NURS 311 Final Exam
what is glomerular filtration determined by? - ANS filtration pressure in the glomeruli and permeable
surface area of the glomerular membrane
with glomerular filtration, what movement does hydrostatic pressure favor? - ANS favors filtration,
the push
with glomerular filtration, what movement does oncotic (colloid) pressure favor? - ANS opposes
filtration, the pull
what 3 factors affect glomerular filtration pressure? - ANS circulating blood volume, rate of blood
flow, myogenic autoregulation
what are the 3 classes of causes of glomerulonephritis? - ANS autoimmune diseases, infectious
diseases, non-immune glomerular injury
what are some examples of autoimmune diseases that cause glomerulonepritis? - ANS lupus (type III
sensitivity), goodpasture syndrome
what are some examples of infectious diseases that cause glomerulonephritis? - ANS strep throat,
bacteria, viral
what are some examples of a non-immune glomerular injury that causes glomerulonephritis? - ANS
ischemia, metabolic disorders, toxins, meds, vascular disorders
how does chronic kidney disease manifest? - ANS progressive and irrevocable loss of nephrons (75%
loss before clinical manifestations begin)
what are chronic kidney disease risk factors? - ANS chronic conditions, congenital conditions,
polycystic kidney disease, neoplasm, infection, chronic glomerulonephritis, recurrent kidney
infections
what complications are associated with chronic kidney disease? - ANS fluid and electrolyte balance,
production of active vit D impaired, alteration in protein/fat/carb metabolism, HTN, fluid overload
affecting lungs, inadequate erythropoietin = decreas. RBC
,what is end stage renal disease? - ANS aka chronic kidney failure, progressive deterioration of kidney
fxn resulting in renal dialysis and/or kidney transplant
what is the MOA of furosemide (lasix)? - ANS loop diuretic -- inhibits Na/K/Cl system in loop of henle
= decreased reabsorption, decreased passive reabsorption of water
what are the adverse effects of furosemide (lasix)? - ANS ototoxicity, SJS, hypotension, hypokalemia,
hyperglycemia, aplastic anemia
furosemide (lasix) is potassium.... - ANS wasting
- this is why it can cause hypokalemia!
- monitor regularly and possibly supplement K
- encourage pt to eat leafy greens, bananas, potatoes
what is the MOA of spironolactone (aldactone)? - ANS blocks action of aldosterone in distal tubule, K
retention
spironolactone (aldactone) is potassium... - ANS sparing
- can cause hyperkalemia
what are the adverse effects of spironolactone (aldactone)? - ANS dehydration + hypotension,
hyperkalemia, dysrhythmias, endocrine effects, SJS
with any diuretic, what is our main concern? - ANS hypotension, increased risk for falls
how do we treat ascites? - ANS IV albumin
where does serotonin antagonist ondansetron (zofran) act? what is its use? - ANS chemoreceptor
trigger zone
- antiemetic
, what is the most concerning adverse effect with ondansetron (zofran)? - ANS prolongation of the QT
interval
where does the dopamine antagonist promethazine act? what is its use? - ANS chemoreceptor
trigger zone
- antiemetic
where does the anticholingeric scopolamine act? what is its use? - ANS vomiting center
- antiemetic
where does the antihistamine diphenhydramine act? what is its use? - ANS vomiting center
- antiemetic
where do cannabinoids act? - ANS associated with vomiting center of the brain, pathway is not well
understood
what is gastritis? - ANS inflammation of the gastric mucosa and acid irritation
what cause chronic gastritis? what causes acute gastritis? - ANS H. pylori or C. diff
ETOH, NSAIDs, smoking, viral/bacterial toxin
what are the sx/sy of gastritis? how is it diagnosed? - ANS buring epigastric pain, N/V, anorexia
upper GI endoscopy, H.pylori testing
how is gastritis treated? - ANS correction of food habits, avoidance of risk factors, PPIs, H2 receptor
blockers, antacids
what complications are associated with gastritis? - ANS gastric ulcers, PUD
what is gastroenteritis? - ANS infection of the stomach and small intestine by infecting organisms
what is glomerular filtration determined by? - ANS filtration pressure in the glomeruli and permeable
surface area of the glomerular membrane
with glomerular filtration, what movement does hydrostatic pressure favor? - ANS favors filtration,
the push
with glomerular filtration, what movement does oncotic (colloid) pressure favor? - ANS opposes
filtration, the pull
what 3 factors affect glomerular filtration pressure? - ANS circulating blood volume, rate of blood
flow, myogenic autoregulation
what are the 3 classes of causes of glomerulonephritis? - ANS autoimmune diseases, infectious
diseases, non-immune glomerular injury
what are some examples of autoimmune diseases that cause glomerulonepritis? - ANS lupus (type III
sensitivity), goodpasture syndrome
what are some examples of infectious diseases that cause glomerulonephritis? - ANS strep throat,
bacteria, viral
what are some examples of a non-immune glomerular injury that causes glomerulonephritis? - ANS
ischemia, metabolic disorders, toxins, meds, vascular disorders
how does chronic kidney disease manifest? - ANS progressive and irrevocable loss of nephrons (75%
loss before clinical manifestations begin)
what are chronic kidney disease risk factors? - ANS chronic conditions, congenital conditions,
polycystic kidney disease, neoplasm, infection, chronic glomerulonephritis, recurrent kidney
infections
what complications are associated with chronic kidney disease? - ANS fluid and electrolyte balance,
production of active vit D impaired, alteration in protein/fat/carb metabolism, HTN, fluid overload
affecting lungs, inadequate erythropoietin = decreas. RBC
,what is end stage renal disease? - ANS aka chronic kidney failure, progressive deterioration of kidney
fxn resulting in renal dialysis and/or kidney transplant
what is the MOA of furosemide (lasix)? - ANS loop diuretic -- inhibits Na/K/Cl system in loop of henle
= decreased reabsorption, decreased passive reabsorption of water
what are the adverse effects of furosemide (lasix)? - ANS ototoxicity, SJS, hypotension, hypokalemia,
hyperglycemia, aplastic anemia
furosemide (lasix) is potassium.... - ANS wasting
- this is why it can cause hypokalemia!
- monitor regularly and possibly supplement K
- encourage pt to eat leafy greens, bananas, potatoes
what is the MOA of spironolactone (aldactone)? - ANS blocks action of aldosterone in distal tubule, K
retention
spironolactone (aldactone) is potassium... - ANS sparing
- can cause hyperkalemia
what are the adverse effects of spironolactone (aldactone)? - ANS dehydration + hypotension,
hyperkalemia, dysrhythmias, endocrine effects, SJS
with any diuretic, what is our main concern? - ANS hypotension, increased risk for falls
how do we treat ascites? - ANS IV albumin
where does serotonin antagonist ondansetron (zofran) act? what is its use? - ANS chemoreceptor
trigger zone
- antiemetic
, what is the most concerning adverse effect with ondansetron (zofran)? - ANS prolongation of the QT
interval
where does the dopamine antagonist promethazine act? what is its use? - ANS chemoreceptor
trigger zone
- antiemetic
where does the anticholingeric scopolamine act? what is its use? - ANS vomiting center
- antiemetic
where does the antihistamine diphenhydramine act? what is its use? - ANS vomiting center
- antiemetic
where do cannabinoids act? - ANS associated with vomiting center of the brain, pathway is not well
understood
what is gastritis? - ANS inflammation of the gastric mucosa and acid irritation
what cause chronic gastritis? what causes acute gastritis? - ANS H. pylori or C. diff
ETOH, NSAIDs, smoking, viral/bacterial toxin
what are the sx/sy of gastritis? how is it diagnosed? - ANS buring epigastric pain, N/V, anorexia
upper GI endoscopy, H.pylori testing
how is gastritis treated? - ANS correction of food habits, avoidance of risk factors, PPIs, H2 receptor
blockers, antacids
what complications are associated with gastritis? - ANS gastric ulcers, PUD
what is gastroenteritis? - ANS infection of the stomach and small intestine by infecting organisms
