NURS 311 Final Exam
what is glomerular filtration determined by? - ANSWER filtration pressure in the glomeruli and
permeable surface area of the glomerular membrane
with glomerular filtration, what movement does hydrostatic pressure favor? - ANSWER favors
filtration, the push
with glomerular filtration, what movement does oncotic (colloid) pressure favor? - ANSWER opposes
filtration, the pull
what 3 factors affect glomerular filtration pressure? - ANSWER circulating blood volume, rate of
blood flow, myogenic autoregulation
what are the 3 classes of causes of glomerulonephritis? - ANSWER autoimmune diseases, infectious
diseases, non-immune glomerular injury
what are some examples of autoimmune diseases that cause glomerulonepritis? - ANSWER lupus
(type III sensitivity), goodpasture syndrome
what are some examples of infectious diseases that cause glomerulonephritis? - ANSWER strep
throat, bacteria, viral
what are some examples of a non-immune glomerular injury that causes glomerulonephritis? -
ANSWER ischemia, metabolic disorders, toxins, meds, vascular disorders
how does chronic kidney disease manifest? - ANSWER progressive and irrevocable loss of nephrons
(75% loss before clinical manifestations begin)
what are chronic kidney disease risk factors? - ANSWER chronic conditions, congenital conditions,
polycystic kidney disease, neoplasm, infection, chronic glomerulonephritis, recurrent kidney
infections
what complications are associated with chronic kidney disease? - ANSWER fluid and electrolyte
balance, production of active vit D impaired, alteration in protein/fat/carb metabolism, HTN, fluid
overload affecting lungs, inadequate erythropoietin = decreas. RBC
,what is end stage renal disease? - ANSWER aka chronic kidney failure, progressive deterioration of
kidney fxn resulting in renal dialysis and/or kidney transplant
what is the MOA of furosemide (lasix)? - ANSWER loop diuretic -- inhibits Na/K/Cl system in loop of
henle = decreased reabsorption, decreased passive reabsorption of water
what are the adverse effects of furosemide (lasix)? - ANSWER ototoxicity, SJS, hypotension,
hypokalemia, hyperglycemia, aplastic anemia
furosemide (lasix) is potassium.... - ANSWER wasting
- this is why it can cause hypokalemia!
- monitor regularly and possibly supplement K
- encourage pt to eat leafy greens, bananas, potatoes
what is the MOA of spironolactone (aldactone)? - ANSWER blocks action of aldosterone in distal
tubule, K retention
spironolactone (aldactone) is potassium... - ANSWER sparing
- can cause hyperkalemia
what are the adverse effects of spironolactone (aldactone)? - ANSWER dehydration + hypotension,
hyperkalemia, dysrhythmias, endocrine effects, SJS
with any diuretic, what is our main concern? - ANSWER hypotension, increased risk for falls
how do we treat ascites? - ANSWER IV albumin
where does serotonin antagonist ondansetron (zofran) act? what is its use? - ANSWER
chemoreceptor trigger zone
- antiemetic
, what is the most concerning adverse effect with ondansetron (zofran)? - ANSWER prolongation of
the QT interval
where does the dopamine antagonist promethazine act? what is its use? - ANSWER chemoreceptor
trigger zone
- antiemetic
where does the anticholingeric scopolamine act? what is its use? - ANSWER vomiting center
- antiemetic
where does the antihistamine diphenhydramine act? what is its use? - ANSWER vomiting center
- antiemetic
where do cannabinoids act? - ANSWER associated with vomiting center of the brain, pathway is not
well understood
what is gastritis? - ANSWER inflammation of the gastric mucosa and acid irritation
what cause chronic gastritis? what causes acute gastritis? - ANSWER H. pylori or C. diff
ETOH, NSAIDs, smoking, viral/bacterial toxin
what are the sx/sy of gastritis? how is it diagnosed? - ANSWER buring epigastric pain, N/V, anorexia
upper GI endoscopy, H.pylori testing
how is gastritis treated? - ANSWER correction of food habits, avoidance of risk factors, PPIs, H2
receptor blockers, antacids
what complications are associated with gastritis? - ANSWER gastric ulcers, PUD
what is gastroenteritis? - ANSWER infection of the stomach and small intestine by infecting
organisms