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
