Final Exam NR574 NR 574
1. Hepatorenal syndrome (HRS): functional form of renal failure that
occurs pri- marily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly progressive
renal impairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a period less
than 2 weeks
-without liver transplant prognosis is very poor
3. Type 2 hepatorenal syndrome is characterized by...: -moderate form of
renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL
reduction in GFR with elevation in serum
creatinine
-associated with a more indolent course and improved survival
,compared to type 1
4. Risk Factors of hepatorenal syndrome: Dilutional
hyponatremia Previous episodes of ascites
Presence of esophageal
varices Poor nutritional
status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5
milliequivalents/liter [mEq/L]) Large-volume paracentesis without
albumin replacement
Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome: Most clients
with HRS have a known diagnosis of acute or chronic liver disease and
present with nonspecific symptoms including:
,-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome: HRS has no
char- acteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver disease
including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
, -bruits.
1. Hepatorenal syndrome (HRS): functional form of renal failure that
occurs pri- marily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly progressive
renal impairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a period less
than 2 weeks
-without liver transplant prognosis is very poor
3. Type 2 hepatorenal syndrome is characterized by...: -moderate form of
renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL
reduction in GFR with elevation in serum
creatinine
-associated with a more indolent course and improved survival
,compared to type 1
4. Risk Factors of hepatorenal syndrome: Dilutional
hyponatremia Previous episodes of ascites
Presence of esophageal
varices Poor nutritional
status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5
milliequivalents/liter [mEq/L]) Large-volume paracentesis without
albumin replacement
Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome: Most clients
with HRS have a known diagnosis of acute or chronic liver disease and
present with nonspecific symptoms including:
,-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome: HRS has no
char- acteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver disease
including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
, -bruits.
