NR507/ NR 507 Final Exam (Latest 2025/ 2026 Update) Advanced Pathophysiology Study Guide with complete solutions| 100% Correct |Grade A – Chamberlain.

NR507/ NR 507 Final Exam (Latest 2025/ i,- i,- i,- i,- i,- i,- i,-




2026 Update) Advanced Pathophysiology i,- i,- i,- i,-




Study Guide with complete solutions| 100% i,- i,- i,- i,- i,- i,-




Correct |Grade A – Chamberlain. i,- i,- i,- i,-




Chronic Renal Failure Chronic Kidney Disease (CKD) is a
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progressive loss of renal function associated with systemic
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disease such as hypertension, diabetes mellitus (most significant
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risk factor), systemic lupus erythematosus or intrinsic kidney
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disease
CKD stage is determined by estimates of GFR and albuminuria
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Who is a candidate for dialysis?
i,- i,- End-stage renal disease
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(ESRD) is the final stage of CKD with the number one cause being
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diabetes mellitus combined with hypertension. At this point, the
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patient is completely dependent on dialysis to survive.
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CKD is classified into five stages and is based on the patient's GFR
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rather than symptoms.
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Patients will need dialysis when the following symptoms are
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present:
--Metabolic acidosis. i,-

,--Hyperkalemia: Hyperkalemia in the presence of EKG changes i,- i,- i,- i,- i,- i,- i,- i,-



(peaked T-waves) is an indication for dialysis. --Hyperkalemia by
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itself is not an indication for dialysis.
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--Drug toxicity: Drug toxicity due to the following drugs is an
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indication for dialysis and include salicylates, Lithium,
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Isopropanol, Methanol and Ethylene glycol). i,- i,- i,- i,-




--Fluid volume overload that is not responsive to diuretics.
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--Uremic symptoms due to nitrogenous wastes in the blood
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stream.


Stage I CKD
i,- i,- i,-i,- i,- There is kidney damage with normal or elevated
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GFR
90-120


Stage II CKD
i,- i,- i,-i,- i,- There is kidney damage with mild decrease in
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GFR
60-89


Stage III CKD
i,- i,- i,-i,- i,- There is a moderate decrease in GFR
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30-59


Stage IV CKD
i,- i,- i,-i,- i,- There is a severe decrease in GFR
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15-29

,Stage V CKD i,- i,- i,-i,- i,- Kidney failure- End-stage renal disease
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<15 (dialysis) Once Stage IV is reached, progression to Stage V is
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inevitable as well as dialysis or kidney transplant
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Acute renal failure
i,- i,- i,-i,- i,- Reversible
Determining prognosis- kidneys respond to diuretic with good
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output; this indicates that kidneys are functioning well
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Acute Pyelonephritis
i,- Diagnosing by clinical symptoms alone i,-i,- i,- i,- i,- i,- i,- i,-



can be difficult; can be similar to cystitis
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Diagnosis established by: i,- i,-




-Urine culture i,-




-Urinalysis (WBC casts indicates pyelonephritis, but may not
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always be present) i,- i,-




-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary i,- i,- i,- i,- i,- i,- i,-



tract imaging
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Renal Calculi (Renal Stones)
i,- i,- i,- i,-i,- i,- Goals of Treatment:i,- i,-




Manage acute pain i,- i,-

, Promote passage of stone i,- i,- i,-




Reduce size of stone i,- i,- i,-




Prevent new stone formation
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Complications of Decreased GFR i,- i,- i,- i,-i,- i,- Anemia
Hypertension
Decreased calcium absorption i,- i,-




Hyperlipidemia
Heart failure i,-




Left ventricular hypertrophy
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Fluid volume overload
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Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metabolic acidosis i,-




Malnutrition (late complication) i,- i,-




GERD i,-i,- i,- Warning signs include: Symptoms over age of 50:
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-Dysphagia (difficulty swallowing) i,- i,-




-Odynophagia (pain on swallowing) i,- i,- i,-




-Nausea and vomiting i,- i,-