Chapter 15: Acute Kidney Injury

MULTIPLE CHOICE 1. With sudden cessation of renal function, all body systems are affected by the inability to maintain fluid and electrolyte balance and eliminate metabolic waste. In critically ill patients, renal dysfunction: a. is a very rare problem. b. affects nearly two thirds of patients. c. has a low mortality once renal replacement therapy has been initiated. d. has little effect on morbidity, mortality, or quality of life. ANS: B The kidney is the primary regulator of the body’s internal environment. With sudden cessation of renal function, all body systems are affected by the inability to maintain fluid and electrolyte balance and eliminate metabolic waste. Renal dysfunction is a common problem in critically ill patients with nearly two thirds of patients experiencing some degree of renal dysfunction. The most severe cases requiringrenal replacement therapy have a reported mortality of 50% to 60%. Acute kidney injury that progresses to chronic renal failure is associated with increased morbidity, mortality and reduced quality of life. DIF: Cognitive Level: Comprehension REF: p. 432 OBJ: Review the anatomy and physiology of the renal system. TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity 2. The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient’s urinalysis results. The nurse should become concerned when a. creatinine levels in the urine are similar to blood levels of creatinine. b. sodium and chloride are found in the urine. c. urine uric acid levels have the same values as serum levels. d. red blood cells and albumin are found in the urine. ANS: D Normal glomerular filtrate is basically protein free and contains electrolytes, including sodium, chloride, and phosphate, and nitrogenous waste products, such as creatinine, urea, and uric acid, in amounts similar to those in plasma. Red blood cells, albumin, and globulin are too large to pass through the healthy glomerular membrane. Their presence in urine may indicate glomerular damage. DIF: Cognitive Level: Comprehension REF: p. 433 OBJ: Review the anatomy and physiology of the renal system. TOP: Nursing Process Step: Assessment MSC: NCLEX: Physiological Integrity