NURS 5461 Final Quiz The University of Texas at Arlington | UPDATED
Questions with 100% Verified Answers
Question:
Renal issues that occur with normal aging
Answer:
Decreased GFR, decreased diluting capacity, decreased
concentration ability, decreased sodium conservation (volume
depletion) decreased sodium excreation (salt
sensitivity/HTN), decreased ammonium & bicarb production
(metabolic acidosis)
Question:
Most accurate indicator of renal function in older adults
Answer:
GFR - declines 8mls per decade starting at age 40
Question:
Small amounts of protein in urine
Answer:
Chronic nephrosclerosis from HTN
Question:
renal artery stenosis
Answer:
partial or complete blocking of one or both renal arteries -
THIS ACTIVATES THE RENIN ANGIOTENSION
ALDOSTERONE SYSTEM AND CAUSES SYSTEMIC
HYPERTENSION TO ATTEMPT TO PERFUSE THE
KIDNEY - if pt has a 30% increase in creatinine after starting
an ACE or ARB - think renal artery stenosis - risk factors
include smoking, HTN, hyperlipidemia, DM, aneurysms -
renal stenting isn't indicated except in extreme cases when
,you can't control BP or there is progressive kidney failure.
Question:
Most common cause of AKI
Answer:
Acute tubular necrosis (ATN) followed by prerenal azotemia
Question:
Acute Tubular Necrosis (ATN)
Answer:
Damage to the renal tubules due to presence of toxins in the
urine or to ischemia. Results in oliguria.
Question:
Prerenal azotemia
Answer:
Due to decreased blood flow to kidneys; common cause of
acute renal failure - increase bun and decreased renal flow -
treat with volume resuscitation
Question:
acute tubular necrosis diagnostic criteria
Answer:
DIAGNOSIS: URINE SEDIMENT WILL INCLUDE
TUBULAR EPITHELIAL CELLS & GRANULAR MUDDY
BROWN CASTS - in oliguria FENa >2% - TREATMENT IS
SUPPORTIVE CARE AND OFTEN TIMES REVERSIBLE
Question:
Acute interstitial nephritis
Answer:
Drug-induced hypersensitivity involving the interstitium and
tubules; results in acute renal failure (intrarenal azotemia) -
,most commone antibiotics to cause this are PENICILLINS,
CEPHLOSPORINS, AND FLUOROQUINOLONES
(floxacins)
Question:
multiple myeloma "myeloma kidney"
Answer:
malignant neoplasm of bone marrow. Proteins light & heavy
chains will deposit in parenchyma - pt will present with lower
back pain - seen AA women - will see sever proteinurea, low
anion gap, hypercalcemia, anemia, and bone pain - treat w
chemotherapy (melphalan and prednisone)
Question:
3 types of glomerular disease
Answer:
Acute nephritic syndrome Post infection glomerulonephritis
(step/staph) IgA nephropathy
Question:
Nephrotic syndrome
Answer:
URINATING >3.5G OF PROTEIN PER DAY! WITH
HYPOALBUMINEMIA, HLD, AND EDEMA - Can be from
primary glomerular disease, infection, malignancy, exposure
to allergen/medication, DM, or HTN.
◦ RENAL BIOPSY IS ESSENTIAL FOR EARLY
DIAGNOSIS
◦ THERAPY CONTROLL BP, USE RASS BLOCKERS,
SODIUM RESTICTION, STATINS, ANTICOAGULATION
WHEN ALBUMIN IS <2.8
, Question:
What do RAAS inhibitors do?
Answer:
Decrease proteinuria
Question:
Chronic Kidney Disease (CKD)
Answer:
progressive, irreversible loss of kidney function - RENAL
GLOMERULAR AND TUBULOINTERSTITIAL
FIBROSIS INCREASES WITH AGE LEADING TO CKD -
presents with a decompensation of the pts preexisting medical
problems. - HTN AND DM ARE HIGH RISK FACTORS
FOR CKD
Question:
RAAS (renin-angiotensin-aldosterone system)
Answer:
Renin is released by kidneys in response to decreased blood
volume; causes angiotensinogen to split & produce
angiotensin I; lungs convert angiotensin I to angiotensin II;
angiotensin II stimulates adrenal gland to release aldosterone
& causes an increase in peripheral vasoconstriction
Question:
Medications to avoid in CKD
Answer:
-NSAIDs- block the synthesis of the renal prostaglandins that
promote vasodilation, and this can worsen renal
hypoperfusion
-DEMEROL: Metabolized to normeperidine in the liver,
which kidneys excrete
-AMINOGLYCOSIDES, PENICILLIN, AND
Questions with 100% Verified Answers
Question:
Renal issues that occur with normal aging
Answer:
Decreased GFR, decreased diluting capacity, decreased
concentration ability, decreased sodium conservation (volume
depletion) decreased sodium excreation (salt
sensitivity/HTN), decreased ammonium & bicarb production
(metabolic acidosis)
Question:
Most accurate indicator of renal function in older adults
Answer:
GFR - declines 8mls per decade starting at age 40
Question:
Small amounts of protein in urine
Answer:
Chronic nephrosclerosis from HTN
Question:
renal artery stenosis
Answer:
partial or complete blocking of one or both renal arteries -
THIS ACTIVATES THE RENIN ANGIOTENSION
ALDOSTERONE SYSTEM AND CAUSES SYSTEMIC
HYPERTENSION TO ATTEMPT TO PERFUSE THE
KIDNEY - if pt has a 30% increase in creatinine after starting
an ACE or ARB - think renal artery stenosis - risk factors
include smoking, HTN, hyperlipidemia, DM, aneurysms -
renal stenting isn't indicated except in extreme cases when
,you can't control BP or there is progressive kidney failure.
Question:
Most common cause of AKI
Answer:
Acute tubular necrosis (ATN) followed by prerenal azotemia
Question:
Acute Tubular Necrosis (ATN)
Answer:
Damage to the renal tubules due to presence of toxins in the
urine or to ischemia. Results in oliguria.
Question:
Prerenal azotemia
Answer:
Due to decreased blood flow to kidneys; common cause of
acute renal failure - increase bun and decreased renal flow -
treat with volume resuscitation
Question:
acute tubular necrosis diagnostic criteria
Answer:
DIAGNOSIS: URINE SEDIMENT WILL INCLUDE
TUBULAR EPITHELIAL CELLS & GRANULAR MUDDY
BROWN CASTS - in oliguria FENa >2% - TREATMENT IS
SUPPORTIVE CARE AND OFTEN TIMES REVERSIBLE
Question:
Acute interstitial nephritis
Answer:
Drug-induced hypersensitivity involving the interstitium and
tubules; results in acute renal failure (intrarenal azotemia) -
,most commone antibiotics to cause this are PENICILLINS,
CEPHLOSPORINS, AND FLUOROQUINOLONES
(floxacins)
Question:
multiple myeloma "myeloma kidney"
Answer:
malignant neoplasm of bone marrow. Proteins light & heavy
chains will deposit in parenchyma - pt will present with lower
back pain - seen AA women - will see sever proteinurea, low
anion gap, hypercalcemia, anemia, and bone pain - treat w
chemotherapy (melphalan and prednisone)
Question:
3 types of glomerular disease
Answer:
Acute nephritic syndrome Post infection glomerulonephritis
(step/staph) IgA nephropathy
Question:
Nephrotic syndrome
Answer:
URINATING >3.5G OF PROTEIN PER DAY! WITH
HYPOALBUMINEMIA, HLD, AND EDEMA - Can be from
primary glomerular disease, infection, malignancy, exposure
to allergen/medication, DM, or HTN.
◦ RENAL BIOPSY IS ESSENTIAL FOR EARLY
DIAGNOSIS
◦ THERAPY CONTROLL BP, USE RASS BLOCKERS,
SODIUM RESTICTION, STATINS, ANTICOAGULATION
WHEN ALBUMIN IS <2.8
, Question:
What do RAAS inhibitors do?
Answer:
Decrease proteinuria
Question:
Chronic Kidney Disease (CKD)
Answer:
progressive, irreversible loss of kidney function - RENAL
GLOMERULAR AND TUBULOINTERSTITIAL
FIBROSIS INCREASES WITH AGE LEADING TO CKD -
presents with a decompensation of the pts preexisting medical
problems. - HTN AND DM ARE HIGH RISK FACTORS
FOR CKD
Question:
RAAS (renin-angiotensin-aldosterone system)
Answer:
Renin is released by kidneys in response to decreased blood
volume; causes angiotensinogen to split & produce
angiotensin I; lungs convert angiotensin I to angiotensin II;
angiotensin II stimulates adrenal gland to release aldosterone
& causes an increase in peripheral vasoconstriction
Question:
Medications to avoid in CKD
Answer:
-NSAIDs- block the synthesis of the renal prostaglandins that
promote vasodilation, and this can worsen renal
hypoperfusion
-DEMEROL: Metabolized to normeperidine in the liver,
which kidneys excrete
-AMINOGLYCOSIDES, PENICILLIN, AND
