MSN 570 Advanced Pathophysiology
Final Exam Study Guide & Review – MSN
Program
Acute renal failure -CORRECTANSWER Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that
kidneys are functioning well
Acute Pyelonephritis -CORRECTANSWER Diagnosing by clinical symptoms alone can
be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones) -CORRECTANSWER Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
,Chronic Renal Failure -CORRECTANSWER Chronic Kidney Disease (CKD) is a
progressive loss of renal function associated with systemic disease such as
hypertension, diabetes mellitus (most significant risk factor), systemic lupus
erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis? -CORRECTANSWER End-stage renal disease (ESRD)
is the final stage of CKD with the number one cause being diabetes mellitus combined
with hypertension. At this point, the patient is completely dependent on dialysis to
survive.
CKD is classified into five stages and is based on the patient's GFR rather than
symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an
indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
, Stage I CKD -CORRECTANSWER There is kidney damage with normal or elevated
GFR
90-120
Stage II CKD -CORRECTANSWER There is kidney damage with mild decrease in GFR
60-89
Stage III CKD -CORRECTANSWER There is a moderate decrease in GFR
30-59
Stage IV CKD -CORRECTANSWER There is a severe decrease in GFR
15-29
Stage V CKD -CORRECTANSWER Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as
dialysis or kidney transplant
Complications of Decreased GFR -CORRECTANSWER Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Final Exam Study Guide & Review – MSN
Program
Acute renal failure -CORRECTANSWER Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that
kidneys are functioning well
Acute Pyelonephritis -CORRECTANSWER Diagnosing by clinical symptoms alone can
be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones) -CORRECTANSWER Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
,Chronic Renal Failure -CORRECTANSWER Chronic Kidney Disease (CKD) is a
progressive loss of renal function associated with systemic disease such as
hypertension, diabetes mellitus (most significant risk factor), systemic lupus
erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis? -CORRECTANSWER End-stage renal disease (ESRD)
is the final stage of CKD with the number one cause being diabetes mellitus combined
with hypertension. At this point, the patient is completely dependent on dialysis to
survive.
CKD is classified into five stages and is based on the patient's GFR rather than
symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an
indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
, Stage I CKD -CORRECTANSWER There is kidney damage with normal or elevated
GFR
90-120
Stage II CKD -CORRECTANSWER There is kidney damage with mild decrease in GFR
60-89
Stage III CKD -CORRECTANSWER There is a moderate decrease in GFR
30-59
Stage IV CKD -CORRECTANSWER There is a severe decrease in GFR
15-29
Stage V CKD -CORRECTANSWER Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as
dialysis or kidney transplant
Complications of Decreased GFR -CORRECTANSWER Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
