NR507 Patho Final Exam, Exams
of Nursing
Acute renal failure
Reversible
Determining prognosis- kidneys respond to diuretic with good output; this indicates that
kidneys are functioning well
Acute Pyelonephritis
Diagnosing by clinical symptoms alone can be difficult; can be similar to cystitis
Diagnosis established by:
-Urine culture
-Urinalysis (WBC casts indicates pyelonephritis, but may not always be present)
-Signs/Symptoms
-Complicated pyelonephritis requires blood cultures and urinary tract imaging
Renal Calculi (Renal Stones)
Goals of Treatment:
Manage acute pain
Promote passage of stone
Reduce size of stone
Prevent new stone formation
Chronic Renal Failure
Chronic Kidney Disease (CKD) is a progressive loss of renal function associated with
systemic disease such as hypertension, diabetes mellitus (most significant risk factor),
systemic lupus erythematosus or intrinsic kidney disease
CKD stage is determined by estimates of GFR and albuminuria
Who is a candidate for dialysis?
End-stage renal disease (ESRD) is the final stage of CKD with the number one cause
being diabetes mellitus combined with hypertension. At this point, the patient is
completely dependent on dialysis to survive.
CKD is classified into five stages and is based on the patient's GFR rather than
symptoms.
Patients will need dialysis when the following symptoms are present:
--Metabolic acidosis.
--Hyperkalemia: Hyperkalemia in the presence of EKG changes (peaked T-waves) is an
indication for dialysis. --Hyperkalemia by itself is not an indication for dialysis.
--Drug toxicity: Drug toxicity due to the following drugs is an indication for dialysis and
include salicylates, Lithium, Isopropanol, Methanol and Ethylene glycol).
--Fluid volume overload that is not responsive to diuretics.
--Uremic symptoms due to nitrogenous wastes in the blood stream.
Stage I CKD
There is kidney damage with normal or elevated GFR
