NR 545 Final Exam Study Guide latest 2021

NR 545 Final
Exam Study
Guide

, NR 545 Final exam Study Guide
The final exam includes content from weeks 1-8. The deadline for this exam is Saturday evening at 11:50 pm. Week 8 closes on Saturday not Sunday.

Week 7 : renal and urological disorders
• Questions can include pathophysiology, health assessment (normal and abnormal), and pharmacologic treatment
• Review required readings, course lectures, case study and learning activity.
Fluid and electrolyte balance- processes in the kidney
 Hormones controls reabsorption of fluid and electrolytes
o Antidiuretic hormone
 From posterior pituitary; controls reabsorption of water by altering permeability of distal convoluted tubule and collecting duct
o Aldosterone
 Secreted by adrenal cortex; controls sodium reabsorption and water by exchanging Na ions for K or hydrogen ions in distal convoluted
tubule
o Atrial natriuretic hormone
 From heart; 3rd hormone controlling fluid balance by reducing Na and fluid reabsorption in kidneys
Renal circulation process
Laboratory testing- purpose and interpretation ; Age related urinary changes ; Conditions/diagnoses associated with urine color changes
Diagnostic test
 Urinalysis
o Constituents and characteristics of urine may vary w/ dietary intake, drugs, and care w/ which specimen is handled
o Urine is normally: clear, straw colored and has mild color
o Urine pH is 4.5-8.0
o Appearance
 Cloudy indicate presence of large amounts of protein, blood cells or bacteria and pus
 Dark color indicate hematuria (blood), excessive bilirubin content or highly concentrated urine
 Unpleasant or unusual odor indicate infection or result from certain dietary components or medications
o Abnormal constituents (present in significant quantities)
 Blood (hematuria)
 small (microscopic) amounts of blood indicates infection, inflammation, or tumors in urinary tract
 large numbers of RBC (gross hematuria) indicates increased glomerular permeability or hemorrhage in tract
 protein (proteinuria, albuminuria)
 indicates leakage of albumin or mixed plasma proteins into filtrate d/t inflammation and increased glomerular
permeability
 bacteria (bacteriuria) and pus (pyuria)
 indicates infection in urinary tract
 urinary casts (microscopic sized molds of tubules, consisting of one or more cells (bacteria, protein, and so on))
 indicates inflammation of kidney tubules
 specific gravity
 indicates ability of tubules to concentrate the urine
 very low specific gravity= dilute urine; related to renal failure
 glucose and ketones (ketoacids)
 found when DM is not well controlled
 blood test
o elevated serum urea (BUN and Cr)
 indicate failure to excrete nitrogen wastes d/t decreased GFR
 results from protein metabolism
o metabolic acidosis (decreased pH and Bicarb)
 indicate decreased GFR and failure of tubules to control acid-base balance
o anemia (low hgb)
 indicated decreased erythropoietin secretion and/or bone marrow depression d/t accumulated wastes
o electrolytes
 depend on related fluid balance
 retention of fluid= GFR is decreased and may result in dilution effect
o antibody level antistreptolysin O (ASO) or antistreptokinase (ASK)
 used for dx of post-streptococcal glomerulonephritis
o renin
 indicate cause of HTN
 other test
o culture and sensitivity on urine specimens
 used to identify the causative organism in urinary infection and select drug tx
o clearance test such as Cr or insulin clearance or radioisotopestudy
 used to assess GFR
o radiologic test such as radionuclide imagining, angiography, US, CT, MRI and IV pyelography(IVP)
 used to visualize structures and abnormalities in urinary system
o cystoscopy
 visualizes lower urinary tract and may be used in performing a biopsy or removing kidney stones