Nursing Science 2

What substance is filtered by the kidney?

blood

The most common type of kidney stone is composed of

calcium

A nurse is counseling a client on the side effects of diuretic therapy. What is a life threatening side effect associated w/ diuretic therapy?

cardiac arrhythmias

A progressive increase in serum urea levels occurs in

chronic kidney failure

The bone disease osteodystrophy is associated w/

chronic renal failure

What is the most likely cause of protein in urine?

damaged glomerular capillaries

Which of the following would trigger the secretion of aldosterone?

decreased blood levels of sodium

Antispasmodics treat the symptoms of overactive bladder by

decreasing bladder tone and suppressing contractions

A client is on a loop diuretic. What comorbidity would warrant close observation?

diabetes

Clinical symptoms associated w/ CKD do NOT include

diabetes mellitus

The cleaning solution used in hemodialysis is called the

dialysate

Which portion of the kidneys plays a role in acid-base balance?

distal convoluted tubule

Acute gout attacks can sometimes be managed w/ nonpharmacological tx such as

eating more red meats

The structure responsible for filtering the blood is the

glomerulus

Which of the following is not normally found in urine?

glucose

A potential side effect of a loop diuretic is

hypokalemia

A 65 yr old ct is being treated for benign prostate hypertrophy (BPH). The ct has been started on Proscar, an antiandrogen med. What potential side effects could happen?

impotence, decreased libido, and decreased ejaculate

Where are the renal corpuscles of the nephrons located?

in the kidney's outer region, where they extend between the cortex and the medulla

One of the first recommendations for any type of kidney stone is to

increase fluid intake

How does high BP damage kidneys?

increases pressure within the glomerulus, causing glomerular capillaries to burst

The primary action of loop diuretics is to

inhibit H20 reabsorption back into the bloodstream

Loop diuretics act by

inhibiting reabsorption of sodium and chloride

A ct taking probenecid, a uricosuric agent, is cautioned regarding use of any other meds due to drug interactions. How does the nurse explain to the ct the use of this med?

it inhibits renal excretion of many drugs, thereby increasing the level of the other drugs and prolonging their effect

What should the nurse explain to her client about Detrol?

it may take several months to see an effect

What is the action of probenecid?

it promotes urinary excretion of uric acid

What is the purpose of the adipose tissue surrounding the kidneys?

it protect the kidneys

An alpha-blocker, Flomax, is prescribed to a ct w/ benign hypertrophy (BPH(. The ct asks if this drug will improve his frequent runs to the bathroom. How should the nurse respond?

it should improve your symptoms, as it relaxes the smooth muscle in the bladder neck and prostate, causing them to relax

Which of the following best describes the action of a thiazide diuretic?

it works on the distal tubules of the kidney, causing increased excretion of water, sodium, chloride, and potassium

The massive edema of nephrotic syndrome is caused by

large protein losses in the urine

The nurse is administering Lasix to her client. She knows that this is what type of diuretic?

loop diuretic

Which structural characteristic of the proximal convoluted tubule enhances its role in tubular reabsorption?

microvilli

Patients w/ chronic renal disease may need to restrict their intake of foods high in phosphorous, such as

milk, nuts, and legumes

Medical nutrition therapy for nephrotic syndrome includes

moderate protein intake

What life threatening side effect is associated w/ diuretic therapy?

muscle weakness or leg cramps

What is the filtration unit of the kidney?

nephron

The microscopic functional units of the kidney are called

nephrons

Symptoms of chronic kidney failure include

nitrogen retention

Disease conditions that can interfere w/ normal kidney function include

obstruction & infection

A major clinical symptom of acute kidney failure is

oliguria

The method of dialysis that allows patients to be mobile is

peritoneal dialysis

What is the function of peritubular capillaries?

pick up water and solutes reabsorbed by the renal tubules

The micturition center is located in the

pons

Clients who are in danger of hypokalemia and associated complications are typically prescribed what type of diuretic?

potassium-sparing

What factor drives filtration in the glomerulus

pressure gradient

When patients w/ CKD begin dialysis, they can increase their intake of

protein

Classic symptoms of acute glomerulonephritis include

proteinuria

The presence of protein in the urine is called

proteinuria

Most of the water, electrolytes, and nutrients are reabsorbed in the

proximal convoluted tubules

For patients w/ uric acid stones, health practitioners may recommend a diet low in

purines

A ct is taking a urinary analgesic. How can the nurse describe the action of this type of med?

relieves pain only

A decline in the BP causes juxtaglomerular cells to secrete:

renin

The nurse is preparing Mr. Ernesto for discharge and instructing him how to take his daily medication. One important point to include is

rise slowly from a reclining position

An older adult ct is started on hydrochlorothiazide diuretic for edema of the legs. What education to prevent injury should the nurse provide?

rise slowly out of a sitting position

Carbs and fats are important in the diets of patients w/ kidney disease b/c they

spare protein for tissue synthesis

Glomerulonephritis or nephritic syndrome is one of the causes of

stage 5 CKD or end stage renal disease (ESRD)

Which of the following could be a contraindication thiazide diuretic therapy?

sulfa allergy

The type of diet recommended for a person w/ a calcium stone depends on

the composition of the stone

Mr. Jones has CKD. He is 55 years of age, weighs 165 lbs, and has a GFR of 22 mL/min. His estimated energy needs per day are approximately

1875 to 2625 kcal/day

How much of the fluid filtered by both kidneys is reabsorbed by the body?

99%

What is the renal tubule?

A collection of tubelike structures that leads away from the glomerulus

An acute episode of gout is treated w/ a nonsteroidal anti-inflammatory drug or colchicine. What tx for prevention of attacks would the nurse expect to be prescribed for a ct?

Allopurinol

Patients w/ acute gout who can't tolerate NSAIDs are often given

Corticosteroids

Which of the following is an effect of atrial natriuretic peptide (ANP)?

Decreased BP

Aldosterone causes which of the following?

Decreased urine output

The nurse also makes sure that she reviews potential interactions w/ other meds and advises Mr. Ernesto to avoid

Digoxin

Which of the following statements accurately describes the function of the Bowman's capsule?

Fluid that filters out of the glomerulus collects in between the two layers of Bowman's capsule and then flows into the renal tubule on the other side of the capsule

Ernesto's physician prescribes a loop diuretic, which acts directly on what part of the kidney?

Loop of Henle

Which of the following is an osmotic diuretic?

Mannitol

Diuretics used more often to reduce intracranial and intraocular pressure are characterized as

Osmotic agents

What oral urinary analgesic is used only for symptomatic relief of UTIs?

Phenazopyradine

Which of the following correctly describes the flow of filtrate as it leaves Bowman's capsule?

Proximal convoluted tubule, loop of Henle, distal convoluted tubule, collecting duct

What drug is used in the tx of both benign prostatic hypertrophy and erectile dysfunction?

Tadalafil

Which statement about the location of the kidneys is correct?

The kidneys extend from the level of the T12 vertebra to the L3 vertebra

Which drug is a diuretic that increases excretion of water, sodium, chloride and potassium?

Thiazide

What type of drug is used to treat chronic gout and acts on the kidney by blocking reabsorption of uric acid and thereby increasing its excretion in urine?

Uricosuric agent

Phenazopyridine (Pyridium), a urinary analgesic, is prescribed for pain in a ct w/ a UTI. What instruction can the nurse share w/ her ct regarding this med?

Your urine will appear orange-reddish in color while taking this

For patients treated w/ dialysis, a good source of protein could be

a scrambled egg

The bone disease osteodystrophy develops b/c of the kidney's inability to

activate vitamin D

Ms. Jones comes to the ED w/ a severe drug reaction to penicillin. She may be at risk for

acute kidney failure

The sudden shutdown of kidney function as the result of traumatic injury is called

acute kidney failure

Nephrotic syndrome, or nephrosis, is a disease that

allows large amounts of protein to escape into the tubule

The hormone that causes the kidneys to reabsorb water and decrease urine production is

antidiuretic hormone

When doxazosin (Cardura) is ordered for BPH, the nurse knows she needs to monitor for which of the following?

BP

How can antiandrogens used in the tx of benign prostatic hypertrophy affect serum prostate specific antigen (PSA) levels (a screening test for prostate cancer)?

By decreasing serum PSA concentration levels even when prostate cancer is present

Drug interactions can pose a potential risk for a client taking diuretic therapy. How can a nurse BEST explain this interaction to a ct taking a diuretic and digoxin for atrial fibrillation?

the hypokalemia associated w/ the diuretic causes digoxin toxicity

The classic symptoms of chronic kidney failure result from

the progressive loss of nephrons

Azotemia refers to elevated blood levels of

urea

What occurs in the descending limb of the loop of Henle?

water diffuses out