal Failure
occurs when kidneys cannot remove wastes or perform regulatory functions can be acute or
chronic, systemic disease
What does renal failure result in?
azotemia, metabolic disturbances
Acute on Chronic
have CKD but having acute exacerbation
Acute Kidney Injury
typically reversible, 5-7% of hospitalized clients, 20% of critically ill clients, mortality rate of 40-
60% clients, 5-20% may develop chronic renal failure
Goal of Treatment for AKI
identify and treat cause quickly
Patho of AKI
idiopathic
,Clinical Manifestations of AKI
azotemia, acidemia, fluid excess, altered calcium and phosphate balance, loss of BP regulation,
anemia
Azotemia
increased creatinine, increased BUN, increased wastes
Acidemia
metabolic acidosis- increased RR, SOB, kussmaul's respirations
Loss of BP regulation
related to RAS
Anemia
impact RBC production, decreased H&H, need to watch oxygen saturation
Oliguria
less than 500 mL/day
Anuria
absence of urine
Pre-Renal AKI
azotemia resulting from poor perfusion, 60% of ARF cases, decreased blood supply to kidneys,
decreased GFR & UOP
Causes of Pre-Renal AKI
dehydration, blood loss, GI loss, decreased CO, states of vasodilation, medications
Decreased CO
related to HF, arrhythmias, MI
, States of Vasodilation
sepsis, anaphylaxis
Medications
nitroglycerin, hydralazine
What MAP must we need to maintain renal perfusion?
60-65
if BUN is high but creatinine is normal...
good sign, we can correct fluids quickly
Intra-Renal AKI
the renal parenchyma or nephron is damaged
What is the most common cause of intra-renal AKI?
acute tubular necrosis
How many causes of ATN are caused by nephrotoxic agents?
12%
Nephrotoxic Agents
aminoglycosides- tobramycin, gentamycin
radiocontrast dyes
heavy metals- lead, mercury
solvents & chemicals
NSAIDs & ACE inhibitors
What do NSAIDs & ACEs do to the kidney?
interfere with normal auto-regulatory mechanisms, can cause ischemia
Pre-Renal AKI can cause...
