NUR 400 FINAL EXAM- NEW STUFF PART 1 UPDATED
QUESTIONS AND CORRECT ANSWERS
Question:
1. what is acute kidney injury?
Answer:
rapid reduction in kidney function resulting in failure to maintain waste elimination, fluid and
electrolyte balance, and acid-base balance
Question:
2. how is AKI defined?
Answer:
increase in creatinine by 0.3 or more within 48 hours, or an increase creatinine to 1.5 times or more
from baseline
Question:
3. what is urine output like in AKI?
Answer:
less than 0.5 mL/kg/hr for 6 hours
Question:
4. what lab value is most used to determine AKI and why is it some-times not good to so-ley use?
Answer:
creatinine is most commonly used but is not ideal because it takes time for the creatinine to increase
which can cause delay in treatment
Question:
5. what other labs can be used to determine AKI earlier than Cr?
Answer:
biomarkers; tissue injury metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein
(IGFBP-7)
Question:
6. is GFR accurate during aki or chronic kidney disease?
Answer:
no because it is effected by metabolic problems and treatments during critical illnesses and also
effected by diuretics and IV fluids
Question:
7. how is the length of oliguria and anuria re-lated to recovery of kidney function in AKI?
Answer:
the longer the duration of oliguria or anuria, the less likely the patient is to return to baseline kidney
function
Question:
8. what are the 3 causes of AKI?
, Answer:
reduced perfusion (prerenal), damage to the tissue (intrarenal) and ob-struction of the urine outflow
(postrenal)
Question:
9. what are risk factors for AKI?
Answer:
shock, cardiac surgery, hypotension, prolonged mechanical ventilation, and sepsis
Question:
10. what are common causes of prerenal AKI?
Answer:
dehydration, burns, sepsis (remember this an outside source causing decreased perfusion)
Question:
11. what causes intrarenal AKI?
Answer:
allergic disorders, embolism or thrombosis of the renal vessels, and nephrotoxic agents (remember
this is something that is damaging the inside of the kidneys)
Question:
12. what causes postrenal AKI?
Answer:
tumors, kidney stones or strictures (remember this is anything that is going to block the flow of urine
from going out of the kidneys)
Question:
13. how do the kidneys compensate in prere-nal and postrenal AKI?
Answer:
constriction of the kidney blood vessels, activating the RAAS, releasing ADH (these are aimed at
increases blood volume and kidney perfusion)
Question:
14. what is bad about the compensating the kid-neys do in prerenal and postrenal AKI?
Answer:
it causes oliguria and azotemia
Question:
15. what is azotemia?
Answer:
the retention and build up of nitrogenous wastes in the blood
Question:
16. what are s/s of compli-cations due to AKI?
Answer:
nausea, vomiting, decrease peristalsis, ulcer formation, bleeding, throm-bosis, anemia, hiccups,
elevated parathyroid and low thyroid hormone
QUESTIONS AND CORRECT ANSWERS
Question:
1. what is acute kidney injury?
Answer:
rapid reduction in kidney function resulting in failure to maintain waste elimination, fluid and
electrolyte balance, and acid-base balance
Question:
2. how is AKI defined?
Answer:
increase in creatinine by 0.3 or more within 48 hours, or an increase creatinine to 1.5 times or more
from baseline
Question:
3. what is urine output like in AKI?
Answer:
less than 0.5 mL/kg/hr for 6 hours
Question:
4. what lab value is most used to determine AKI and why is it some-times not good to so-ley use?
Answer:
creatinine is most commonly used but is not ideal because it takes time for the creatinine to increase
which can cause delay in treatment
Question:
5. what other labs can be used to determine AKI earlier than Cr?
Answer:
biomarkers; tissue injury metalloproteinase 2 (TIMP-2) and insulin-like growth factor binding protein
(IGFBP-7)
Question:
6. is GFR accurate during aki or chronic kidney disease?
Answer:
no because it is effected by metabolic problems and treatments during critical illnesses and also
effected by diuretics and IV fluids
Question:
7. how is the length of oliguria and anuria re-lated to recovery of kidney function in AKI?
Answer:
the longer the duration of oliguria or anuria, the less likely the patient is to return to baseline kidney
function
Question:
8. what are the 3 causes of AKI?
, Answer:
reduced perfusion (prerenal), damage to the tissue (intrarenal) and ob-struction of the urine outflow
(postrenal)
Question:
9. what are risk factors for AKI?
Answer:
shock, cardiac surgery, hypotension, prolonged mechanical ventilation, and sepsis
Question:
10. what are common causes of prerenal AKI?
Answer:
dehydration, burns, sepsis (remember this an outside source causing decreased perfusion)
Question:
11. what causes intrarenal AKI?
Answer:
allergic disorders, embolism or thrombosis of the renal vessels, and nephrotoxic agents (remember
this is something that is damaging the inside of the kidneys)
Question:
12. what causes postrenal AKI?
Answer:
tumors, kidney stones or strictures (remember this is anything that is going to block the flow of urine
from going out of the kidneys)
Question:
13. how do the kidneys compensate in prere-nal and postrenal AKI?
Answer:
constriction of the kidney blood vessels, activating the RAAS, releasing ADH (these are aimed at
increases blood volume and kidney perfusion)
Question:
14. what is bad about the compensating the kid-neys do in prerenal and postrenal AKI?
Answer:
it causes oliguria and azotemia
Question:
15. what is azotemia?
Answer:
the retention and build up of nitrogenous wastes in the blood
Question:
16. what are s/s of compli-cations due to AKI?
Answer:
nausea, vomiting, decrease peristalsis, ulcer formation, bleeding, throm-bosis, anemia, hiccups,
elevated parathyroid and low thyroid hormone
