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Nurs 611 Exam (4) With 150 Questions and Answers
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Nurs 611 Exam (4) With 150 Questions andAnswers 2024-2025
Acute 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, so what ends up happening is
that 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 will react due to obstruction, because they expect their
20-25% of cardiac output. The kidneys do not know why they are not
getting their normal share of cardiac output but they sense the
decreased perfusion due to the obstruction, so those kidneys
activate what - ANSWER The RAAS system
With activation of that RAAS system from the kidneys, there is
angiotensin, which is a powerful peripheral constrictor. So, what
happens within those kidneys themselves is decreased tissue
perfusion so they activate the RAAS system which contains the
angiotensin with powerful constrictor properties, so it constricts
what? - ANSWER Arterioles
When angiotensin constricts the arterioles, what happens as a
result? - ANSWER Hypertension, so basically HTN happens due to
,urinary obstruction
Which population do we think mainly about when we think about
UTIs? - ANSWER The older populaiton
With older adults it may be harder to determine if they have a UTI
because clinically, the main manifestation that is often seen with the
elderly and a UTI is what? - ANSWER Confusion, abdominal pain
or discomfort, blood in urine.
What can a UTI lead to very quickly, especially with 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 is the funnel-like dilated part
of the ureter in the kidney, The renal pelvis functions as a funnel for
urine flowing to the ureter.
When the urine flows backward from an obstruction into the renal
pelvis, what happens? - ANSWER it causes inflammation, which is
caused by bacteria
, A condition that includes non bacterial infectious cystitis and
noninfectious cystitis is called what? - ANSWER Painful bladder
syndrome or interstitial cystitis
Painful Bladder Syndrome/Interstitial Cystitis (PBS/IC) mimics -
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:
- Radiation
- 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).
Because it is difficult to differentiate between pyelonephritis and
cystitis by clinical manifestations alone, what diagnostic testing
should be performed? - ANSWER Urine culture, urinalysis, and
clinical manifestations
Gold standard indicator of kidney function - ANSWER GFR
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