renal 1

Question 1

amt of blood going to kidneys

Answer 1

20-25% circulates 12 x hr

Question 2

nephrons

Answer 2

initial formation of urine

if less than 20% need RRT

Question 3

bladder capacity

Answer 3

400-500mL but can distend larger

Question 4

changes ass w aging-6

Answer 4

1. reduced blood flow to kid
2. thickened glomerular and tubular basement membranes
3. decreased tubule length
4. decreased GFR
5. nocturnal polyuria
6. risk for dehydration

Question 5

risks ass w aging

Answer 5

The decrease in glomerular filtration, combined with the use of multiple medications that are cleared by the kidney, puts the older person at higher risk for adverse drug effects and drug-drug interactions.

Question 6

assessment methods-6

Answer 6

1. demographic info
2. SES
3. nutrition hx
4. medication hx
5. fy/genetic risk
6. current health prob

Question 7

african americans and kid disease

Answer 7

more rapid age related decreases in GFR

Question 8

daily fluid intake

Answer 8

2 L

Question 9

nutrition changes

Answer 9

change in appetite, taste, thirst

-ass protein intake

Question 10

palpation of the kidneys

Answer 10

usually not palpable, but could indicate enlargement

-rt kidney easier-lower

Question 11

abdomen ass

Answer 11

ascities

-tenderness over costovertebral angle

Question 12

deep tendon reflex of knee

Answer 12

• quality and symmetry

- test for neuro causes of bladder dys

Question 13

creatinine-5

Answer 13

• produced from muscle/protein breakdown
• indicator of kid function
• kid disease has higher cr
• increase after 50% loss of funct, decrease loss of muscle
• 0.6-1.2 male, 0.5-1.1 female

Question 14

BUN

Answer 14

10-20

• does not always indicate kid problem
• dehydration if only BUN increase

Question 15

labs indicate kid dysfunction

Answer 15

BUN and Cr raise at same rate

Question 16

increase BUN-7

Answer 16

1. liver/kid disease
2. dehydration
3. decrease kid perfusion
4. increase protein diet
5. infection/stress
6. steroid use
7. GI bleed

Question 17

decrease BUN-3

Answer 17

malnutrition, fluid volume excess, severe hepatic damage

Question 18

BUN/Cr ratio

Answer 18

• BUN divided by Cr

- 6-25

Question 19

urine osmolarity

Answer 19

the most accurate measurement of the kindney’s ability to dilute and concentrate urine. Concentrating ability is lost early in kidney disease

Question 20

specific gravity-5

Answer 20

• concentration of particles in urine
• 1.005-1.030
• increase-> concentrated, dehydration
• decrease->diluted, DM, renal damage
• kid disease->does not change w fluid intake

Question 21

urine pH more alkaline-3

Answer 21

left unrefridgerated, bacteria present, left uncovered

Question 22

urine pH affected by-4

Answer 22

diet, drugs, acid/base disturbance, kid tubular function

Question 23

abnormal urine-7

Answer 23

protein, ketones, glucose, nitrites (e coli), bilirubin, casts, crystals (allowed to stand)

Question 24

24 hr urine collection

Answer 24

Cr. clearance detects and evaluates progression of renal disease-best indication of overall kid function

Question 25

renal impairment labs

Answer 25

Cr greater than 1.5

GFR lower than 45

Question 26

bladder scanner

Answer 26

use male setting on female w hysterectomy

Question 27

CT dye-4

Answer 27

• increase fluid intake
• contrast-induced nephroplasty (fail 24-72hrs)
• metformin-stop 24 hrs prior and 48 hrs after eval kid funct=>lactic acidosis
• sodium bicarb in L of fluid/ acetylcysteine for prevention

Question 28

MRI

Answer 28

• will be able to communicate through microphone
• all metal credit cards removed
• avoid alcohol, caffiene, smoking 2 hrs prior and food 1 hr post

Question 29

3 things kid filter

Answer 29

hydrogen ions, urea (toxins from liver), creatine

=> not filtered drops HnH from no erythropoitin

Question 30

hydrogen ions not filtered

Answer 30

metabolic acidosis

Question 31

GFR

Answer 31

85-125

• controlled by BP and blood flow
• decrease w age, DM, HTN