NR507- Advanced Pathophysiology Final Exam

1. A ute renal failure: Reversible
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Determining prognosis- kidneys respond to diureti with good output; this indi ates t t



that kidneys are fun tioning well t



2. A ute Pyelonephritis: Diagnosing by lini al symptoms alone an be diffi ult; an
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be similar to ystitis t




Diagnosis established by:
-Urine ulture t



-Urinalysis (WB asts indi ates pyelonephritis, but may not always be present)
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-Signs/Symptoms
- ompli ated pyelonephritis requires blood ultures and urinary tra t imaging
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3. Renal al uli (Renal Stones): Goals of Treatment:
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Manage a ute pain Promote t



passage of stone Redu e t



size of stone
Prevent new stone formation
4. hroni Renal Failure: hroni Kidney Disease ( KD) is a progressive loss of
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renal fun tion asso iated with systemi disease su h as hypertension, diabetes
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mellitus (most signifi ant risk fa tor), systemi lupus erythematosus or intrinsi t t t t



kidney disease
TKD stage is determined by estimates of GFR and albuminuria
5. Who is a andidate for dialysis?: End-stage renal disease (ESRD) is the final
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stage of KD with the number one ause being diabetes mellitus ombined with
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hypertension. At this point, the patient is ompletely dependent on dialysis to survive. t



KD is lassified into five stages and is based on the patient's GFR rather than
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symptoms.

Patients will need dialysis when the following symptoms are present:
--Metaboli a idosis. t t



--Hyperkalemia: Hyperkalemia in the presen e of EKG hanges (peaked T-waves) is t t



an indi ation for dialysis. --Hyperkalemia by itself is not an indi ation for dialysis.
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--Drug toxi ity: Drug toxi ity due to the following drugs is an indi ation for dialysis and
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in lude sali ylates, Lithium, Isopropanol, Methanol and Ethylene gly ol).
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--Fluid volume overload that is not responsive to diureti s. t



--Uremi symptoms due to nitrogenous wastes in the blood stream.
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6. Stage I KD: There is kidney damage with normal or elevated GFR
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90-120
7. Stage II KD: There is kidney damage with mild de rease in GFR
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60-89

, 8. Stage III KD: There is a moderate de rease in GFR
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30-59
9. Stage IV KD: There is a severe de rease in GFR
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15-29
10. Stage V KD: Kidney failure- End-stage renal disease
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<15 (dialysis) On e Stage IV is rea hed, progression to Stage V is inevitable as well
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as dialysis or kidney transplant
11. ompli ations of De reased GFR: Anemia
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Hypertension
De reased al ium absorption Hyperlipidemia
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Heart failure
Left ventri ular hypertrophy
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Fluid volume overload
Hyperkalemia
Hyperparathyroidism
Hyperphosphatemia
Metaboli a idosis t t



Malnutrition (late ompli ation) t t



12. GERD: Warning signs in lude: Symptoms over age of 50: t



-Dysphagia (diffi ulty swallowing) t



-Odynophagia (pain on swallowing)
-Nausea and vomiting
-Weight loss
-Melena
-Early satiety (feeling full after eating very little food
13. Hiatal Hernia: Often asymptomati t




Generally, a wide variety of symptoms develop later in life and are asso iated with t



other GI disorders, primarily GERD

--Sliding hiatal hernia: treatment usually onservative. Individuals an diminish reflux t t



by eating small, frequent meals and avoiding the re umbent position after eating. t



Abdominal supports and tight lothing are avoided and weight ontrol re ommended fo t t t



obese individuals.
14. Duodenal Ul er: hara teristi manifestation = hroni intermittent pain in epi-
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gastri area t




Pain begins 30 minutes to 2 hours after eating when stoma h is empty t