NUR 243 Exam 2 Study Questions and
Correct Answers
What is uremic frost? ✅increase in uric acid crystals causes white scaly on skin and
causes pruritus.
-seen in pt with CRF-
-teach pt self care, apply cream, wash with oatmeal but do not take hot showers or
baths
SIGNS AND SYMPTOMS OF ACUTE REJECTION (happens in first week or month of
transplant) ✅-Similar signs to ARF...
-tenderness over site
- decrease in urine output (oliguria)
- fever
Chronic Rejection of Renal transplant ✅can happen years after transplant or even
months.. First symptoms are going to be the same as acute renal failure
Renal Calculi ✅"Kidney stones"
Usually result from increase in Calcium (calcium oxalate stones, too much oxalate in
urine is most common)
Uric Acid Stones :develop when the urine concentration of uric acid is too high.
Common with people with gout
Struvite Stones: "infection stones associated with utis caused by Urease-producing
bacteria that form cyrstals.
Risk factors for renal calculi? ✅-hyperparathyroidism,
-high calcium,
-gout (increase uric acid)
-patient who eats high oxalate diet (spinach, strawberries, coffee, chocolate, purines,)
Pain associated with Renal calculi? ✅-Colic pain from the flank
-Costovertebral pain
- urter stones = genital pain
Bladder stones= suprapubic pain
Diet for renal calculi ✅-avoid foods high in oxalate==spinach, strawberry, etc. As
previously mentioned.
-Sodium restricted==3 to 4 grams per day
-Protein restricted ==60 grams per day
, -Calcium= does not need to be completely restricted unless their lab work show
Hypercalcium, or if known history of calcium being the cause of their kidney stones.
- encourage fluids that are non caffeinated.
-no purines = cause uric acid crystals
What do we Assess for pt who has Renal calculi? ✅- assess urine
-asses for hematuria,
-assess color= dark color like cola
-assess for decreased urine output
-assess for pain
-assess for straining of urine (crystals)
Pt teaching for renal calculi: ✅-drink water, hydration
-drink non caffeinated
-teach patient how to strain urine
Age related changes in renal complex: ✅-Renal cortex will shrink or become smaller,
this has direct affect on blood pressure and RAAS(H20 and NA conversion) nephrons
also decrease.
-Renal arteries become artherosclorotic, meaning perfusion is impaired causing
prerental failure.
-urine osmolality decreases = hypoosmolarity
-GFR DECREASES
- aldosterone decreases
-decrease in renal tubule function =decrease of substances
Risk factors for age related changes in renal pt? ✅- increased risk for hyponatremia
-effetcs of medication may be altered
-1+ proteinuria may occur
-bladder will weaken, apacity decreases, delayed microturition reflex, difficulty in
complete emptying
- increase in urine retention, frequency, urgency, stress incontinence
Is urinary incontinence a normal part of aging? ✅No (even though it is more common
in elderly age and severity increases with age)
Nursing Management to prevent renal disease? ✅- encourage fluid intake
-encourage frequent urination
-Ph of urine increases with aging and many older adults have DM which leads to
glycosuria and increases risk for UTI
Pt teaching to prevent renal disease: ✅-increase fluid intake
-good hygeine
-Report changes in urine color, odor, clarity, or symptoms such as pain, burning,
frequency or urgency
Correct Answers
What is uremic frost? ✅increase in uric acid crystals causes white scaly on skin and
causes pruritus.
-seen in pt with CRF-
-teach pt self care, apply cream, wash with oatmeal but do not take hot showers or
baths
SIGNS AND SYMPTOMS OF ACUTE REJECTION (happens in first week or month of
transplant) ✅-Similar signs to ARF...
-tenderness over site
- decrease in urine output (oliguria)
- fever
Chronic Rejection of Renal transplant ✅can happen years after transplant or even
months.. First symptoms are going to be the same as acute renal failure
Renal Calculi ✅"Kidney stones"
Usually result from increase in Calcium (calcium oxalate stones, too much oxalate in
urine is most common)
Uric Acid Stones :develop when the urine concentration of uric acid is too high.
Common with people with gout
Struvite Stones: "infection stones associated with utis caused by Urease-producing
bacteria that form cyrstals.
Risk factors for renal calculi? ✅-hyperparathyroidism,
-high calcium,
-gout (increase uric acid)
-patient who eats high oxalate diet (spinach, strawberries, coffee, chocolate, purines,)
Pain associated with Renal calculi? ✅-Colic pain from the flank
-Costovertebral pain
- urter stones = genital pain
Bladder stones= suprapubic pain
Diet for renal calculi ✅-avoid foods high in oxalate==spinach, strawberry, etc. As
previously mentioned.
-Sodium restricted==3 to 4 grams per day
-Protein restricted ==60 grams per day
, -Calcium= does not need to be completely restricted unless their lab work show
Hypercalcium, or if known history of calcium being the cause of their kidney stones.
- encourage fluids that are non caffeinated.
-no purines = cause uric acid crystals
What do we Assess for pt who has Renal calculi? ✅- assess urine
-asses for hematuria,
-assess color= dark color like cola
-assess for decreased urine output
-assess for pain
-assess for straining of urine (crystals)
Pt teaching for renal calculi: ✅-drink water, hydration
-drink non caffeinated
-teach patient how to strain urine
Age related changes in renal complex: ✅-Renal cortex will shrink or become smaller,
this has direct affect on blood pressure and RAAS(H20 and NA conversion) nephrons
also decrease.
-Renal arteries become artherosclorotic, meaning perfusion is impaired causing
prerental failure.
-urine osmolality decreases = hypoosmolarity
-GFR DECREASES
- aldosterone decreases
-decrease in renal tubule function =decrease of substances
Risk factors for age related changes in renal pt? ✅- increased risk for hyponatremia
-effetcs of medication may be altered
-1+ proteinuria may occur
-bladder will weaken, apacity decreases, delayed microturition reflex, difficulty in
complete emptying
- increase in urine retention, frequency, urgency, stress incontinence
Is urinary incontinence a normal part of aging? ✅No (even though it is more common
in elderly age and severity increases with age)
Nursing Management to prevent renal disease? ✅- encourage fluid intake
-encourage frequent urination
-Ph of urine increases with aging and many older adults have DM which leads to
glycosuria and increases risk for UTI
Pt teaching to prevent renal disease: ✅-increase fluid intake
-good hygeine
-Report changes in urine color, odor, clarity, or symptoms such as pain, burning,
frequency or urgency
