NR574 Exam 2024 Final NR 574 Actual
Exam Update Latest 2024 Questionsd and
Correct Answers Rated A+
1. Hepatorenal syndrome (HRS): functional form of renal failure that occurs pri-
marily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly progressive
renalimpairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a period less than 2
weeks
-without liver transplant prognosis is very poor
3. Type 2 hepatorenal syndrome is characterized by...: -moderate form of
renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL reduction in GFR with elevation in
serum creatinine
-associated with a more indolent course and improved survival compared to type
1
4. Risk Factors of hepatorenal syndrome: Dilutional hyponatremiaPrevious
episodes of ascites
Presence of esophageal varicesPoor nutritional status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5 milliequivalents/liter [mEq/L])
Large-volume paracentesis without albumin replacement
, Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome: Most clients
withHRS have a known diagnosis of acute or chronic liver disease and present
with nonspecific symptoms including:
-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome: HRS has no
char-acteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver disease including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
-bruits.
7. Dx criteria in hepatorenal syndrome: 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL within 48 hrs or >50% increase from baseline
within a7 day period
, 3. no response to a 2 consecutive day diuretic withdrawal and volume expansion
w/ albumin 1g/kg body wt
4. absence of shock
5. no nephrotoxic drug use
6. no macroscopic signs of structural kidney injury (proteinuria >500 mil-
ligrams/deciliter[(mg/dL], microhematuria with >50 red blood cells per high-power
field, and/or abnormal renal ultrasonography)
8. What is the Creatinine criteria when diagnosing hepatorenal syndrome:
in-crease in serum creatinine of
-greater than or equal to 0.3 mg/dLor
-greater than or equal to 50% increase from baseline Cr
this is within a 7 day period.
9. What surgical intervention is used to treat hepatorenal syndrome?: TIPS
Procedure
10. What is a TIPS procedure?: The TIPS procedure bypasses a portion of the
hepatic circulation by shunting blood flow from the portal vein to the hepatic vein
-This reduces portal pressure and minimizes back pressure on the splanchnic
organs. This also decreases the likelihood of bleeding from the esophageal varies
and reduces the amount of ascites
*Hemorrhage is a significant risk during TIPS
11. What is the treatment of choice for both type 1 and type 2 HRS?: Liver
transplant.
Exam Update Latest 2024 Questionsd and
Correct Answers Rated A+
1. Hepatorenal syndrome (HRS): functional form of renal failure that occurs pri-
marily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly progressive
renalimpairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a period less than 2
weeks
-without liver transplant prognosis is very poor
3. Type 2 hepatorenal syndrome is characterized by...: -moderate form of
renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL reduction in GFR with elevation in
serum creatinine
-associated with a more indolent course and improved survival compared to type
1
4. Risk Factors of hepatorenal syndrome: Dilutional hyponatremiaPrevious
episodes of ascites
Presence of esophageal varicesPoor nutritional status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5 milliequivalents/liter [mEq/L])
Large-volume paracentesis without albumin replacement
, Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome: Most clients
withHRS have a known diagnosis of acute or chronic liver disease and present
with nonspecific symptoms including:
-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome: HRS has no
char-acteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver disease including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
-bruits.
7. Dx criteria in hepatorenal syndrome: 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL within 48 hrs or >50% increase from baseline
within a7 day period
, 3. no response to a 2 consecutive day diuretic withdrawal and volume expansion
w/ albumin 1g/kg body wt
4. absence of shock
5. no nephrotoxic drug use
6. no macroscopic signs of structural kidney injury (proteinuria >500 mil-
ligrams/deciliter[(mg/dL], microhematuria with >50 red blood cells per high-power
field, and/or abnormal renal ultrasonography)
8. What is the Creatinine criteria when diagnosing hepatorenal syndrome:
in-crease in serum creatinine of
-greater than or equal to 0.3 mg/dLor
-greater than or equal to 50% increase from baseline Cr
this is within a 7 day period.
9. What surgical intervention is used to treat hepatorenal syndrome?: TIPS
Procedure
10. What is a TIPS procedure?: The TIPS procedure bypasses a portion of the
hepatic circulation by shunting blood flow from the portal vein to the hepatic vein
-This reduces portal pressure and minimizes back pressure on the splanchnic
organs. This also decreases the likelihood of bleeding from the esophageal varies
and reduces the amount of ascites
*Hemorrhage is a significant risk during TIPS
11. What is the treatment of choice for both type 1 and type 2 HRS?: Liver
transplant.
