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NUR 213 ( LATEST 2024 / 2025 ) EXAM 5 | ACTUAL QUESTIONS AND ANSWERS 100% CORRECT
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NUR 213 ( LATEST 2024 / 2025 ) EXAM 5 | ACTUAL QUESTIONS AND ANSWERS 100% CORRECT
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NUR 213 EXAM 51. 6 functions of the kidneys
Answer
Filters waste called urea Regulates electrolytes Na, K, Ca, Mg, Phos
Balances H2O in the body (absorbs and excretes) Helps control Blood Pressure through rennin
Helps build red blood cells by producing erythropoetin
Helps build strong bones by producing active vitamin D
2. Acute Kidney Injury (AKI)
Answer
Rapid-onset disease of the kidneys resulting in a failure to produce urine
Reversible
Days to months to recover
3. ROOM 1 - Patient H.C.
52 year old male, medical history of HTN and DM, developed AKI s/p elective Heart Cath.
Answer
Risks
Prerenal- chronic conditions HTN, DM Causes
Intrarenal- Contrast dye
4. ROOM 2- Patient B.F.
75 yo female with recent N/V due to stomach virus, admitted to hospital 2 days ago due to
syncopal episode and fall. Today she was diagnosed with AKI. Cause
Answer
Prerenal- Dehydration
5. ROOM 3- Patient R.C.
30 yo male with history of GERD, kidney stones, admitted to hospital with AKI.Cause
Postrenal- Obstruction
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,6. 3 causes of AKI
Answer
prerenal- before kidneys
something has occured in the body before the kidneys become effected Intrarenal- inside the
kidneys
postrenal (obstruction)- after the kidneys urethra, bladder
7. Prerenal AKI
Answer
Cause is "before" MOST COMMON AKI Reduced renal artery blood flow
Lack of perfusion to the kidneys
Hypotension, Low CO, Hypo-perfusion, Cardiogenic Shock, Sepsis, Burns NSAIDS OTC-
Aspirin, Naproxen, Ibuprofen
8. NSAIDs
contrast dye
Aminoglycoside (antibiotics)
Answer
Meds to Avoid in Renal Injury/ Failure
9. Calcium gluconate Kayexalate
Insulin/d50
Answer
What can we give to reduce potassium levels?
10. Intrarenal AKI
Answer
Direct damage to the kidneys inflammation(Lupus)
nephrotoxic drugs(aminoglycosides) "mycin" contrast dye
infection (Glomerulonephritis) reduced blood supply(Hypertension)
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,Glomerulonephritis is most common infection
11. Postrenal AKI
Answer
Due to obstruction of urine flow - can occur anywhere post kidney (ureter, bladder, urethra)
Kidney stones Tumors
Enlarged prostate Bladder retention
12. Initially asymptomatic
Progression-significant fall in GFR, Oliguria (NORMAL GFR 125ml/min) Azotemia- waste in
blood
Elevated BUN/Cr (>20,1) Edema
Electrolyte imbalances
-hyperkalemia (3.5-5.3)
-hyperphosphatemia (2.5-4.5)
-hypocalcemia (8.5-10.2) Metabolic acidosis
Fever/ chills Hypertension Tachycardia
LOC will decline over time- Irritable, Confusion, lethargic Chest pain, SOB
Loss of appetite (Anorexia), N/V
Renal function may take up to 1 year to fully recover
Answer
Signs and Symptoms of AKi
13. Urinalysis
Proteinuria If pt has protein, WBC, or RBC in urine the kidney is not filtering properly
Specific Gravity <1.010 diluted in tubial injury >1.035 concentrated in glomular injury
(tubular necrosis) Epithelial and CASTS show up in urine- tubial is sloughing off
Serum BUN/CR >
Electrolytes K+ >
Ca < Phos >
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, RBC's <
ABG metabolic acidosis PH < 7.35 HCO3 < 24
Ultrasound
Answer
Kidney Diagnostic Tests
14. IV fluids- NS 0.9%
Blood volume expanders (albumin) Diuretics (lasix/Furosemide) Reduction of potassium
-Sodium Polystyrene (Kayexalate) Blood pressure management Peptic ulcer prevention
Medications may need a dose reduction based on kidney function
Answer
Medications for AKI
15. Show no signs of increased fluid overload
Show no S/S azotemia Have a UOP > 30ml/hr
Appropriate Renal diet
Answer
Patient Goals
16. Foods high in water content
-Fruits
-Vegetables
-soups, broths, stew
-Chicken
-Fish
-Milk
-Yogurt
-Jell-O
Fluid retention
17. Less
Answer
Potasium- potatoes, sweet potatoes, canned salmon, bananas, avocado, lima beans]
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