NUR 213 Mod 2 Renal Failure Exam #1 Question with
verified answers
Normal GFR- √√-Approximately 125ml/min
Rate of Kidney Filtration- √√-Filters the entire blood volume every 40 minutes
Nonfiltration Kidney Functions- √√-Create erythropoietin
-Activate Vitamin D
-Secrete renin
Acute Renal Failure Overview- √√-(ARF/AKI)
-Rapid deterioration in kidneys' ability to regulate fluid and solutes
-Produces azotemia (nitrogenous wastes in blood)
ARF Prognosis- √√-Most pts have a full recovery
Postrenal ARF- √√-Least common
-Caused by an obstruction (such as a kidney stone)
-Treatment is to remove or bypass the obstruction
Percentage of CO that goes to kidneys- √√25%
Prerenal ARF- √√-Most common kind of ARF
-Caused by decreased renal perfusion
Clinical Manifestations of Prerenal ARF- √√-Decreased LOC
-Edematous
-Tenting of skin
-Cold and/or clammy
-Tachycardic
-Hypotensive
-Tachypneic
-Oliguric
Normal BUN- √√8-20
-Measures nitrogenous wastes in blood
, Normal Creatinine- √√0.6-1.2
-More direct/specific measure of kidney function
BUN:Creatinine Ratio Indicative of Prerenal ARF- √√>20
Potassium in Renal Failure- √√-Increased in most kinds of renal failure due to acidosis>cell
damage>lysis/release of K as well as impaired renal excretion
EKG Changes in Hyperkalemia- √√-ECG changes may begin as level exceeds 6 mEq/L (varies
by person)
-First, you see tall, peaked T waves
-Next, the QRS widens
-Then, P waves lost
-Then, ventricular fibrillation
Hyperkalemia Rx- √√-10U IV Insulin and an amp of D50 immediately
-Calcium gluconate for cardioprotective effects
-Sodium polystyrene sulfonate (kayexalate) is the definitive treatment
Normal Ca- √√9-10.5
Normal Phos- √√2.5-4
Ca/Phos in Renal Failure- √√-Renal failure increases Phos and decreases Ca
-Rx with phosphate binders, Ca and Vit D
Signs of Hypocalcemia- √√-Chvostek's: tapping cheek at masseter elicits ipsilateral twitching
-Trousseau's: inflating BP 20mmHg beyond systolic for 3 min elicits forearm twitching, wrist
and finger flexion
Treatment for Prerenal ARF- √√-Find/fix the Cx
-Fluid challenge 500mL/30 minutes, possibly repeated if no signs of fluid overload
-May require pressors to increase renal perfusion
Intrarenal ARF- √√-Due to damage to renal tissue
-Most commonly via ATN
verified answers
Normal GFR- √√-Approximately 125ml/min
Rate of Kidney Filtration- √√-Filters the entire blood volume every 40 minutes
Nonfiltration Kidney Functions- √√-Create erythropoietin
-Activate Vitamin D
-Secrete renin
Acute Renal Failure Overview- √√-(ARF/AKI)
-Rapid deterioration in kidneys' ability to regulate fluid and solutes
-Produces azotemia (nitrogenous wastes in blood)
ARF Prognosis- √√-Most pts have a full recovery
Postrenal ARF- √√-Least common
-Caused by an obstruction (such as a kidney stone)
-Treatment is to remove or bypass the obstruction
Percentage of CO that goes to kidneys- √√25%
Prerenal ARF- √√-Most common kind of ARF
-Caused by decreased renal perfusion
Clinical Manifestations of Prerenal ARF- √√-Decreased LOC
-Edematous
-Tenting of skin
-Cold and/or clammy
-Tachycardic
-Hypotensive
-Tachypneic
-Oliguric
Normal BUN- √√8-20
-Measures nitrogenous wastes in blood
, Normal Creatinine- √√0.6-1.2
-More direct/specific measure of kidney function
BUN:Creatinine Ratio Indicative of Prerenal ARF- √√>20
Potassium in Renal Failure- √√-Increased in most kinds of renal failure due to acidosis>cell
damage>lysis/release of K as well as impaired renal excretion
EKG Changes in Hyperkalemia- √√-ECG changes may begin as level exceeds 6 mEq/L (varies
by person)
-First, you see tall, peaked T waves
-Next, the QRS widens
-Then, P waves lost
-Then, ventricular fibrillation
Hyperkalemia Rx- √√-10U IV Insulin and an amp of D50 immediately
-Calcium gluconate for cardioprotective effects
-Sodium polystyrene sulfonate (kayexalate) is the definitive treatment
Normal Ca- √√9-10.5
Normal Phos- √√2.5-4
Ca/Phos in Renal Failure- √√-Renal failure increases Phos and decreases Ca
-Rx with phosphate binders, Ca and Vit D
Signs of Hypocalcemia- √√-Chvostek's: tapping cheek at masseter elicits ipsilateral twitching
-Trousseau's: inflating BP 20mmHg beyond systolic for 3 min elicits forearm twitching, wrist
and finger flexion
Treatment for Prerenal ARF- √√-Find/fix the Cx
-Fluid challenge 500mL/30 minutes, possibly repeated if no signs of fluid overload
-May require pressors to increase renal perfusion
Intrarenal ARF- √√-Due to damage to renal tissue
-Most commonly via ATN
