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CCRN

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Question
Answer
How does the kidney maintain perfusion?   AFFERENT ARTERIOLAR DILATION AND EFFERENT ARTERIOLAR CONSTRICTION  
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Fluid is forced from the glomerulus, forming an ultrafiltrate. Into which compartment is the fluid forced?   PROXIMAL TUBULE  
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Which element is not filtered during glomerular filtration?   PROTEINS  
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Cortex   The outer one third of the kidney tissue, consisting of the glomeruli, nephrons and the convoluted portions of the distal and proximal tubules.  
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Medulla   The inner portion of the kidney. It contains the loop of Henle, vasa recta, and the collecting ducts.  
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Nephron   The functional unit of the kidney.  
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Glomerulus   A network of capillaries that are formed by the afferent arterioles  
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The normal adult urine volume is   1 to 2 L/day  
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The total glomeruli filter is   180L/day  
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Loop of Henle   Function to concentrate or dilute urine as necessary.  
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Serum osmolarity to   Normal level 280 to 320  
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Countercurrent Mechanism   Serves to concentrate urine and excrete excessive solutes.  
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BUN   Measures the level of urea. Normal level 10 to 20mg/dL  
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Creatinine   A waste product of muscle metabolism and is freely filtered. Normal serum level .8 to 1.8 mg/dL  
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BUN TO CREATININE RATIO (serum)   Normal 10:1 A ratio of 20:1 or more in indicative of prerenal insufficiency (water and salt depletion).  
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Creatinine clearance   Probably the most reliable index of kidney function available. Normal is 125mL/min.  
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Aldosterone   Maintain normal sodium concentration in the extracellular fluid. Promotes reabsorption of sodium in both the distal convoluted tubule and the collecting ducts of the kidneys.  
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Angiotesin II   A potent vasoconstricting agent.  
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Prostaglandins   Promote a vasodilatin of the renal medulla to maintain renal perfusion during severe or prolonged systemic hypoperfusion.  
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Oliguria   less than 400mL of urine is produced per day.  
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Prerenal acute renal failure   A decrease renal perfusion secondary to renal hypoperfusion, often due to decreased cardiac output  
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Intrarenal acute renal failure   Caused by disease or injuries of the nephron from the glomerulus to the collecting duct. The most common cause is acute tubular necrosis.  
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Postrenal acute renal failure   Indicates an intra or extrarenal obstruction at or below the level of the collecting ducts.  
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What are the four phases of acute renal failure?   ONSET, OLIGURIC, DIURETIC AND RECOVERY  
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Normal urine volume   .5 mL/kg/h  
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What is the normal range of urine sodium values?   40 to 220 meq/L  
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Creatinine level is a valuable indicator of glomerular filtration rate for which reason?   Once filtered in the glomerulus, creatinine is not reabsorbed in the tubular system.  
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Most water reabsorption occurs in which part of the nephron?   PROXIMAL TUBULES  
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the presence of oliguria, a BUN/creatinine ratio greater than normal suggests that which condition has developed?   PRERENAL FAILURE  
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Aldosterone exerts an effect on renal function at which anatomic site?   DISTAL TUBULE  
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The juxtaglomerular system is responsible for releasing which substance?   ANGIOTENSIN  
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Which electrolyte is directly related to the reabsorption of magnesium?   SODIUM  
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Hypomagnesemia is manifested clinically by which of the following symptoms?   MUSCLE IRRITABILITY  
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Elevated chloride levels are associated with which condition?   ALKALOSIS  
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Left ventricular failure will cause which effect on the BUN/creatinine ratio?   It will cause the ratio to rise. (BUN rises faster than creatinine.)  
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What is the clinical value in establishing wheter or not an anion gap exists?   The finding permits determination of a metabolic acidosis.  
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Measurement of what is helpful in differentiating ARF from prerenal azotemia?   FENa  
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FENa (fractional excretion of sodium   FENa is > than 1% and usually > than 3% wit ATN n severe obstruction of the urinary drainage of both kidneys. It is generally < than 1% in pts with acute glomerulonephritis, hepatorenal syndrome, and states of prerenal azotemia such as CHF or dehydration.  
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What are the indications for continuous arteriovenous hemofitration?   1. Treating acute volume oveload in CHF. 2. FLUID REMOVAL WHEN DIURETIC THERAPY HAS FAILED. 3. ACUTE HYPERKALEMIA  
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Renal trauma is best diagnosed by.   INTRAVENOUS PYELOGRAM  
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UREMIC SYNDROME   Results fromthe kidney's inability to excrete toxic waste products.  
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