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NURS 6030 Exam 3 QUESTIONS WITH VERIFIED AND DETAILED ANSWERS. A+ GRADED., Exams of Nursing

Rutgers University - CamdenNursing

NURS 6030 Exam 3 QUESTIONS WITH VERIFIED AND DETAILED ANSWERS. A+ GRADED. What's the difference between acute and chronic? - Acute: short duration, rapid onset - Chronic: long term What is gfr? Glomerular filtration rate Why is creatinine important to renal function? Creatinine indicates how well the kidneys are filtering waste from the blood What can happen if there is an obstruction in one kidney? What happens to the other kidney if one is obstructed? - the opposite kidney will be responsible for taking on the additional workload from the obstructed kidney - the opposite kidney can go into hyperfunction and will hypertrophy - could eventually lead to renal failure

Typology: Exams

2024/2025

Available from 07/12/2025

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Download NURS 6030 Exam 3 QUESTIONS WITH VERIFIED AND DETAILED ANSWERS. A+ GRADED. and more Exams Nursing in PDF only on Docsity!

A+ GRADED. What's the difference between acute and chronic? - Acute: short duration, rapid onset - Chronic: long term What is gfr? Glomerular filtration rate Why is creatinine important to renal function? Creatinine indicates how well the kidneys are filtering waste from the blood What can happen if there is an obstruction in one kidney? What happens to the other kidney if one is obstructed? - the opposite kidney will be responsible for taking on the additional workload from the obstructed kidney - the opposite kidney can go into hyperfunction and will hypertrophy - could eventually lead to renal failure What are characteristics of struvite-staghorn stones? Comprised of magnesium-ammonium-phosphate, associated with utis, associated with alkaline urine and pathogens What are characteristics of calcium stones? Most common type of stone, comprised of calcium oxalate or calcium phosphate, can cause hypercalcemia from hyperparathyroidism and immobility What are characteristics of uric acid stones? Associated with gout as uric acid is deposited in the joints What is stress incontinence? Loss of urine with increased abdominal pressure (ex. Cough, laugh, sneeze, exercise) Why does stress incontinence happen (explain patho)? In women, pelvic floor muscles change angle between bladder and urethra (placing it in a position for easy voiding and leakage) Explain the pathophysiology of a uti in patients with a foley catheter. - bacteria attach to catheter - biofilm coats catheters leading to colonies of bacteria - ascending infection travels up the catheter in the urinary tract (accounts for 40% of hais) What does strep have to do with kidney disease? Antigen-antibody complex from strep infection can deposit in glomerular membrane and cause acute glomerulonephritis Explain the pathophysiological changes in nephrons when a patient has high blood sugars (diabetic glomerulopathy). - glomerular sclerosis: formation of scar tissue that thickens and damages the glomerular capillary membrane - needs increased blood flow to glomeruli and increased filtration pressure, enlarged capillary pores become leaky - accumulation of sugar in glomeruli tissue causes damage Explain the pathophysiological changes of the kidney from chronic htn. - causes renal arteries to thicken to compensate for the increased pressure - narrowed diameter of vessels results in decreased blood flow which damages the nephrons and changes the glomerulus What is a way we can detect diabetic glomerulosclerosis in patients early? What is happening? Control blood glucose and carefully monitor renal functions What is rifle criteria? Risk of renal dysfunction Injury to the kidney Failure of kidney function Loss of kidney function Endstage kidney disease How is rifle criteria used? Used to determine severity and outcomes for aki Your patient presents with a high serum creatinine, low gfr, and low urine output. What do you suspect is happening? Acute kidney injury What are the stages of acute tubular necrosis? - lasts weeks to months What happens in the recovery/diuretic phase of acute tubular necrosis? - tubular epithelial repair/regeneration - diuresis, may be excessive and cause loss of fluid/electrolytes What are the symptoms of acute tubular necrosis? - increased creatinine and bun - oliguria - hyperkalemia, hypokalemia, and/or hyperphosphatemia - weight gain - edema - neuro changes Explain the pathophysiology of hemolytic uremic syndrome (hus). -causal agent (e. Coli) triggers inflammation in glomerulus - swollen glomerular arterioles, occluded by platelets and fibrin clots - decreased gfr, hematuria, proteinuria - damage to erythrocytes results in hemolytic anemia - activated or damaged platelets leads to thrombocytopenia What is the "triad" in hemolytic uremic syndrome (hus)? Hemolytic anemia, thrombocytopenia, renal impairment What substance/chemical produced in the body is the main culprit of causing glomerular htn? Angiotensin ii- induces vasoconstriction of the efferent arteriole, resulting in glomerular capillary htn and an increase in glomerular size How is a patient treated/managed with end stage ckd/ stage 5? Needs dialysis to survive What are indicators for "emergency" treatment in relation to end stage ckd/stage 5? Gfr less than 15, uremia, may need renal replacement therapy How can the heart be impacted by kidney disease? List some complications. - htn - dyslipidemia - pericarditis d/t metabolic toxins - hf d/t volume overload and anemia - increased risk for stroke, pvd, and cad What is a lethal dysrhythmia? Ventricular fibrillation Trace the blood flow through the heart when it returns from the lungs. 1.) Left atrium 2.) Mitral valve 3.) Left ventricle (pumped here during diastole) 3.) Aortic valve 4.) Aorta (pumped out to systemic circulation during systole) What is acute coronary syndrome? - unstable plaques lead to rupture and thrombosis - unstable angina, chest pain at rest - non stemi - stemi What is heart failure (hf)? - impaired ability of the ventricles to fill (preload) or eject blood (contract) - heart is unable to maintain sufficient cardiac output to meet the body's needs What are s/s of right sided hf? - lower extremity edema - hepatomegaly - ascites *explain the pathophysiologic causes of right sided hf. Congestion of peripheral tissues What are s/s of left sided hf? - pulmonary edema - coughing with sputum production - sob Explain the pathophysiologic causes of left sided hf. - decreased cardiac output because heart cannot adequately pump blood throughout body - causes decreased tissue perfusion and pulmonary congestion Explain the pathophysiology for acute pulmonary edema. - increased pressure and volume in left atrium causes pulmonary interstitial edema What is ldl1? Explain the pathophysiology. Bad cholesterol, excess can lead to injury and plaque build up in blood vessel What are triglycerides? Explain the pathophysiology. Another name for lipids, essential for cell membrane and hormone synthesis What is non-hdl? All the particles other than hd] What is vidi? Explain the pathophysiology. - very-low-density lipoprotein - mainly carry triglycerides, another type of fat, to your tissues How do lipids transport/move through the body in the exogenous pathway? Lipids are absorbed from gi tract (packaged as chylomicrons) and transported to adipose tissue, skeletal muscle, and liver How do lipids transport/move through the body in the endogenous pathway? Liver synthesizes vldl, ldl, and hdl and stores it What is atherosclerosis? - abnormal thickening and hardening of the arteries - plaques form (fatty lesions in the lining of arterial blood vessels) What are the steps in the development of atherosclerosis? 1.) Endothelial damage/injury 2.) Inflammation 3.) Migration of inflammatory cells 4.) Macrophages engulf Idl 5.) Fatty streak formation 6.) Proliferation of smooth muscle and collagen 7.) Fibrous plaque formation (core of lipids, foam cells, fatty debris) What are the consequences of atherosclerosis? - decreased blood flow and 02 carrying capacity - ischemia and infarction -stable plaque: older and harder usually due to calcification, unlikely to rupture, causes partial blockage of vessels What is a pericardial effusion? Accumulation of fluid in the pericardial cavity, preventing the heart from expanding how it should and limiting the blood it can pump out What is the danger with a pericardial effusion? Risk of cardiac tamponade (compression causes increased intracardiac pressure and constriction of the heart chambers, leading to decreased filling) What is acute pericarditis? Acute inflammation of the pericardium (sac that encloses the heart) What is constrictive/chronic pericarditis? Fibrous scarring/calcifications leading to stiffening of pericardium What are symptoms of pericarditis? -*chest pain (severe, sudden onset, retrosternal) -*pericardial friction rub -*ecg changes -*development of pericardial effusion What is mitral stenosis? Narrowing of the mitral valve opening that blocks blood flow from the left atrium to the left ventricle Explain the pathophysiology of mitral stenosis. Autoimmune response causing inflammation which leads to scarring and fusion of valve leaflets, shortens chordae tendineae With mitral valve regurgitation, how does blood flow through the chambers and when? Blood flows back into the left atrium during systole (contraction) causing pulmonary congestion What is endocarditis? Infection of the endocardium and valves which leads to lesions and destruction of tissue, caused by a bacterial infection - implantable cardiac devices What does vegetation of a heart valve mean? There are irregular growths/masses (ex. Bacteria, fungus) on the heart valve, impairing their function What are the short term mechanisms that regulate bp? - neural: sns (baroreceptors monitor pressure) - hormonal: raas, adh What are the long term mechanisms that regulate bp? - renal pressure diuresis and pressure naturesis What is the pressure diuresis mechanism? As bp increases, diuresis occurs (increased urine production) What is the pressure naturesis mechanism? As na+ increases, excretion should occur What are the main determinants of systolic bp? - amount ejected, velocity, elasticity of aorta - reflects rapid ejection of blood from lv What is the main determinant of diastolic bp? - systemic vascular resistance - reflects constant pressure which enables flow to tissues What is mean arterial bp and what does it reflect? Index of perfusion pressure, reflects cardiac output