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
