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Maryville Nurs 611 Exam 4 Questions And Answers
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Maryville Nurs 611 Exam 4 Questions And AnswersAcute unilateral renal obstruction and hypertension are caused by-ANSWER Renal
stones
most common type of kidney stone-ANSWER Calcium oxalate
Amount of cardiac output that kidneys expect to receive-ANSWER 20-25%
Passage of kidney stones can be extremely painful and cause referred pain to where?
-ANSWER Umbilicus area
The kidney stones are often jagged, and as a result, what usually happens is they get
stuck in what? - ANSWER The ureters
When that kidney stone gets stuck in the ureter, what does it obstruct? - ANSWER Urine
flow
The kidneys are going to respond because of obstruction-they want their 20-25% of
cardiac output. They do not understand why they are not getting their normal share of
cardiac output, but they sense the reduced perfusion due to the obstruction, and those
kidneys activate what? ANSWER The RAAS system
With stimulation of that RAAS system from the kidneys, there is angiotensin, which is a
potent peripheral constrictor. So, what occurs within those kidneys themselves is
impaired tissue perfusion so they stimulate the RAAS system which contains the
angiotensin with potent constrictor properties, so it constricts what? - ANSWER
Arterioles
When angiotensin constricts the arterioles, what does that result in? -ANSWER
,Hypertension, so basically HTN happens due to urinary obstruction
What population do we think mainly about when we think about UTIs? -ANSWER The
older populaiton
With older adults, it can be trickier to determine if they have a UTI because clinically,
which major manifestation is so commonly linked with the elderly and UTI is what? -
ANSWER Confusion, abdominal pain/discomfort, hematuria.
To what can a UTI progress to very quickly in the older population? - ANSWER Sepsis
Infection of one or both upper urinary tracts (ureter, renal pelvis, kidney interstitium) is
what? - ANSWER Pyelonephritis
most common risk factors for pyelonephritis - ANSWER Urinary obstruction, and reflux
of urine from the bladder.
most common culprit of pyelonephritis - ANSWER E. coli, proteus, pseudomonas
Why do we think of E. coli, especially for women with pyelonephritis? - ANSWER
Because of proximity of the anus to the urinary tract
On urinalysis what would you see with pyelonephritis - ANSWER WBC casts, because
they are only formed in the renal tubules
Urine should always go ---- and when there is an obstruction urine goes ---- - ANSWER
Forward, backward
When the urine flows backward from an obstruction, where does it flow back into -
ANSWER The renal pelvis
, What is the renal pelvis? - ANSWER the funnel-like dilated part of the ureter in the
kidney, The renal pelvis acts like a funnel for the urine moving into the ureter.
When the urine backs up from an obstruction into the renal pelvis, what occurs? -
ANSWER it becomes inflamed, which is due to bacteria
A condition that encompasses non bacterial infectious cystitis and noninfectious cystitis
is known as what? - ANSWER Painful bladder syndrome or interstitial cystitis
Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) masquerades as - ANSWER UTI,
but is non bacterial. Patients present with UTI and are treated with multiple rounds of
abx and do not improve is the clue it is PBS/IC
Cause of PBS/IC - ANSWER Non bacterial infectious cystisis:
- Viral
- Mycobacterial
- Chlamydia
- Fungal
Noninfectious Cystitis:
- Irradiation
- Chemical
- Autoimmune
- Hypersensitivity
Which patients do we generally think about when we think about PBS/IC? - ANSWER
Diabetics because they are prone to infection, but when they have gotten what we think
is a UTI and we keep giving antibiotics again and again and here it is the third time, we
need to think that they probably have PBS painful bladder syndrome or also known as
interstitial cystitis.
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