Exam 27: Kidney Disorders and Therapeutic Management

The most common site for short-term vascular access for immediate hemodialysis is the

What is a continuous venovenous hemodialysis filter permeable tO₂

An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage.Which category of renal failure is the patient at the greatest risk of developing?

A patient with chronic renal failure receives hemodialysis treatments 3 days a week.Every 2 weeks,the patient requires a transfusion of 1 or 2 U of packed red blood cells.What is the probable reason for this patient's frequent transfusion needs?

To control azotemia,the recommended nutritional intake of protein is

One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin.How do these agents lower potassium?

A patient in acute renal failure presents with a potassium level of 6.9 mg/dL.He has had no urine output in the past 4 hours despite urinary catheter insertion and Lasix 40 mg intravenous push.Vital signs are as follows: HR,76 beats/min; respiratory rate,18 breaths/min; and BP,145/96 mm Hg.He is given 100 mL of 50% dextrose in water and 20 U of regular insulin intravenous push.A repeat potassium level 2 hours later shows a potassium level of 4.5 mg/dL.What order would now be expected?

A patient has acute tubular necrosis.The following blood work was noted: complete blood count shows a white blood cell count of 11,000 mm³,a hemoglobin of 8 g/dL,and a hematocrit of 30%.His chemistry panel shows serum potassium,4.5 mg/dL; serum sodium,135 mg/dL; serum calcium,8.5 mg/dL; BUN,20 mg/dL; and creatinine,1.5 mg/dL.What laboratory value(s)need(s)to be treated most immediately and why?

To remove fluid during hemodialysis,a positive hydrostatic pressure is applied to the blood and a negative hydrostatic pressure is applied to the dialysate bath.This process is known as

Laboratory results come back on a newly admitted patient.They are as follows: serum BUN,64 mg/dL; serum creatinine,2.4 mg/dL; urine osmolality,210 mOsm/kg; specific gravity,1.002; and urine sodium,96 mEq/L.The urine output has been 120 mL since admission 2 hours ago.These values are most consistent with which of the following diagnoses?

Which of the following conditions is associated between kidney failure and respiratory failure?

A patient has been hospitalized for a subtotal gastrectomy.After the procedure,an infection developed that eventually had to be treated with gentamicin,an aminoglycoside antibiotic.After 3 days of administration,oliguria occurred,and subsequent laboratory values indicated elevated BUN and creatinine levels.The patient is transferred to the critical care unit with acute tubular necrosis.Which dialysis method would be most appropriate for the patient's condition?

Which of the following diuretics maybe combined to work on different parts of the nephron?

Which of the following IV solutions is contraindicated for patients with kidney or liver disease or in lactic acidosis?

The patient is a gravida 6,para 1.She is admitted after a cesarean section after an amniotic embolus.Her heart rate (HR)is more than 150 beats/min with a systolic BP less than 80 mm Hg.Her temperature is 38°C,and her condition has caused her to develop prerenal azotemia.The patient was fluid resuscitated through a double-lumen catheter,which was placed into her right femoral access,and started on vasopressors with a fair response (BP,80/50 mm Hg; HR,122 beats/min).Because of her diagnosis and a concern regarding fulminating sepsis,the patient was begun on CVVH.Why would this therapy be chosen for this patient?

An alert and oriented patient presents with a pulmonary artery wedge pressure of 4 mm Hg and a cardiac index of 0.8.The BUN is 44 mg/dL,creatinine is 3.2 mg/dL,and BP is 88/36 mm Hg.Urine output is 15 mL/hr.Lungs are clear to auscultation with no peripheral edema noted.Which of the following treatments would the physician most likely order?

What is the dose for low-dose dopamine?

The patient is a gravida 6,para 1.She is admitted after a cesarean section after an amniotic embolus.Her heart rate (HR)is more than 150 beats/min with a systolic BP less than 80 mm Hg.Her temperature is 38°C,and her condition has caused her to develop prerenal azotemia.The patient was fluid resuscitated through a double-lumen catheter,which was placed into her right femoral access,and started on vasopressors with a fair response (BP,80/50 mm Hg; HR,122 beats/min).Because of her diagnosis and a concern regarding fulminating sepsis,the patient was begun on CVVH.Which of the statements best describes CVVH?

Which of the following IV solutions is recommended for treatment of prerenal failure?

A patient has been hospitalized for a subtotal gastrectomy.After the procedure,an infection developed that eventually had to be treated with gentamicin,an aminoglycoside antibiotic.After 3 days of administration,oliguria occurred,and subsequent laboratory values indicated elevated blood-urea-nitrogen and creatinine levels.The patient is transferred to the critical care unit with acute tubular necrosis.The patient is in the oliguric/anuric phase of acute tubular necrosis.Which statement best describes this phase?