NR 507 PATHOPHYSIOLOGY FINAL EXAM
GUIDE QUESTIONS AND ANSWERS
Acute renal failure - correct answer- Reversible
Determining prognosis- kidneys respond to diuretic with good
output; this indicates that kidneys are functioning well
Acute Pyelonephritis - correct answer- 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) - correct answer- Goals of
Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
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Chronic Renal Failure - correct answer- 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? - correct answer- 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.
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--Uremic symptoms due to nitrogenous wastes in the blood
stream.
Stage I CKD - correct answer- There is kidney damage with
normal or elevated GFR
90-120
Stage II CKD - correct answer- There is kidney damage with
mild decrease in GFR
60-89
Stage III CKD - correct answer- There is a moderate decrease
in GFR
30-59
Stage IV CKD - correct answer- There is a severe decrease in
GFR
15-29
Stage V CKD - correct answer- Kidney failure- End-stage renal
disease