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NURS 5461 RENAL 2 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED $9.99   Add to cart

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NURS 5461 RENAL 2 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED

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NURS 5461 RENAL 2 EXAM QUESTIONS AND ANSWERS WITH COMPLETE SOLUTIONS VERIFIED Differential Diagnosis of an Elevated Creatinine determine the cause and if it is acute or chronic history+exam, Labs /Diagnostics, ▪ UA ▪ CMP ▪ uric acid level ▪ CPK ▪ CBC ▪ Toxicology ▪ FeNa (Fractional...

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  • November 2, 2024
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NURS 5461 RENAL 2 EXAM QUESTIONS AND ANSWERS WITH

COMPLETE SOLUTIONS VERIFIED

Differential Diagnosis of an Elevated Creatinine

determine the cause and if it is acute or chronic

history+exam, Labs /Diagnostics, ▪ UA ▪ CMP ▪ uric acid level ▪ CPK ▪ CBC ▪ Toxicology

▪ FeNa (Fractional excretion of sodium)-dont do in someone with diuretics, or FEurea

(Fractional Excretion of urea).▪ Renal US

o Renal Biopsy

▪ Generally indicated: • when the H&P, labs and diagnostics have ruled out prerenal and

post renal causes. • when intrarenal causes due to primary renal disease is felt to be

likely. • suspect glomerulonephritis

Proteinuria

Normal urinary protein excretion is <150mg/24 hours o Daily albumin excretion is a

normal person is < 30mg

Tubular Proteinuria

• Occurs as a result of a disease which affects the renal tubules/interstium of the kidney.

The normal protein associated with this type of proteinuria is beta-2 microglobulin. This

is normally absorbed by the proximal tubules. The amount is <2g and the dipstick may

be negative.

Overflow proteinuria

, Associated with an increased production of low molecular weight proteins such as light

chains in multiple myeloma or myoglobin in rhabdomyolysis. These proteins exceed the

reabsorption capacity of the tubules and spill into the urine. These proteins are toxic to

the tubules and can cause AKI.

Glomerular Proteinuria

(4 types) discussed as follows

Transient Proteinuria (glomerular)

Does not represent glomerular damage. It occurs in persons with normal renal function,

bland urine sediment, and normal blood pressure. The amount is less than one 1g/24

hours and usually occurs with fever or heavy exercise and disappears on repeat testing.

Laboratory Evaluation Transient Proteinuria

▪ UA with Microscopy on 3 different occasions ▪ Albumin to creatinine ratio or protein to

creatinine ration in a random urine sample ▪ UA from an early morning sample, before

the pt engages in physical activity

Orthostatic Proteinuria (glomerular)

Does not represent glomerular damage. This is diagnosed when the patient does not

have proteinuria upon rising in the morning but has it later in the day. Typically occurs in

tall, thin adolescents or adults less than 30y/o and is associated with severe lordosis.

Renal function is normal and the amount is < 1g/day

Lab evaluation orthostatic proteinuria

▪ Urine microscopy ▪ Split urine collection for protein on sample between 7-11am and

another between 11pm-7am

Non-Nephrotic Range Proteinuria (glomerular)

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