Renal failure

Question 1

T OR F?

Renal failure only requries unilateral failure

Answer 1

F! bilateral

Question 2

Pre-renal failure happens when__

caused by: (anything that causes a decrease in cardiac output)

• hypotension
• decreased heart rate
• decreased cardiac output

Answer 2

blood cannot get to the kidneys

Question 3

intra-renal failure happens when___

caused by: (anything that causes kidney vascular damage)
-glomerulonephritis
-nephrotic syndrome
-malignant hypertension (uncontrolled hypertension)
and Diabetes melitis (causing severe vascular damage)

Answer 3

damage has occured inside the kidneys

Question 4

post-renal failure happens when___

caused by: (anything that keeps urine trapped in kidney)
-enlarged prostate
-kidney stones
-tumors
ureter obstruction
-edematous stoma

Answer 4

urine cannot get out of the kidneys

Question 5

We’ve got to have a BP of at least___ in order to perfuse vital organs.

Answer 5

90

Question 6

it only takes __ mins of poor perfusion for acute tubular necrosis to occur.

Answer 6

20

Question 7

EX question)

we have an 18 month old who has gotten bilateral ureteral stents. you’re taking care of this patient post-op and you assess that the U.O has dropped.

a) call M.D

B) turn side to side

C) Irrigate

D) Reassess in 15 min

Answer 7

A) call doc

• new nurses should not be messing around with fresh surgery*

– we need to select a safe answer that will address the immediate outcome

Question 8

in renal failure, we expect the initial urine output to be concentrated, and dark urine, so the specific gravity will increase. However, they can get to a point of fixed specific gravity. what does that mean?

Answer 8

• they lose the ability to concentrate and dilute urine (even if that patient gets more fluid, doesn’t matter how much, the gravity will stay the same. unlike in normal people where the pee would become more dilute)

Question 9

why can anemia occur in renal failure patients?

Answer 9

• not enough erythropoetin

Question 10

CHF occurs because?

anorexia, nausea, and vomiting because?

uremic/itching frost occur because?

Answer 10

• fluid retention
• retaining toxins
• retention of urea

Question 11

renal failure people tend to retain phosphorus which does what to their calcium level?

Answer 11

decrease it

Question 12

So, increased phosphorus= decreased calcium. this causes calcium to be pulled from the__.

Answer 12

bones; this causes osteoporosis

Question 13

what are the 2 phases of renal failure?

Answer 13

Oliguric and diuretic phase

Question 14

Oliguric phase:

what has happened to U.O?

This patient is in a fluid volume___

what do you think will happen to the K+?

Answer 14

• decreased
• excess
• increase

Question 15

Diuretic phase:

what is happening to the U.O?

this patient is in a fluid volume____

what do you think will happen to K+?

Answer 15

• increase
• deficit
• decrease