NURS 223 Exam 1, Questions & Answers

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NURS 223 Exam 1, Questions & Answers-protein - Patients with chronic kidney disease (CKD) who are on hemodialysis (HD) or peritoneal dialysis (PD) are known to lose ____ during these treatments. As a ... result, they are special diets. Sevelamer (Renagel) - The nurse's patient has has chronic kidney disease (CKD) with elevated PHOSPHORUS levels according to the latest labs. Elevated phosphorus can lead to BONE RESORPTION and HYPERCALCEMIA. The nurse anticipates an order for _____, a PHOSPHATE BINDER to control the phosphorus levels and return them to WNL. muscles - Urea and creatinine are excreted by the kidneys. Creatinine is a metabolic by product that is produced by the ____. 0.6-1.0 - When serum creatinine is high the GFR (glomerular filtration rate) is low. The WNL range for SERUM creatinine is ___ (#.#-#.#) mg/dL. 7-20 - When the BUN (Blood Urea Nitrogen) level rises, the GFR (Glomerular Filtration Rate) is low. The WNL range for BUN is ____ (#-#) mg/dL. 3.5-5.0 - The WNL range for potassium (K+) is ____ (#.#-#-#) mEq/L. 135-145 - The WNL range for sodium (Na+) is ____ (#-#) mEq/L. creatinine - A proxy (another way) for determining the glomerular filtration rate (GFR) is known as ____ clearance. A 24-hour urine specimen is collected to determine this. This is the most important lab value to understand kidney function. urine - The glomerulus is the first part of the nephron where the blood gets filtered. Blood enters through the afferent arteriole to the proximal tubule and begins the process of ____ formation. The proximal and distal tubules are semi-selective membranes. Blood and proteins are reabsorbed into the circulation. kidneys - Urine formation * excretion of waste products * electrolyte, water and acid-base balance * renal clearance * regulation of RBC prod'n via ERYTHROPOIETIN * synthesis of active form of vitamin D * secretion of prostaglandins * All of these are key functions of the ____. hypertension - The nurse knows that diabetes and ____ are major risk factors for chronic kidney disease (CKD) and end-stage renal disease (ESRD). reabsorption - Urine is formed in the nephrons through a complex three-step process: glomerular filtration, tubular ____, and tubular secretion. Approximately 180L/day of filtrate results in 1-2 L of urine. secretion - Tubular ___ occurs when substances move from the peritubular capillary (blood) into the tubular lumen (filtrate). It helps with the elimination of K+, H+, ammonia, uric acid, some drugs and other waste products. 125 - The WNL GFR is ___ (#) mL/min. This is measured by (urine) creatinine clearance. decreases - As renal function worsens, the level of creatinine clearance [ decreases / increases ]. older adult - * Decreased kidney size * 50% fewer nephrons * 50% decrease in renal blood flow * kidney tubules less able to concentrate urine * risk for dehydration due to decreased perception of thirst. These are all factors which affect the kidneys in the ____ (two words) population. toxicity - Due to many factors that result in decreased GFR in older adults, the nurse knows that older adults are more susceptible to drug ____. lengthen - The nurse knows to [ lengthen / shorten ] intervals between doses and use the "start low and go slow" method with elderly patients to avoid drug toxicity. NSAIDs (non-steroidal anti-inflammatory drugs) - The nurse knows to monitor ELDERLY PATIENTS who may be taking aminoglycoside antibiotics like GENTAMICIN, TETRACYCLINE, CEPHALOSPORIN and ____ (acronym only) for acute kidney injury (AKI). anemia - The kidneys release a hormone known as ERYTHROPOIETIN that stimulates the production of red blood cells (RBCs) by the bone marrow. This is an important underlying cause of ____ in patients with AKI. nephrons - The glomerulus, Bowman's capsule, and proximal and distal tubules comprise the functional units of the kidneys known as the ____. directly - The GFR is [ directly / indirectly ] related to adequate blood flow (blood volume) to the kidneys. Kidneys receive 1300 mL/min of blood or 25% of cardiac output. ADH (antidiuretic hormone) - During urine formation, 1) glomerular filtration occurs from the blood into the nephron; 2) reabsorption occurs from the filtrate into blood; 3) tubular secretion from the peritubular capillaries into the filtrate; and reabsorption of water under the effects of ____ (acronym only). Angiotensin II - Dopamine, prostaglandins and nitric oxide are to vasodilation as ____ (two words) is to vasoconstriction. afferent - NSAIDs like IBUPROFEN result in decreased GFR through VASOCONSTRICTION of the [ afferent / efferent ] arteriole. vasodilation - ACE Inhibitors like CAPTOPRIL (capoten) and ARBs like LOSARTAN (Cozaar) lead to decreased GFR resulting from [ vasoconstriction / vasodilation ] of the EFFERENT arteriole. azotemia - The abnormal concentration of nitrogenous wastes like urea in the blood is known as ____. one-half - By age 90, the GFR is [ one-third / one-half / three-fourths ] of what it was at the age of 30. osmolality - Anti-diuretic hormone (ADH), also known as Vasopressin, is a hormone that is secreted by the posterior portion of the pituitary gland in response to changes in ____ of the blood. sodium - The regulation of ____ volume that the kidneys excrete depends on a hormone synthesized and released by the adrenal cortex called aldosterone. RAAS (renin-angiotensin-aldosterone system) - This system is activated when pressure in the renal arterioles falls below normal levels, as occurs with shock, dehydration or decreased NaCl delivery to the tubules. Activation increases retention of water and expansion of intravascular fluid volume thereby maintaining blood pressure. It is the ____ (acronym only). [Show More]

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