NUR 555 Advanced Pathophysiology Final Exam
Study Questions and Correct Answers
Acute renal failure
Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys
are functioning well
Acute Pyelonephritis
Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones)
Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
Chronic Renal Failure
,Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic
disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus
erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis?
End-stage renal disease (ESRD) is the final stage of CKD with the number one cause being
diabetes mellitus combined with hypertension. At this point, the patient is completely dependent
on dialysis to survive.
CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an
indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include
salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
Stage I CKD
There is kidney damage with normal or elevated GFR
90-120
Stage II CKD
, There is kidney damage with mild decrease in GFR
60-89
Stage III CKD
There is a moderate decrease in GFR
30-59
Stage IV CKD
There is a severe decrease in GFR
15-29
Stage V CKD
Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis
or kidney transplant
Complications of Decreased GFR
Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Fluid volume overload
Hyperkalemia
Study Questions and Correct Answers
Acute renal failure
Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that kidneys
are functioning well
Acute Pyelonephritis
Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones)
Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
Chronic Renal Failure
,Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with systemic
disease such as hypertension, diabetes mellitus (most significant risk factor), systemic lupus
erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis?
End-stage renal disease (ESRD) is the final stage of CKD with the number one cause being
diabetes mellitus combined with hypertension. At this point, the patient is completely dependent
on dialysis to survive.
CKD is classified into five stages and is based on the patient's GFR rather than symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an
indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and include
salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
Stage I CKD
There is kidney damage with normal or elevated GFR
90-120
Stage II CKD
, There is kidney damage with mild decrease in GFR
60-89
Stage III CKD
There is a moderate decrease in GFR
30-59
Stage IV CKD
There is a severe decrease in GFR
15-29
Stage V CKD
Kidney failure- End-stage renal disease
<15 (dialysis) Once Stage IV is reached, progression to Stage V is inevitable as well as dialysis
or kidney transplant
Complications of Decreased GFR
Anemia
Hypertension
Decreased calcium absorption
Hyperlipidemia
Heart failure
Left ventricular hypertrophy
Fluid volume overload
Hyperkalemia
