CC renal

1. Decreases blood flow to the kidney 2. Decreases glomerular filtration rate (GFR) 3. Decreases urine output

A patient is admitted with respiratory failure and is being mechanically ventilated. The nurse understands there is a significant association between acute kidney injury and respiratory failure. How does mechanical ventilation alter kidney function? (Select all that apply)

CLS (Capillary leak syndrome)

A patient is admitted with septic shock and is hemodynamically unstable. The increased vascular permeability will cause what condition?

Serum creatinine

A patient has developed acute kidney injury (AKI) secondary to cardiogenic shock. Which laboratory value would the nurse find helpful in evaluating patient's renal status?

Post-renal

A patient is admitted with a uretheral obstruction causing hydronephrosis. Acute renal failure is produced as a result of this type of acute kidney injury?

Lack of production of erythropoietin to stimulate red blood cell formation

A patient with chronic kidney disease receives hemodialysis treatments 3 days a week. Every 2 weeks, the patient requires a transfusion of 1 or 2 U of packed red blood cells. What is the probable reason for this patient's frequent transfusion needs?

Anion Gap

The difference between extracellular cations and measurable anions is recorded as?

1. Restore and maintain fluid balance 2. Restore and maintain electrolyte balance 3. Restore and preserve renal function

The goals of treatment for Acute Tubular Necrosis include?

1. Acidosis 2. Volume overload 3. Hyperkalemia 4. Uremia

The most common reasons for initiating dialysis in acute kidney injury include which of the following? (Select all that apply.)

Intra-renal

A patient was admitted with an infection that had to be treated with gentamicin, an aminoglycoside antibiotic. After 3 days of administration, the patient developed oliguria, and an elevated blood urea nitrogen and creatinine levels. The nurse suspects the patient has developed what type of kidney injury?

Presence of a third heart sound

A patient was admitted with multiple trauma who has been volume resuscitated. The nurse suspects the patient is fluid overloaded. Which assessment findings would confirm the nurse's suspicion?

Fluid removal and maximum solute removal

A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse understands that this type of continuous renal replacement therapy (CRRT) is indicated for the patient who needs what type of treatment?

Sodium Kayexalate 15 g PO

A patient with acute kidney injury has a potassium level of 6.9 mg/dL. The patient has had no urine output in the past 4 hours despite administration of Lasix 40 mg intravenous push. To correct the hyperkalemia the patient is given 50 mL of 50% dextrose in water and 10 U of regular insulin intravenous push. A repeat potassium level 2 hours later shows a potassium level of 4.5 mg/dL. What order would the nurse expect now?

Albumin

A patient has been admitted with a severe kidney infection. The nurse suspects the patient has damage to the glomerular membrane. Which substance in the urine would confirm the nurse's suspicion?

Daily weights

A patient has been admitted with acute kidney injury. Which parameter is most important for evaluating the patient's fluid status?

Decreased creatinine clearance

A patient has been admitted with acute kidney injury. Which parameter would the nurse expect to find to confirm this diagnosis?

Blood urea nitrogen (BUN) and creatine

A patient has been admitted with acute kidney injury. Which serum laboratory values would the nurse expect to be ordered to confirm this diagnosis?

1. Hyponatremia (exam answer) 2. hypocalcemia 3. hyponatremia 4. hyperphosphatemia 5. acid-based imbalances

A patient with chronic kidney disease was admitted with severe electrolyte disturbances. The patient had been ill and missed several hemodialysis sessions. The patient is disoriented, dizzy, cold, clammy, and complains of severe abdominal cramping. The patient's electrocardiogram appears normal. Which electrolyte disturbance would the nurse suspect the patient may be experiencing?

Red blood cells and albumin are found in the urine.

The nurse is caring for a patient who has sustained blunt trauma to the left flank area, and is evaluating the patient's urinalysis results. What related assessment finding should concern the nurse?

Administer intravenous sodium bicarbonate.

The patient diagnosed with acute kidney injury and has been getting dialysis 3 days per week reports general malaise and is tachypneic. An arterial blood gas is ordered and shows that the patient's pH is 7.19, with a PCO2 of 30 mm Hg and a bicarbonate level of 13 mEq/L. The nurse prepares to take what action?

Pre-renal

An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage. The nurse knows the patient is at risk for developing what type of acute kidney injury (AKI)?

Auscultate the left arm for a bruit and palpate for a thrill.

The patient in progressive care unit following arteriovenous fistula implantation in the left upper arm, is due to have blood drawn with the next set of vital signs and assessment. When the nurse assesses the patient, the nurse should take what action?

Kayexalate

The patient's potassium level is 7.0 mEq/L. Besides dialysis, which of the following actually reduces plasma potassium levels and total body potassium content safely in a patient with renal dysfunction?

Ultrafiltration

The removal of plasma water and some low-molecular weight particles by using a pressure or osmotic gradient is identified by what term?

Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow.

To assess whether or not an arteriovenous fistula is functioning, what must the nurse do and why?

Hypertonic IV Fluids

Treatment of SIADH includes?

1. Formation of urine 2. Blood pressure regulation 3. Regulation of acid-base balance

What are the functions of the kidneys? (Select all that apply)

Obstruction of the flow of urine.

What event triggers acute kidney injury from post renal etiology?

1 to 2 L/day

What is a normal urine output?

Nephron

What is the functional unit of the kidney called?

1. Subclavian vein (answer on exam) 2. Femoral vein

What is the most common site for short-term vascular access for immediate hemodialysis?

Control of sodium and water

What is the primary function of aldosterone?

Sodium

When calculating the anion gap, what is the predominant cation?

Aldosterone

When renin eventually stimulates angiotensin II, the adrenal glands then secrete what hormone?

Phosphorus

Which electrolyte abnormality is evident early in the course of kidney failure?

Intra-renal acute kidney injury

Laboratory results come back on a newly admitted patient: Serum blood urea nitrogen, 64 mg/dL; serum creatinine, 2.4 mg/dL; urine osmolality, 210 mOsm/kg; specific gravity, 1.002; and urine sodium, 96 mEq/L. The patient's urine output has been 120 mL since admission 2 hours ago. These values are most consistent with which diagnosis?

Peripheral edema

Loss of albumin from the vascular space may result in which condition?

Nervous impulse conduction

Maintaining a normal range of serum potassium is important for what physiologic process?

Rhabdomyolysis

Myoglobinurea is caused by what?

harmful to the kidney possibly detrimental

Pre-renal acute kidney injury from hypovolemic sock (effective cause) causes the body to react by reabsorbing sodium and water in efforts to replenish volume. In this type of pre renal failure this reaction is?

Remove plasma water in cases of volume overload.

Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used for what purpose?

Magnesium level

A patient is admitted with severe hypokalemia. On admission the patient's laboratory values are serum K+, 2.2 mEq/L; blood urea nitrogen (BUN), 15 mg/dL; and creatinine, 1.2 mg/dL. Urine output is averaging 45 mL/h. The patient is given a total of 80 mEq of potassium over 4 hours. The potassium level is repeated and the result is K+, 2.4 mEq/L. What other information would be beneficial at this time?

Volume deficit

A patient was admitted with acute heart failure a few days ago. Today the patient's urine has a specific gravity of 1.040. What could be the potential cause for this value?

Specific gravity of 1.000

A patient was admitted with acute kidney failure. Which urinalysis value reflects a decreased ability of the kidneys to concentrate urine?

Hemodialysis

A patient was admitted with an infection that had to be treated with an aminoglycoside antibiotic. After a few days the patient developed oliguria and elevated blood urea nitrogen and creatinine levels. The patient's vital signs are stable. The nurse would anticipate the practitioner ordering which dialysis method for this patient?

Antidiuretic hormone

As serum osmolality rises, intravascular fluid equilibrium will be maintained by the release of what substance?

Calcium Gluconate

Hypocalcemia can cause CNS manifestations such as tetany, Chvostek, and Trousseau. This can be treated by giving what medication?

Isotonic

Which type of intravenous fluid will not create a shift of fluids within the vascular space?

DI

You would anticipate giving DAVP for treatment of what condition?

DI

Your patient recently was admitted with a traumatic brain injury and is getting ready to transfer to rehab. Your patient is experiencing an increase in urine output, excessive thirst, low blood pressure, hypernatremia, and a low specific gravity. You are holding transfer as you are concerned your patient is experiencing?

SIADH

Your patient was diagnosed with lung cancer a year ago. Your patient presents to the ER experiencing increased weight, tachycardia, edema, hypertension, a decreased urine output and a high specific gravity. You suspect your patient is in?