N3630: Management of Nephrological
& Urological Conditions Test
Questions Fully Solved.
renal HH - Answer - DM? HTN?
- neuromsk? (PD, MS)
- family hx of KD
- age (increased risk with higher age)
renal physical exam - Answer urinary, pain, GI, integument
urinary findings in renal ax - Answer - usually 1-2L in 24h
- anurea = no u/o
- oliguria = low u/o
- hematurea, proteinurea, polyurea
renal pain ax - Answer - costovertebral angle; radiates forward as it worsens
- don't always have pain
- can come & go
renal GI ax - Answer - NVD
- abd discomfort & distension
renal integument ax - Answer - azotemia: increase in nitrogenous products
- pruritus: excreting waste products thru sweat & skin leading to tissues
renal ax labs - Answer - serum Cr: good measure of acute injury (sensitive marker of KD)
- blood urea nitrogen (BUN)
- Cr clearance/estimated glomerular filtration rate (eGFR)
- Hgb: decreased erythropoietin (anemia)
renal medication ax (nephrotoxic) - Answer - NSAIDs: ibuprofen, naproxen
- loop diuretics: furosemide
- abx
, - contrast dyes & metformin
- chemo: Cisplatin
nursing role in taking eGFR - Answer - 24h urine collection & blood draw (nonsterile)
- keep on ice or in fridge
- draw blood @ end of specimen collection
- teach: void at beginning of test & discard 1st urine specimen, at the end ask pt to empty
bladder
- document start & end time
signs of kidney dysfxn - Answer - increased Cr/BUN
- decreased eGFR
- FVD/FVO
- high protein
- decreased renal perfusion
signs of end stage renal disease - Answer - increase/decrease in Na: water retention
(FVO/HTN) OR water loss (FVD/hypotn)
- increased K: cardiac arrhythmias (hyperkalemia & acidosis occur together)
- decreased Vit D (Ca) & increased Phos (bone problems)
- decreased HCO3
acute kidney injury (AKI) - Answer - sudden loss of renal fxn
- fluid, lyte & pH imbalances (metabolic acidosis)
classifications/causes of AKI - Answer - prerenal (hypoperfusion of kidneys)
- intrarenal (damage to kidney tissues)
- postrenal (obstruction of urine flow)
goal of treating AKI - Answer avoid death & minimize long term kidney dysfxn
phases of AKI - Answer - initiation: initial insult
- oliguria: increased Cr/BUN (pruritus), K (hyperkalemia)
- diuresis: normal u/o
- recovery: labs normalize (>3 months)
& Urological Conditions Test
Questions Fully Solved.
renal HH - Answer - DM? HTN?
- neuromsk? (PD, MS)
- family hx of KD
- age (increased risk with higher age)
renal physical exam - Answer urinary, pain, GI, integument
urinary findings in renal ax - Answer - usually 1-2L in 24h
- anurea = no u/o
- oliguria = low u/o
- hematurea, proteinurea, polyurea
renal pain ax - Answer - costovertebral angle; radiates forward as it worsens
- don't always have pain
- can come & go
renal GI ax - Answer - NVD
- abd discomfort & distension
renal integument ax - Answer - azotemia: increase in nitrogenous products
- pruritus: excreting waste products thru sweat & skin leading to tissues
renal ax labs - Answer - serum Cr: good measure of acute injury (sensitive marker of KD)
- blood urea nitrogen (BUN)
- Cr clearance/estimated glomerular filtration rate (eGFR)
- Hgb: decreased erythropoietin (anemia)
renal medication ax (nephrotoxic) - Answer - NSAIDs: ibuprofen, naproxen
- loop diuretics: furosemide
- abx
, - contrast dyes & metformin
- chemo: Cisplatin
nursing role in taking eGFR - Answer - 24h urine collection & blood draw (nonsterile)
- keep on ice or in fridge
- draw blood @ end of specimen collection
- teach: void at beginning of test & discard 1st urine specimen, at the end ask pt to empty
bladder
- document start & end time
signs of kidney dysfxn - Answer - increased Cr/BUN
- decreased eGFR
- FVD/FVO
- high protein
- decreased renal perfusion
signs of end stage renal disease - Answer - increase/decrease in Na: water retention
(FVO/HTN) OR water loss (FVD/hypotn)
- increased K: cardiac arrhythmias (hyperkalemia & acidosis occur together)
- decreased Vit D (Ca) & increased Phos (bone problems)
- decreased HCO3
acute kidney injury (AKI) - Answer - sudden loss of renal fxn
- fluid, lyte & pH imbalances (metabolic acidosis)
classifications/causes of AKI - Answer - prerenal (hypoperfusion of kidneys)
- intrarenal (damage to kidney tissues)
- postrenal (obstruction of urine flow)
goal of treating AKI - Answer avoid death & minimize long term kidney dysfxn
phases of AKI - Answer - initiation: initial insult
- oliguria: increased Cr/BUN (pruritus), K (hyperkalemia)
- diuresis: normal u/o
- recovery: labs normalize (>3 months)
