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Nur 195 Test 1 Questions And 100% Correct Answers
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Nur 195 Test 1 Questions And 100% CorrectAnswers
Nursing Process - Renal Failure - ANSWER • Assessment • Nursing Diagnosis /
Outcomes • Planning
Implementation-renal failure - ANSWER Monitor fluid balance - Administer medications-
Monitor lab values - Mouth care- Skin care - Impact on individual, family and community
Hemodialysis - ANSWER Uses a dialyzing membrane unit
Requires vascular access
-AV shunt or fistula (arteriovenous)
-bruit
Peritoneal dialysis - ANSWER Highly vascular peritoneum serves as dialyzing membrane
Done daily- Peritoneal catheter - Can lead to high glucose - More freedom - Less dietary
restriction
hemodialysis - ANSWER 3x/week- Vascular access - Efficient, fast clearance- Puts heavy
demand on equipment - Less protein lost - Contributesto anemia
complications of hemodialysis - ANSWER Infection/clotting of vascular access-
Hypotension - Muscle cramps- Blood loss - Sepsis
Complications of Peritoneal Dialysis-ANSWER Infection of exit site - Peritonitis -
Abdominal pain - Lower back pain- Bleeding- Protein loss
,Kidney transplant pre-operative care-ANSWER Emotional and physical preparation
•Immunosuppressive drugs • EKG, CXR, Blood tests
Post-kidney transplant-ANSWER Monitor output / fluid retention• Monitor electrolytes,
BUN, creatinine, CBC • Observe for S/S of rejection, Monitor for S/S of infection
glomular filtration - ANSWER First step in the process of urine formation.
•Glomerular Filtration Rate (GFR) is the volume of plasma (filtrate) filtered per minute,
normal 120mL/min.
•Efficient filtration depends on adequate blood flow to maintain consistent pressure.
•Factors affecting blood flow: hypotension, decreased oncotic pressure and increased
tubular pressure from an obstruction
•Amino acids (proteinuria) and glucose (glycosuria) in the urine indicates glomerular
disorders.
Tubular Reabsorption - ANS •The second process in the formation of urine
•Filtrate moves through tubules, filtrate is altered; 45 gallons of filtrate is filtered each
day.
•99% of what is filtered is returned to the blood.
•Substances reabsorbed: sodium, chloride, bicarbonate, potassium, glucose,
creatinine, and uric acid
•Selective reabsorption maintains acid-base and electrolyte balance
Tubular Secretion - ANS •The third process in the formation of urine.
• Collecting system in the tubules is where concentration and secretion of urine takes
place. (1000-1500 mL per day)
•Daily minimum 500 mL u/o is required to excrete enough solute load to keep waste
products down in the blood.
•Urine flows from renal pelvis into the ureters and with smooth muscle peristalsis,
,moves into the bladder (holds 300-500mL) for storage.
Urine Storage - ANSWER Bladder: a muscular sac with stretch receptors; anatomic
capacity 1500-2000 mL, functional capacity 350 mL
Sympathetic and parasympathetic innervation and reflexes
Detrusor muscle contraction results in micturation; once completed, pressure drops
and efflux of urine resumes to replace urine in bladder. Residual urine volume 50 mL.
Urethra is outlet that carries urine to external meatus.
Bladder filling pressure must be low so that urine may easily exit the renal pelvis.
Which of the following best describes the glomerulus? - ANSWER The cluster of
capillaries where filtration takes place.
Osmolarity (L) and Osmolality (kg) - ANSWER •Concentration ratio of solute-substances
to water
•One litre liquid is equal to one kilogram, same examinations
•Isotonic, Hypertonic and Hypotonic are used for osmolarity.
•Control salt and water to maintain osmolarity.
•Very narrow range: with just a modest rise in solutes, the sensation of thirst is triggered
along with a urine excretion that minimizes water loss from the kidneys.
•Impaired cognition results in an inability to rehydrate which results in dehydration.
Which of the following is true or false?
A hypotonic solution would contain fewer molecules and more water than blood. -
ANSWER •True
Rationale: A hypotonic solution has fewer molecules and more water in the solution, less
, than 275 mOsm/L compared to the normal osmolality of the blood, which is between 275
to 295 mOsm/kg of body weight.
Assessment of the Patient
with Urinary Tract Dysfunction - ANSWER •Health History: Risk factors
•Chief complaints:
-Fatigue, short of breath
-Pain
-Changes in Voiding
-GI symptoms, mimics GI disorders
•Family and Social History
Physical Examination- Head-to-Toe
•Kidney palpation
•Abdominal inspection, auscultation, palpation, and percussion
•Bladder palpation and percussion
•Palpation of the prostate and inguinal area (males)
•Inspection and palpation of the female genitalia
•Assessment for edema and body weight
•Assessment of lower extremities
how to palpate kidneys - ANSWER under the 12th rib and costovertebral angle
Gerontologic Considerations - ANSWER •Structural and functional changes in upper and
lower urinary tract
•Steady decrease in GFR and renal reserve
•Prone to acute and chronic renal failure
•Increased risk for adverse drug reactions
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