unit 5 check ur understanding

A patient, age 3, has vesicoureteral reflux. "Why does that make him have so many bladder infections?" asks his mother. The nurse's best response is

"When he urinates, urine runs back toward his kidneys and then into the bladder again, making it easy for bacteria to grow if they reach the bladder."

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

GFR declines

The risk for contrast media-induced acute tubular necrosis (ATN) is highest in

a 70-year-old with heart failure

The condition characterized by oliguria and hematuria is

acute glomerulonephritis

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

The pathophysiologic basis of acute glomerulonephritis is

an immune complex reaction

A major modifiable risk factor for nephrolithiasis is

dehydration

The patient most at risk for postrenal acute kidney injury is a(n)

elderly patient with hypertrophy of the prostate

Appropriate management of end-stage renal disease includes

erythropoietin administration

Appropriate therapy for prerenal kidney injury includes

fluid administration

The oliguric phase of acute tubular necrosis is characterized by

fluid excess and electrolyte imbalance

A patient who has difficulty walking without assistance is incontinent of urine when help doesn't get to her quickly enough. The term for this type of incontinence is

functional

In patients with polycystic kidney disease, renal failure is expected to progress over time as the cystic process destroys more nephrons. At what point will a patient reach end-stage renal disease?

greater than 90% nephron loss

Findings that should prompt an evaluation for renal cancer include

hematuria

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

hematuria

Nephrotic syndrome does not usually cause

hematuria

The most frequent initial symptom of bladder cancer is

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

Calcium oxylate stone formation is facilitated by

hypercalciuria

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

what is the cause of CKD and result of CKD

hypertension

The major cause of glomerulonephritis is

immune system damage to the glomeruli

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

increased serum creatinine

What can lead to bladder stone formation?

infection

The most common direct cause of acute pyelonephritis is

infection by E.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 rub. Appropriate therapy at this time would include

initiation of dialysis

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

The patient reports persistent pelvic pain and urinary frequency and urgency. She says the pain improves when she empties her bladder. She does not have a fever and her repeated urinalyses over the past months have been normal, although she has a history of frequent bladder infections. She also has a history of fibromyalgia and hypothyroidism. Based on her history and complaints, her symptoms are characteristic of

interstitial cystitis

The difference between stress incontinence and urge incontinence is that stress incontinence

is caused by a pelvic floor muscle problem, whereas urge incontinence is caused by a problem with the detrusor muscle.

one of the most common causes of acute tubular necrosis (ATN) is

ischemic conditions

the normal post-void residual urine in the bladder is

less than 100 mL

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

man who has chronic UTI

The pain that accompanies kidney disorders is called

nephralgia

glomerular disorders include

nephrotic syndrome

The disorder characterized by a neurologic lesion that affects bladder control is

neurogenic bladder

The urinalysis finding most indicative of cystitis includes the presence of

nitrites

The defining characteristic of severe acute kidney injury is

oliguria

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

Urinary retention with consistent or intermittent dribbling of urine is called

overflow incontinence

The most common sign/symptom of renal calculi is

pain

One cause of an extrinsic renal system obstruction is

pelvic tumor

Which disease is genetically transmitted

polycystic kidney disease

which condition is caused by a genetic defect?

polycystic kidney disease

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

polyuria and sodium wasting

what is the nest intervention for acute kidney injury (AKI)

prevention

A progressive decrease in the force of the urinary stream, dribbling of urine, and difficulty initiating the urinary stream are characteristic of

prostatic enlargement

Nephrotic syndrome involves loss of large amounts of ________ in the urine.

protein

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 effect on the renal tubules during the postoliguric phase of acute tubular necrosis involves

regeneration of the renal tubular epithelium

The most common cause of ischemic acute tubular necrosis (ATN) in the United States is

sepsis

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

serum creatinine

prerenal acute kidney injury may be caused by

severe hypotension

Which group is at the highest risk for urinary tract infection?

sexually active women

The greatest risk factor for bladder cancer is

smoking

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

struvite

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

the glomerular membrane has increased permeability

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

they're deficient in vitamin D

The infection frequently associated with development of postinfectious acute glomerulonephritis is

throat infection

The most common cause of intrinsic kidney injury is _____ injury.

tubular

The most commonly ordered diagnostic test for evaluation of the urinary system is

ultrasonography

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

uremia

pelvic floor muscle training is appropriate for

urge incontinence **technically it should be stress??

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 retentinon and reflux

A patient being treated for acute tubular necrosis (ATN) develops mild polyuria. The nurse responds to questions about why this occurring by stating

"his renal tubules are recovering, so hes making more urine, but he's unable to concentrate urine well, because he is not fully recovered"

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 'prerenal,' the nurse responds

"your husbands'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 3 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 in your kidneys that allow RBC to leak into the fluid that becomes urine and make it coffee-colored"

Renal insufficiency occurs when _____ of the nephrons are not functional.

75%-90%

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

ACE inhibitors

Postrenal acute kidney injury may be caused by

bilateral kidney stones

Activation of parasympathetic nerves to the bladder will cause

bladder contraction

Detrusor muscle overactivity can be improved by administration of

botuliminum toxin

A common component of renal calculi is

calcium

The most common type of renal stone is

calcium

A patient has ureteral colic. The manifestation that requires immediate notification of the physician is

chills and fever

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

contrast media

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

vesicoureteral reflux is associated with

curent cystitis