NR574 Exam 2024 Final NR 574 Actual
Exam Update Latest 2024 Questionsd and
Correct Answers Rated A+
1. Hepatorenal syndrome (HRS): functional form of renal failure that occurs pri-
marily in pt with cirrhosis and ascites.
2. Type 1 hepatorenal syndrome is characterized by...: -rapidly progressive
renalimpairment
-doubling of initial serum Cr to greater than 2.5mg/dL over a period less than 2
weeks
-without liver transplant prognosis is very poor
3. Type 2 hepatorenal syndrome is characterized by...: -moderate form of
renal failure
-serum Cr levels between 1.5 to 2.5 mg/dL reduction in GFR with elevation in
serum creatinine
-associated with a more indolent course and improved survival compared to type
1
4. Risk Factors of hepatorenal syndrome: Dilutional hyponatremiaPrevious
episodes of ascites
Presence of esophageal varicesPoor nutritional status
Infections such as spontaneous bacterial peritonitis
Severe urinary sodium retention (urine sodium < 5 milliequivalents/liter [mEq/L])
Large-volume paracentesis without albumin replacement
, Acute alcoholic hepatitis
Low mean arterial blood pressure (map <80 mm Hg)
5. subjective clinical presentation of hepatorenal syndrome: Most clients
withHRS have a known diagnosis of acute or chronic liver disease and present
with nonspecific symptoms including:
-dysgeusia (altered taste perception)
-malaise
-fatigue
-decreased urine output.
6. objective clinical presentation of hepatorenal syndrome: HRS has no
char-acteristic physical exam findings.
It is important to assess the client for stigmata of chronic liver disease including:
-spider nevi
-scleral icterus
-lower extremity edema
-asterixis
-abdominal distention
-fluid wave
-paraumbilical hernia
-bruits.
7. Dx criteria in hepatorenal syndrome: 1. cirrhosis with ascites
2. increase in Cr >0.3 mg/dL within 48 hrs or >50% increase from baseline
within a7 day period
, 3. no response to a 2 consecutive day diuretic withdrawal and volume expansion
w/ albumin 1g/kg body wt
4. absence of shock
5. no nephrotoxic drug use
6. no macroscopic signs of structural kidney injury (proteinuria >500 mil-
ligrams/deciliter[(mg/dL], microhematuria with >50 red blood cells per high-power
field, and/or abnormal renal ultrasonography)
8. What is the Creatinine criteria when diagnosing hepatorenal syndrome:
in-crease in serum creatinine of
-greater than or equal to 0.3 mg/dLor
-greater than or equal to 50% increase from baseline Cr
this is within a 7 day period.
9. What surgical intervention is used to treat hepatorenal syndrome?: TIPS
Procedure
10. What is a TIPS procedure?: The TIPS procedure bypasses a portion of the
hepatic circulation by shunting blood flow from the portal vein to the hepatic vein
-This reduces portal pressure and minimizes back pressure on the splanchnic
organs. This also decreases the likelihood of bleeding from the esophageal varies
and reduces the amount of ascites
*Hemorrhage is a significant risk during TIPS
11. What is the treatment of choice for both type 1 and type 2 HRS?: Liver
transplant.
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Tutorhailey. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $18.99. You're not tied to anything after your purchase.
