Exam 4

Renal insufficiency occurs when ____ of the nephrons are not functional

75% to 90%

Serious renal impairment generally does not occur until ____ of the total nephrons have been damaged

80%

The normal post void residual urine in the bladder is

less than 100 mL

Glomerular disorders include

nephrotic syndrome

Which intervention has been found to retard the advancement of chronic kidney disease

ACE inhibitors

Appropriate therapy for pre-renal kidney injury includes

fluid administration

It is true that polycystic kidney disease is

genetically transmitted

Findings that should prompt an evaluation for renal cancer include

hematuria

Calcium oxalate stone formation is facilitated by

hypercalciuria

The most common direct cause of acute pyelonephritis is

infection by E. coli.

The most common cause of intrinsic kidney injury is ____ injury

tubular

Pelvic floor muscle training is appropriate for

urge incontinence

The type of glomerulonephritis which is most likely to result in a swift decline in renal function that then progresses to acute kidney injury is

crescentic glomerulonephritis

The risk for contrast media induced acute tubular necrosis is highest in

A 70-year-old patient with heart failure

Hypotension is both a cause of chronic hidden disease and a result of chronic kidney disease

False

A person is unaware that his bladder is full of urine, but complains that he is leaking. Urine almost constantly. The most accurate term for this type of incontinence is

Overflow

An important sign of global modular basement membrane dysfunction is

Proteinuria

Approximately 2/3 of the water and electrolytes filter by the kidney are reabsorbed by the

Proximal tubule

The effect on the renal tubes during the post oliguric phase of acute tubular necrosis involves

Regeneration of the renal tubular epithelium

The most common cause of ischemic, acute tubular necrosis in United States, is

Sepsis

When a patient experiencing nephrotic syndrome asks, "what causes my urine to be so full of protein," the nurses response is based on the knowledge that

The glomerular membrane has increased permeability

The infection frequently associated with development of post infectious, acute glomerulonephritis is

Throat infection

The best intervention for acute kidney injury is prevention

True

What problem is a patient likely to experience an end-stage renal disease

Uremia

Anemia, people who have end-stage chronic renal disease is caused by

decreased secretion of erythropoietin

A major modifiable risk factor for nephrolithiasis is

dehydration

The patient most at risk for post renal, acute kidney injury is a

elderly patient with hypertrophy of the prostate.

Appropriate management of end-stage renal disease includes

erythropoietin administration

The underlying mechanism which directly results in glycosuria is

exceeding the threshold for glucose reabsorption

A person with acute pyelonephritis would most typically experience

fever

The oliguric phase of acute tubular necrosis is characterized by

fluid excess and electrolyte imbalance.

Factors that increase the glomerular filtration rate include

fluid volume excess

The primary selectivity barrier for glomerular filtration is the

glomerular basement membrane

In addition to renal colic, pain, signs or symptoms of ureteral stones may frequently include

hematuria

Nephrotic syndrome does not usually cause

hematuria

Hyperlipidemia occurs in nephrotic syndrome because

hepatocytes synthesize excessive lipids.

The consequence of an upper urinary tract obstruction in a single ureter is

hydronephrosis

The main driving force for glomerular filtration is

hydrostatic pressure in glomerular capillaries

The condition associated with end-stage chronic renal disease that is the most immediately life threatening is

hyperkalemia

One of the most frequent causes of chronic kidney disease is

hypertension

The most likely cause of anemia in a patient with end-stage renal disease is

insufficient erythropoietin

The most likely cause of acidosis in a patient with end-stage renal disease is

insufficient metabolic acid excretion resulting from nephron loss.

One of the most common causes of acute tubular necrosis is

ischemic conditions

Renin is released from

juxtaglomerular cells

The individual at highest risk of pyelonephritis who requires monitoring for signs of its occurrence is the

man who has chronic urinary tract infections.

The glucose transporter in the proximal tubule

may be saturated at high filtered glucose loads.

Serum creatinine may be increased by

muscle breakdown

The pain that accompanies kidney disorders is called

nephralgia

It is true that glucose reabsorption in the tubules

occurs in proximal convoluted tubule

The defining characteristic of severe acute kidney injury is

oliguria

Urinary retention with consistent or intermittent dribbling of urine is called

overflow incontinence

The most common sign/symptom of renal calculi is

pain

The direct cause of stress incontinence is

pelvic muscle weakness

One cause of an extrinsic renal system obstruction is

pelvic tumor

Which condition is caused by genetic defect?

polycystic kidney disease

If acute tubular necrosis does not resolve and continued tubular dysfunction ensues, the patient will then experience

polyuria and sodium wasting.

Nephrotic syndrome involves loss of large amounts of ____ in the urine

protein

The blood urea nitrogen (BUN) level is affected by

protein intake, fluid intake, catabolism, renal function

Signs consistent with a diagnosis of glomerulonephritis include

proteinuria

The major underlying factor leading to the edema associated with glomerulonephritis and nephrotic syndrome is

proteinuria

The primary function of the vasa recta is to

reabsorb interstitial fluid

The main clinical manifestation of a kidney stone obstructing the ureter is

renal colic

Excess potassium is excreted from the body by the renal system primarily via

secretion based on aldosterone level

The most helpful laboratory value in monitoring the progression of declining renal function is

serum creatinine

The glomerular filtration rate is most accurately reflected in the

serum creatinine level

Pre-renal acute kidney injury may be caused by

severe hypotension

Which group is at the highest risk for urinary tract infection

sexually active women

The urea-splitting bacteria contribute to the formation of ________ kidney stones.

struvite

Individuals with end-stage chronic renal disease are at risk for renal Osteodystrophy and spontaneous bone fractures, because

they are deficient in active vitamin D.

A patient with gouty arthritis develops renal calculi. The composition of these calculi is most likely to be

uric acid crystals

In addition to E. coli, a risk factor for development of pyelonephritis is

urinary retention and reflux

Renal stone formation is affected by

urine concentration. urine PH. metabolic/congenital conditions. dietary intake.

Risk factors for renal carcinoma include

Genetics. Cigarette smoking. Obesity. Chemicals. Hypertension.

The organism most commonly associated with acute pyelonephritis is

Escherichia coli

At his most recent clinic visit, a patient with end-stage renal disease is noted to have edema congestive signs in the pulmonary system, and a pericardial friction rep appropriate therapy at this time would include

Dialysis

The condition characterized by oliguria and hematuria is

Acute glomerulonephritis

Post renal, acute kidney injury may be caused by

Bilateral kidney stones

Detrusor muscle overactivity can be improved by administration of

Botulinum toxin

A common component of renal calculate is

Calcium

The most common type of renal stone is

Calcium

The manifestations of acute pyelonephritis

Can result in dehydration Often include symptoms of lower UTI Include fever, chills, and costo vertebral angle tenderness May include urosepsis.

Acute tubular necrosis can occur from

Contrast dyes used for radiologic studies, ischemia because of hypovolemia, antibiotics that are nephro toxic

The most common agent resulting in nephrotoxicity and subsequent acute tubular necrosis in hospitalized patients is

Contrast media

A patient with renal disease is at risk for developing uremia as the nephrons progressively deteriorate, because

GFR declines

In patients with polycystic kidney disease, renal failure is expected to progress overtime as the cystic process destroys more nephrons. at what point will a patient reach in stage renal disease

Greater than 90% nephron loss

The diet for a patient with chronic kidney disease should include

High carbohydrates and fats, low sodium and potassium, low phosphorus, high calorie

Signs of late chronic renal failure include

High serum potassium levels, high serum, phosphorus, high blood urea, nitrogen, anemia

The patient being treated for acute tubular necrosis develops mild polyurea. The nurse responds to questions about why this occurring by stating

His renal tubes are recovering, so he is making more urine, but he is not able to concentrate urine well because he is not fully recovered.

Osteoporosis commonly occurs in patients with end-stage renal disease because of

Hyperparathyroidism

The major cause of glomerulonephritis is

Immune system damage to glomeruli

A primary laboratory finding an end-stage chronic renal disease is

Increase serum creatinine

Which findings on a urinalysis should prompt further evaluation?

White blood cells 20 per high power field

A patient injured severely in a motor vehicle accident is hospitalized with acute kidney injury, as well as multiple broken bones and lacerations. when family members ask what is meant by the term pre-renal the nurse responds

Your husband's kidney injury did not start in the kidney itself, but rather in the blood flow to the kidney

A patient who reported a very painful sore throat. Three weeks ago is now diagnosed with acute post-streptococcal glomerulonephritis. When asked "why is my urine the color of coffee?" the Nurse responds

Your immune system was activated by your sore throat and has caused some damage and your kidneys that allow red blood cells to leak into the fluid that becomes urine and make it coffee colored.

Gastrointestinal, drainage, perioperative, and postoperative hypotension, and hemorrhage may all contribute to renal failure by causing.

acute tubular necrosis

A person who is diagnosed with nephrotic syndrome is also experiencing hypoalbuminemia. This happens because

albumin is excreted in the urine.

Hormones that increase sodium reabsorption from the tubular fluid include

aldosterone and angiotensin II

The pathophysiologic basis of acute glomerulonephritis is

an immune complex reaction

Scrotal pain in males and labial pain in females may accompany renal pain as a result of

associated dermatomes.

Activation of the parasympathetic nerves to the bladder will cause

bladder contraction