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NUR 337 MSU Exam 2 Practice Questions With 100% Correct Solutions.

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  • Course
  • NUR 337
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  • NUR 337

Renal Failure - Answer Results when the kidneys are unable to remove metabolic waste and perform their regulatory functions. Glomerular Filtration Rate (GFR) - Answer Amount of plasma filtered through the glomeruli per unit of time. Acute Kidney Injury (AKI) - Answer An abrupt or rap...

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  • September 6, 2024
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NUR 337 MSU Exam 2 Practice
Questions With 100% Correct Solutions.
Renal Failure - Answer Results when the kidneys are unable to remove metabolic waste and perform
their regulatory functions.



Glomerular Filtration Rate (GFR) - Answer Amount of plasma filtered through the glomeruli per unit of
time.



Acute Kidney Injury (AKI) - Answer An abrupt or rapid decline in renal filtration function manifested by
acute elevation in BUN and creatinine occurring in hours to day to weeks.

Occurs for less than 3 months.

AKI is usually reversible.



Normal BUN Levels - Answer 8-21 mg/dL



Normal Creatinine Levels - Answer 0.51-1.21 mg/dL



Pre-renal AKI - Answer Physiological state of diminished perfusion.



Conditions associated with pre-renal AKI: - Answer Severe dehydration

Excessive volume losses (GI, renal, cutaneous, hemorrhage)

Hypotension

Heart failure/myocardial infarction

Sepsis

Vascular occlusion



Intra-renal AKI - Answer Damage to the kidney or glomeruli.

,Conditions associated with intra-renal AKI: - Answer Acute tubular necrosis (diabetes) -most common

Infectious processes (glomerulonephritis, pyelonephritis)

Nephrotoxic agents (non-steroidal anti-inflammatory drugs, ACE inhibitors, radiographic media, amino-
glycosides)



Post-renal AKI - Answer Associated with obstruction of the urinary system.



Conditions associated with post-renal AKI: - Answer Urethral obstruction

Bladder obstruction

Neurogenic problem

Renal calculi

Tumors

Pregnancy



Acute Kidney Injury (AKI): Clinical Manifestations - Answer Lethargy, nausea/vomiting/diarrhea, dry
skin and mucous membranes, drowsiness, headache, muscle twitching, seizures, hyperkalemia, anemia,
rise in BUN levels, acidosis.



What are the 4 phases of AKI? - Answer Onset/initiation, oliguric, diuretic, and recovery



Acute Kidney Injury (AKI): Onset/Initiation Phase - Answer Marked by precipitating event (if something
happens to the kidneys).



Acute Kidney Injury (AKI): Oliguric Phase - Answer Characterized by decrease in urine output to 100-
400 ml/24 hours.



Acute Kidney Injury (AKI): Diuretic Phase - Answer Prompt onset marked by increase in urine output
over several days.

Diuresis (increased/expressive production of urine) can result in urine output of up to 10 L/day.



Acute Kidney Injury (AKI): Recovery Phase - Answer Slow return to normal levels of renal activity.

,May permanently reduce GFR by 1%-3%.



Acute Kidney Injury (AKI): Treatments - Answer Pre-renal failure:

- rapidly reversible

- correct primary hemodynamic abnormality

Intra-renal failure:

- elimination of causative toxin, infection, or other cause

- prevention

Post-renal failure:

- relief of obstruction

- if tumor, surgery

- if stone, lithotripsy



Acute Kidney Injury (AKI): Collaborative Interventions - Answer Drug therapy

- modified dosages (decrease metabolite stress on kidneys and compensate for decreased renal
metabolism)

- fluid balance (transfusions for pre-renal cases)

Diet therapy

- decrease Na+, K+, or foods with phosphorus

- high carbs and high calories

- initially low protein diet following diuretic phase switch to high protein and high calorie diet



Acute Kidney Injury (AKI): Management - Answer Avoid use of nephrotoxic meds

Maintain adequate hydration and nutrition

Minimize risk for infection

Correct fluids and electroyte imbalances

Skin care (prevent skin breakdown related to uremia, malnutrition, and immobility)



RIFLE (classification for AKI) - Answer R = risk for injury

, I = injury

F = failure

L = loss of function

E = end-stage kidney disease



Dialysis - Answer Complete separation of wastes from the blood when the kidneys fail.



What are the types of renal replacement therapies? - Answer Hemodialysis

Peritoneal dialysis or continuous ambulatory peritoneal dialysis (CAPD)

Continuous renal replacement therapy (CRRT)

Renal transplant



Hemodialysis (HD) - Answer A procedure where a dialysis machine and a special filter called an artificial
kidney, or a dialyzer, are used to clean the blood.

Blood pumped through dialyzer (filter) with dialysate (solution) on other side of the semipermeable
membrane.



Osmosis - Answer Movement of water across a semipermeable membrane from region of lower
concentration (blood) to region of higher concentration (dialysate).



Diffusion - Answer Movement of particles from an area of high concentration (blood) to an area of
lower concentration (dialysate).



Ultrafiltration - Answer Movement of particles by pressure.



What are the 3 access devices used for hemodialysis? - Answer Vascular access devices (short-term
use)

Arteriovenous fistula (long-term use)

Arteriovenous graft (long-term use with compromised vasculature)

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