NURS 425 Exam 2 Practice Questions
and Correct Answers
Acute glomerulonephritis ✅an immune reaction to a strep infection that causes
immune complexes to become trapped in the glomerular capillary loop. This causes
obstruction, edema, and vasospasm within the kidney. This causes swelling, decreasing
the glomerular filtration rate which decreases the removal of waste and removal of
excess fluid
Initial signs and symptoms of acute glomerulonephritis ✅tea colored urine is the
biggest indicator, oliguria, dysuria, electrolyte imbalances, periorbital edema, lower
extremity edema, distended neck veins, adventitious lung sounds, increase in BP from
fluid retention, dyspnea, seizure precautions, decreased appetite, anorexia, diet
restrictions, lethargic, decreased activity tolerance, irritable, pale in color
Lab findings of acute glomerulonephritis ✅proteinuria, hematuria, increased specific
gravity, increased erythrocyte sedimentation rate, increased BUN, increased serum
creating, wbcs, potassium, magnesium, DECREASED sodium,
Nursing care of acute glomerulonephritis ✅place on seizure precuatoins, position head
of bed up, monitor urine output, measure abdominal girth daily, monitor edema, small
frequent meals of favorite foods, avoid foods high in potassium, administer diuretics and
antihypertensives
Precautions with acute glomerulonephritis ✅seizure precautions, watch for severe
edema and electrolyte issues
Common medications given with acute glomerulonephritis ✅furosemide (lasix),
aldactone (potassium sparing), beta blockers, and ace inhibitors
Nutrition with acute glomerulonephritis ✅decreased. Watch decreased albumin levels,
offer small meals with favorite foods, watch foods high in potassium
Main cause of acute renal failure ✅hypovolemia
Main intrarenal cause of acute renal failure ✅drug toxicities like tylenol, nsaids, mycin
antibiotics, acute glomerular nephritis
Main post renal cause of acute renal failure ✅vesicouretral reflux
, Acute renal failure ✅sudden cessation of renal function and ability of the kidneys to
regulate volume and composition of the urine. Uncommon in children but very critical.
Must treat the cause of the acute renal failure to fix
Three phases of acute renal failure ✅oliguria phase - up to 3 weeks, diuresis - up to 2
weeks, recover 3-12 moths
Chronic renal failure ✅loss of renal function and kidneys cannot regulate volume and
composition of urine
Risk factors for acute renal failure ✅hypovolemic shock huge, drug toxicities, reflux,
illness/infection, acute renal injury
Renal failure labs in peds patients ✅heaturia,proteinuria, increased specific gravity,
increased potassium, decreased sodium, decreased calcium, increased magnesium,
decreased rbis because of damage to kidneys, anemia, metabolic acidosis
Precautions with intravenous pyelogram in renal failure ✅need to have some sort of
decent GFR to do this because of the contrast dye used. Allows us a clear image of
blood flow through the kidneys
Peritoneal dialysis ✅used by injecting fluid into the abdomen and pulling it out to pull
wastes out of the body. Used in chronic renal failure. Preferable to hemodialysis
Hemodialysis ✅using an av fistula to filter blood out of the body, pull the waste out,
and put the clean blood back into the body. Huge infection risk, needs to be completely
sterile, must go to a facility 3-4 times per week for a few hours at a time. Very hard on
kids getting pulled out of school. Advantage is its more efficient at getting wastes out.
Requires very strict dietary restrictions
Adverse effects of hemodialysis ✅nausea, vomiting, low blood pressure
Advantages to peritoneal dialysis ✅can be done while child is sleeping or when
convenient, can be done outpatient, allows more freedom, can eat and drink more freely
Disadvantages to peritoneal dialysis ✅can lead to weight gain and appearance
changes, distended abdomen
Assessing patency of the shunt for hemodialysis ✅presence of bruit, palpable thrill,
distal pulses, and circulation
Precautions with hemodialysis ✅do not give hypertension meds before dialysis as
dialysis can drop blood pressure, don't take bp or give injections on side with fistula
