NURSADN8: Lecture For Exam #2 – Questions/Answers
What is the *most accurate indicator* of fluid loss or gain in an acutely ill
patient? Right Ans - Weight (Daily)
Daily weights should be taken at what time of day? Right Ans - Early
mornings
If using a bed scale to weigh a patient, it is important for the nurse to ensure
what? Right Ans - There are no presence of extra blankets/pillows/items
that were not on there previously when taking the weight measurements
The *two* leading causes of ESRD (End stage renal disease) are: Right Ans -
Diabetes and Hypertension
What is GFR? Right Ans - Glomerular Filtration Rate
Normal GFR: Right Ans - 125 mL/min (Above 60)
GFR in Kidney *Disease*: Right Ans - 15-60 mL/min
GFR in Kidney *Failure*: Right Ans - <15 ml/min
*Lab Tests:* Blood Urea Nitrogen (BUN) Right Ans - Measurement of urea
levels in blood indicates hydration and renal status. High levels indicate
dehydration, low levels indicate overhydration; *Range:* 10-20 mg/dL
*Lab Tests:* Creatinine Right Ans - Nitrogenous waste excreted in the urine
by the kidneys; *Range:* 0.6-1.2
*CKD Stages:*
Stage 1 kidney disease Right Ans - Kidney damage with normal GFR >90
with persistent albuminuria
*CKD Stages:*
Stage 2 Kidney Disease Right Ans - Kidney damage with mild decrease in
GFR 60-89
,*CKD Stages:*
Stage 3 Kidney Disease Right Ans - Kidney damage with excessive decrease
in GFR 30-59
*CKD Stages:*
Stage 4 Kidney Disease Right Ans - Kidney damage with severe decrease in
GFR 15-29
*CKD Stages:*
Stage 5 Kidney Disease Right Ans - Kidney damage with highly severe
decrease in GFR <15 (or dialysis) - Considered kidney *Failure*
In CKD, one might experience a decrease in what blood cell? Right Ans -
Red blood cell; Inadequate erythropoietin production
Why will electrolyte levels increase in those with CKD? Right Ans - The
body is unable to filter them out properly via the kidneys
How can a nurse appropriately *manage* a case of CKD? Right Ans - Treat
underlying cause, perform regular clinical/lab assessments, keep BP below
130/80 (decrease salt), control cardiovascular risk factors and blood sugar
About 35% of ESRD patients are 65+ years old. What are the most common
diseases leading *renal failure* in the *older adult*? Right Ans - Primarily
hypertension, then diabetes
What is nephrosclerosis? Right Ans - Hardening of the small blood vessels
in the kidney (due to HTN and Diabetes); The decreased blood flow results in
ischemia and necrosis of parts of the kidney
Treatment of *nephrosclerosis* is aimed at achieving what? Right Ans -
Dialysis and decreasing BP
What results in *renal failure* Right Ans - The kidneys cannot remove
wastes or perform regulatory functions; Can occur from many various causes
, *True or False?*
Acute Kidney Injury (AKI) is an irreversible syndrome that results in
decreased GFR and oliguria Right Ans - False; Acute Kidney Injury (AKI) is
an *reversible* syndrome that results in decreased GFR and oliguria while
*chronic renal failure* is a progressive (ESRD), irreversible deterioration of
renal function that results in azotemia
PreRenal AKI Right Ans - Cause is "before" Glomerular Apparatus; MOST
COMMON AKI caused by *reduced renal artery blood flow to the kidney* from
dehydration, hypovolemia, Schock and cardiac insufficiency.
IntraRenal AKI Right Ans - Direct parenchymal damage to the glomeruli or
kidney tubules by inflammation, trauma, toxins, drugs, infection, or reduced
blood supply; May occur from antibiotics and contrast dyes
PostRenal AKI Right Ans - Sudden obstruction of urine flow due to
enlarged prostate (BPH), kidney stones, bladder tumor, or injury
What are the four phases of acute kidney injury? Right Ans - Initiation
Oliguria
Diuresis
Recovery
*Phases of AKI:*
Initiation Right Ans - Begins with the initial insult and ends when oliguria
develops
*Phases of AKI:*
Oliguria Right Ans - Begins with kidney insult; Increase in serum
concentration of substances usually excreted (urea, Creatinine, urice acid, K+
and Mg) for 3 weeks
*Phases of AKI:*
What is the *most accurate indicator* of fluid loss or gain in an acutely ill
patient? Right Ans - Weight (Daily)
Daily weights should be taken at what time of day? Right Ans - Early
mornings
If using a bed scale to weigh a patient, it is important for the nurse to ensure
what? Right Ans - There are no presence of extra blankets/pillows/items
that were not on there previously when taking the weight measurements
The *two* leading causes of ESRD (End stage renal disease) are: Right Ans -
Diabetes and Hypertension
What is GFR? Right Ans - Glomerular Filtration Rate
Normal GFR: Right Ans - 125 mL/min (Above 60)
GFR in Kidney *Disease*: Right Ans - 15-60 mL/min
GFR in Kidney *Failure*: Right Ans - <15 ml/min
*Lab Tests:* Blood Urea Nitrogen (BUN) Right Ans - Measurement of urea
levels in blood indicates hydration and renal status. High levels indicate
dehydration, low levels indicate overhydration; *Range:* 10-20 mg/dL
*Lab Tests:* Creatinine Right Ans - Nitrogenous waste excreted in the urine
by the kidneys; *Range:* 0.6-1.2
*CKD Stages:*
Stage 1 kidney disease Right Ans - Kidney damage with normal GFR >90
with persistent albuminuria
*CKD Stages:*
Stage 2 Kidney Disease Right Ans - Kidney damage with mild decrease in
GFR 60-89
,*CKD Stages:*
Stage 3 Kidney Disease Right Ans - Kidney damage with excessive decrease
in GFR 30-59
*CKD Stages:*
Stage 4 Kidney Disease Right Ans - Kidney damage with severe decrease in
GFR 15-29
*CKD Stages:*
Stage 5 Kidney Disease Right Ans - Kidney damage with highly severe
decrease in GFR <15 (or dialysis) - Considered kidney *Failure*
In CKD, one might experience a decrease in what blood cell? Right Ans -
Red blood cell; Inadequate erythropoietin production
Why will electrolyte levels increase in those with CKD? Right Ans - The
body is unable to filter them out properly via the kidneys
How can a nurse appropriately *manage* a case of CKD? Right Ans - Treat
underlying cause, perform regular clinical/lab assessments, keep BP below
130/80 (decrease salt), control cardiovascular risk factors and blood sugar
About 35% of ESRD patients are 65+ years old. What are the most common
diseases leading *renal failure* in the *older adult*? Right Ans - Primarily
hypertension, then diabetes
What is nephrosclerosis? Right Ans - Hardening of the small blood vessels
in the kidney (due to HTN and Diabetes); The decreased blood flow results in
ischemia and necrosis of parts of the kidney
Treatment of *nephrosclerosis* is aimed at achieving what? Right Ans -
Dialysis and decreasing BP
What results in *renal failure* Right Ans - The kidneys cannot remove
wastes or perform regulatory functions; Can occur from many various causes
, *True or False?*
Acute Kidney Injury (AKI) is an irreversible syndrome that results in
decreased GFR and oliguria Right Ans - False; Acute Kidney Injury (AKI) is
an *reversible* syndrome that results in decreased GFR and oliguria while
*chronic renal failure* is a progressive (ESRD), irreversible deterioration of
renal function that results in azotemia
PreRenal AKI Right Ans - Cause is "before" Glomerular Apparatus; MOST
COMMON AKI caused by *reduced renal artery blood flow to the kidney* from
dehydration, hypovolemia, Schock and cardiac insufficiency.
IntraRenal AKI Right Ans - Direct parenchymal damage to the glomeruli or
kidney tubules by inflammation, trauma, toxins, drugs, infection, or reduced
blood supply; May occur from antibiotics and contrast dyes
PostRenal AKI Right Ans - Sudden obstruction of urine flow due to
enlarged prostate (BPH), kidney stones, bladder tumor, or injury
What are the four phases of acute kidney injury? Right Ans - Initiation
Oliguria
Diuresis
Recovery
*Phases of AKI:*
Initiation Right Ans - Begins with the initial insult and ends when oliguria
develops
*Phases of AKI:*
Oliguria Right Ans - Begins with kidney insult; Increase in serum
concentration of substances usually excreted (urea, Creatinine, urice acid, K+
and Mg) for 3 weeks
*Phases of AKI:*
