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
