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NURS 611 Exam 3: Questions & Solutions (Detailed)
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NURS 611 Exam 3: Questions & Solutions (Detailed)
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NURS 611 Exam 3: Questions & Solutions (Detailed)What is the most common type of kidney stone? Right Ans - calcium
oxalate
what is the 'scientific name for kidney stones? Right Ans - nephrolithiasis
how are kidney stones classified? Right Ans - mineral and location
where is referred pain experienced with kidney stones? Right Ans -
umbilicus area
what is the pathophysiology of kidney stones? Right Ans - a)
supersaturation of the minerals of the urine
b) grow through crystallization or agglomeration
c) lack of stone inhibitors (uromodulin)
where can kidney stones be located? Right Ans - kidneys, ureters, bladder
what other renal disorder increases risk for nephrolithiasis and why? Right
Ans - pyelonephritis with e coli, proteus or pseudomonas
these microorganisms split urea into ammonia, increasing alkaline, increasing
stone formation risk
What is pyelonephritis? Right Ans - infection of one or both sides of the
upper urinary tracts
what are the three elements of the upper urinary tracts? Right Ans - ureter
renal pelvis
kidney interstitium
What are the two most common underlying risk factors for pyelonephritis?
(2) Right Ans - urinary obstruction
reflux of urine from the bladder (vesicoureteral reflux)
what are the three most common organisms that cause pyelonephritis?
Right Ans - E. Coli
Proteus
Pseudomonoas
,what is a complication of pyelonephritis wrought by the common
microorganisms and what is the pathogenesis? Right Ans - Complication:
kidney stones
Pathogenesis: the organisms that are usually causative split urea into
ammonia, making alkaline urine that increases the risk of stone formation
What are clinical manifestations for UTI in older adults? (2) Right Ans -
confusion
poorly localized abdominal discomfort
what two factors account for UTI? Right Ans - virulence of the pathogen
efficiency of the immune response
what is the most common organism in UTI? Right Ans - E. coli
what gender is more susceptible to UTI? Right Ans - females due to
anatomy
how do you differentiate between cystitis and pylenophritis? Right Ans -
urine culture, UA, clinical signs and symptoms all together
what is an indication on UA of pyelonephritis? Right Ans - WBC casts
An estimated ______% of children younger than ___ years old who develop UTI
have vesicoureteral reflux? Right Ans - 30-40%
5 years old
what are the long term complications of vesicoureteral reflux? Right Ans -
renal parenchymal injury
scarrying
hypertension
CKD
explain the pathophysiology of primary VUR Right Ans - urine sweeps up
into the ureter and flow back into the bladder. An abnormally short
submucosal tunnel and ureter permits reflux by the rising pressure of the
filling bladder.
, what are secondary causes of VUR? Right Ans - acquired conditions
- neurogenic bladder dysfunction
-uretal obstructions
what is painful bladder syndrome/interstitial cystitis? Right Ans - -
considered a bladder pain disorder
- exact cause unknown, but may include an autoimmune reaction responsible
for the inflammatory response --> mast cell activiation --> altered epithelial
permeability --> neuroinflammation --> increased sensory nerve sensitivity
what other diseases are associated with painful bladder syndrome? Right
Ans - fibromyalgia
IBS
chronic fatigue syndrome
what are results of painful bladder syndrome on the bladder? Right Ans -
inflammation
fibrosis of the bladder wall
bladder volume decrease
What is acute glomerularnephritis? Right Ans - includes renal disease in
which glomerular inflammation is caused by immune mechanisms that
damage the glomerular capillary filtration membrane through antigen-
antibody complexes
what are the three layers of the glomerular filtrations membrane? Right
Ans - endothelium
basement membrane
epithelium (podocytes)
what are the symptoms of acute glomerularnephritis? Right Ans - sudden
onset hematuria
RBC casts and proteinuria (milder than nephrotic syndrome)
severe cases: edema, hypertension and impaired renal function
what secondary disorders are associated with chronic glomerular injury?
Right Ans - lupus nephritis
diabetic nephropathy
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