NUR 255 final study guide Exam 2026
Questions and Answers Graded A+
Acute renal failure - Correct answer--AKI
-Onset: sudden
-Common cause: acute tubular necrosis
-Dx criteria: Acute reduction in urine output and or elevation in serum creatinine
-Reversibility: potentially
-Primary cause of death: infection
-Most commonly, AKI follows severe, prolonged hypertension, hypovolemia, or
exposure to a nephrotoxic agent.
-There are increases in BUN, Creatinine and urine output can be less than 40cc/hr
but can be normal.
3 causes of AKI - Correct answer-Causes: 3 Types.
Pre-renal,
Intra-renal
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,Post-renal
Phases of Acute renal failure - Correct answer-1. The initiation period: initial when
oliguria develops, less than 400ml a day.
2. The oliguria period is an in ability to excrete fluids, regulate fluids, and excrete
metabolic wastes thus they increase.
3. Diuretic phase is when there is large amount of fluids and electrolytes are lost.
4. The last phase is recovery and this can last up to 12 months and most pts. are left
with some renal dysfunction. Lab values are normal for pt.
Manifestations of ARF - Correct answer--appears very ill and weak
-dehydration
-headache
-oliguria
-drowsiness
-tachycardia
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,-crackles
-irritability
-drowsiness
-dry skin
-n/v
Dx of ARF - Correct answer-*Labs
-UA: proteinuria, RBC's due to glomerular dysfunction, WBC's (inflammation).
-Serum creatinine and BUN increase rapidly and GFR declines
-Potassium increases
-anemia (reduced RBC's from decreased erythropoietin secretion)
-Metabolic acidosis occurs.
*Cat or MRI, ultrasound, biopsy may be used as well.
Treatment of ARF - Correct answer--Focus: Restore and maintain renal function.
-Medications, IV fluids, and blood volume expanders are used to restore perfusion
to the kidneys.
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, -Proteins are limited in the diet with increased carbohydrates to minimize
azotemia.
-Some cases, may need dialysis.
Meds for ARF - Correct answer--Dopamine- increase perfusion to the kidneys and
increased cardiac output, and dilates blood vessels of the kidneys.
-Furosemide and Mannitol: excrete toxins and help increase output.
-Antihypertensives: control b/p.
Nursing care for ARF - Correct answer--Good intake and output, daily weights
-VS
-Semi-Fowlers to help promote respiratory and cardiac function.
-Monitor electrolytes (esp. K as it is increased and Na as it may be decreased to
due fluid retention) and increased Phosphate.
-Fluid restriction.
-Administer medications with meals to decrease fluid intake
-good skin care.
-Good infection control as infection is the leading cause of death in AKI.
©COPYRIGHT 2025,ALL RIGHTS RESERVED 4
Questions and Answers Graded A+
Acute renal failure - Correct answer--AKI
-Onset: sudden
-Common cause: acute tubular necrosis
-Dx criteria: Acute reduction in urine output and or elevation in serum creatinine
-Reversibility: potentially
-Primary cause of death: infection
-Most commonly, AKI follows severe, prolonged hypertension, hypovolemia, or
exposure to a nephrotoxic agent.
-There are increases in BUN, Creatinine and urine output can be less than 40cc/hr
but can be normal.
3 causes of AKI - Correct answer-Causes: 3 Types.
Pre-renal,
Intra-renal
©COPYRIGHT 2025,ALL RIGHTS RESERVED 1
,Post-renal
Phases of Acute renal failure - Correct answer-1. The initiation period: initial when
oliguria develops, less than 400ml a day.
2. The oliguria period is an in ability to excrete fluids, regulate fluids, and excrete
metabolic wastes thus they increase.
3. Diuretic phase is when there is large amount of fluids and electrolytes are lost.
4. The last phase is recovery and this can last up to 12 months and most pts. are left
with some renal dysfunction. Lab values are normal for pt.
Manifestations of ARF - Correct answer--appears very ill and weak
-dehydration
-headache
-oliguria
-drowsiness
-tachycardia
©COPYRIGHT 2025,ALL RIGHTS RESERVED 2
,-crackles
-irritability
-drowsiness
-dry skin
-n/v
Dx of ARF - Correct answer-*Labs
-UA: proteinuria, RBC's due to glomerular dysfunction, WBC's (inflammation).
-Serum creatinine and BUN increase rapidly and GFR declines
-Potassium increases
-anemia (reduced RBC's from decreased erythropoietin secretion)
-Metabolic acidosis occurs.
*Cat or MRI, ultrasound, biopsy may be used as well.
Treatment of ARF - Correct answer--Focus: Restore and maintain renal function.
-Medications, IV fluids, and blood volume expanders are used to restore perfusion
to the kidneys.
©COPYRIGHT 2025,ALL RIGHTS RESERVED 3
, -Proteins are limited in the diet with increased carbohydrates to minimize
azotemia.
-Some cases, may need dialysis.
Meds for ARF - Correct answer--Dopamine- increase perfusion to the kidneys and
increased cardiac output, and dilates blood vessels of the kidneys.
-Furosemide and Mannitol: excrete toxins and help increase output.
-Antihypertensives: control b/p.
Nursing care for ARF - Correct answer--Good intake and output, daily weights
-VS
-Semi-Fowlers to help promote respiratory and cardiac function.
-Monitor electrolytes (esp. K as it is increased and Na as it may be decreased to
due fluid retention) and increased Phosphate.
-Fluid restriction.
-Administer medications with meals to decrease fluid intake
-good skin care.
-Good infection control as infection is the leading cause of death in AKI.
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