NBSN 4102C Complex Exam 2 – Questions With
Correct Solutions
Add to calendar
Play your way to mastery with fun games
Match Blocks Charms NEW
Terms in this set (109)
Pre-renal failure Initial problem is above the kidney
Kidney is inadequately perfused resulting in kidney
tissue hypoxia and ischemic injury
Cause of pre-renal failure Hypovolemic shock
Vasodilation
Third spacing
Dehydration
Sepsis, DIC
CHF
Hypoxia of any origin
Pre-renal failure - at risk Post-surgical
Cardiac pathology
Trauma
Burns
Anaphylaxis
(ABOVE the kidney cause)
,S/S of pre-renal failure Oliguria < 400 ml/day
Anuria
Hypernatremia
Hyperkalemia
Hyperchloremia
Acidosis (low pH)
Increased nitrogenous wastes - azotemia
Increased BUN, increased creatinine
Management of pre-renal failure Not aimed at the kidney but at the underlying
cause. If the cause is corrected quickly, the renal
failure is corrected.
Best management is prevention → Fluids,
hydration, oxygenation
Intra-renal failure Problem within the kidney. Acute tubular necrosis.
Characterized by ischemic damage.
Causes of intra-renal failure Direct trauma to the kidney
Acute glomerulonephritis
Acute pyelonephritis
Hemoglobinuria
Myoglobinuria
Damage to other cells/tissues
Blood transfusion reactions
Nephrotoxins - chemicals, organic solvents,
pesticides
Venoms - copperhead and centipedes
Nephrotoxins - heavy metals, mercury, arsenic, lead
Nephrotoxins: Drugs
Nephrotoxic medications causing Aminoglycosides
intra-renal failure NSAIDs, acetaminophen
Antineoplastic agents
Vancomycin, neomycin
Cocaine
Lithium
Contrast media
Cyclosporine
, Contrast media Check creatinine before giving this because it shows
how well the kidney functions and how well the
kidneys can excrete this
S/S of intra-renal failure Oliguria < 400 ml/day
Anuria
Hypernatremia
Hyperkalemia
Hyperchloremia
Acidosis (low pH)
Increased nitrogenous wastes - azotemia
Increased BUN & Creatinine
Management of intra-renal failure Correct underlying problem (infections can be
problematic - cultures before antibiotics
Tubular membrane is intact
Patient survives imbalances
Post-renal failure Problem is obstruction either lower in the urinary
tract or elsewhere in the abdomen, external to the
renal/urinary system.
Management of renal failures Once the causative problem is removed or
corrected, the person must be supported while
renal function is diminished/absent
Tubular system in regenerating
- Adequate hydration
- Monitor fluid volume excess
- Diuretics (if not a kidney problem itself)
- Weigh daily
- Maintain accurate I&O
- Renal replacement therapy
Nursing Interventions for renal Monitor for potential causative agents
failures Medication administration and monitor effectiveness
Dietary restrictions
Strict I&O, weight
Supportive for patient and family
May need dialysis
Correct Solutions
Add to calendar
Play your way to mastery with fun games
Match Blocks Charms NEW
Terms in this set (109)
Pre-renal failure Initial problem is above the kidney
Kidney is inadequately perfused resulting in kidney
tissue hypoxia and ischemic injury
Cause of pre-renal failure Hypovolemic shock
Vasodilation
Third spacing
Dehydration
Sepsis, DIC
CHF
Hypoxia of any origin
Pre-renal failure - at risk Post-surgical
Cardiac pathology
Trauma
Burns
Anaphylaxis
(ABOVE the kidney cause)
,S/S of pre-renal failure Oliguria < 400 ml/day
Anuria
Hypernatremia
Hyperkalemia
Hyperchloremia
Acidosis (low pH)
Increased nitrogenous wastes - azotemia
Increased BUN, increased creatinine
Management of pre-renal failure Not aimed at the kidney but at the underlying
cause. If the cause is corrected quickly, the renal
failure is corrected.
Best management is prevention → Fluids,
hydration, oxygenation
Intra-renal failure Problem within the kidney. Acute tubular necrosis.
Characterized by ischemic damage.
Causes of intra-renal failure Direct trauma to the kidney
Acute glomerulonephritis
Acute pyelonephritis
Hemoglobinuria
Myoglobinuria
Damage to other cells/tissues
Blood transfusion reactions
Nephrotoxins - chemicals, organic solvents,
pesticides
Venoms - copperhead and centipedes
Nephrotoxins - heavy metals, mercury, arsenic, lead
Nephrotoxins: Drugs
Nephrotoxic medications causing Aminoglycosides
intra-renal failure NSAIDs, acetaminophen
Antineoplastic agents
Vancomycin, neomycin
Cocaine
Lithium
Contrast media
Cyclosporine
, Contrast media Check creatinine before giving this because it shows
how well the kidney functions and how well the
kidneys can excrete this
S/S of intra-renal failure Oliguria < 400 ml/day
Anuria
Hypernatremia
Hyperkalemia
Hyperchloremia
Acidosis (low pH)
Increased nitrogenous wastes - azotemia
Increased BUN & Creatinine
Management of intra-renal failure Correct underlying problem (infections can be
problematic - cultures before antibiotics
Tubular membrane is intact
Patient survives imbalances
Post-renal failure Problem is obstruction either lower in the urinary
tract or elsewhere in the abdomen, external to the
renal/urinary system.
Management of renal failures Once the causative problem is removed or
corrected, the person must be supported while
renal function is diminished/absent
Tubular system in regenerating
- Adequate hydration
- Monitor fluid volume excess
- Diuretics (if not a kidney problem itself)
- Weigh daily
- Maintain accurate I&O
- Renal replacement therapy
Nursing Interventions for renal Monitor for potential causative agents
failures Medication administration and monitor effectiveness
Dietary restrictions
Strict I&O, weight
Supportive for patient and family
May need dialysis
