NRNP 6550 Final 2023 COMPLETE QUESTIONS AND ANSWERS ALREADY PASSED

1. Stages of CKD: o Stages - 5 stages 80 - 120 ml/min § 1: Kidney damage (protein in the urine) and Normal GFR > 90 § 2: Mild decrease in GFR 60 - 89 § 3a: Mild-Mod. GFR 45 - 59 § 3b: Mod-severe GFR 30 - 44 § 4: Severe decrease GFR 15 - 29 § 5: ESRD GFR < 15, uremia, cardiovascular disease. 2. Prerenal renal failure: Characterized by diminished renal perfusion resulting from a decrease in blood supply to the kidneys: NO NEPHRON damage - Decreased blood supply; intravascular volume depletion, vasodilatory states - Increased tubular sodium and water reabsorption, causing: oliguria, decreased urine sodium, high urine osmolality, increased urine specific gravity caused by: Intravascular Volume depletion: absolute decrease in blood volume: - Hemorrhage - GI losses (diarrhea, vomiting, large amt of NGT aspirate or pancreatitis) - Urinary losses (e.g DI & use of diuretics) - Skin losses (e.g., third spacing, large surface area burns, or wounds. Vasodilatory States: relative decrease in blood volume: - Sepsis - Anaphylaxis - Drugs a. ACE inhibitors b. NSAIDs c. Diuretics Decreased CO relative decrease in blood volume - Severe systolic heart failure - MI - Cardiogenic shock Arterial occlusion/vasoconstriction states (e.g., catcholamines) Liver disease: advanced hepatic disease with cirrhosis that may cause relative hypovolemia d/t splanchnic pooling or hepatorenal syndrome d/t vasoconstriction in the kidneys