Maryville Nurs 611 Exam 4 Questions
and Answers (100% Correct Answers)
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Acute unilateral renal obstruction and hypertension are caused
by Ans: Renal stones
most common type of kidney stone Ans: Calcium oxalate
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Amount of cardiac output that kidneys expect to receive Ans:
20-25%
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Passage of kidney stones can be extremely painful and cause
referred pain to where? Ans: Umbilicus area
The kidney stones are often jagged, so what ends up
happening is that they get stuck in what? Ans: The ureters
When that kidney stone gets stuck in the ureter, what does it
obstruct? Ans: Urine flow
The kidneys will react due to obstruction, because they expect
their 20-25% of cardiac output. The kidneys do not know why
they are not getting their normal share of cardiac output but
they sense the decreased perfusion due to the obstruction, so
those kidneys activate what Ans: The RAAS system
With activation of that RAAS system from the kidneys, there is
angiotensin, which is a powerful peripheral constrictor. So,
what happens within those kidneys themselves is decreased
tissue perfusion so they activate the RAAS system which
contains the angiotensin with powerful constrictor properties,
so it constricts what? Ans: Arterioles
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When angiotensin constricts the arterioles, what happens as a
result? Ans: Hypertension, so basically HTN happens due to
urinary obstruction
Which population do we think mainly about when we think
about UTIs? Ans: The older populaiton
With older adults it may be harder to determine if they have a
UTI because clinically, the main manifestation that is often
seen with the elderly and a UTI is what? Ans: Confusion,
abdominal pain or discomfort, blood in urine.
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What can a UTI lead to very quickly, especially with the older
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population? Ans: sepsis
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Infection of one or both upper urinary tracts (ureter, renal
pelvis, kidney interstitium) is what? Ans: Pyelonephritis
most common risk factors for pyelonephritis Ans: Urinary
obstruction, and reflux of urine from the bladder.
most common culprit of pyelonephritis Ans: E. coli, proteus,
pseudomonas
Why do we think of E. coli, especially for women with
pyelonephritis? Ans: Because of proximity of the anus to the
urinary tract
On urinalysis what would you see with pyelonephritis Ans:
WBC casts, because they are only formed in the renal tubules
Urine should always go (----) and when there is an obstruction
urine goes (----) Ans: Forward, backward
, 3
When the urine flows backward from an obstruction, where
does it flow back into Ans: The renal pelvis
What is the renal pelvis? Ans: is the funnel-like dilated part of
the ureter in the kidney, The renal pelvis functions as a funnel
for urine flowing to the ureter.
When the urine flows backward from an obstruction into the
renal pelvis, what happens? Ans: it causes inflammation,
which is caused by bacteria
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A condition that includes non bacterial infectious cystitis and
noninfectious cystitis is called what? Ans: Painful bladder
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syndrome or interstitial cystitis
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Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics
Ans: UTI, but is non bacterial. Patients present with UTI and
are treated with multiple rounds of abx and do not improve is
the clue it is PBS/IC
Cause of PBS/IC Ans: Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Radiation