A nurse is caring for a client who reports to the clinic for laboratory tests. The client has an acute kidney injury caused by acute tubular necrosis and asks why their glomerular filtration rate (GFR) keeps decreasing. Which of the following pathophysiological changes occurring in the kidney should the nurse explain as the cause of the decrease?
The glomerular filtration rate decreases because there is injury to the renal tubular cells.
The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down.
The glomerular filtration rate decreases because in?ammatory cells invade the already damaged kidneys.
The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys.
The Correct Answer is A
Choice A reason: Acute tubular necrosis (ATN) is a condition where there is damage to the renal tubular cells, which can lead to a decrease in GFR. This is because the tubular cells are responsible for reabsorbing substances from the filtrate back into the blood. When these cells are injured, they cannot function properly, leading to a buildup of waste products and a decrease in GFR.
Choice B reason: While obstruction can lead to a decrease in GFR, it is not the primary cause in the context of acute tubular necrosis. Obstruction typically occurs in postrenal causes of acute kidney injury.
Choice C reason: In?ammatory cells do invade damaged kidneys, but this is more characteristic of conditions such as acute interstitial nephritis rather than ATN. In ATN, the primary issue is the injury to the tubular cells themselves.
Choice D reason: A reduction of blood flow to the kidneys, or prerenal azotemia, can indeed lead to a decrease in GFR. However, in the context of ATN, the primary issue is not the blood flow but the damage to the renal tubules.
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Related Questions
Correct Answer is B
Explanation
Choice A reason: Hyperkalemia is not typically associated with corticosteroid therapy. Corticosteroids can lead to increased excretion of potassium, not retention.
Choice B reason: Hypokalemia is a common side effect of corticosteroid therapy due to increased excretion of potassium in the urine.
Choice C reason: Hypomagnesemia is not commonly associated with corticosteroid therapy.
Choice D reason: Hypermagnesemia is not typically induced by corticosteroid therapy.
Correct Answer is A
Explanation
Choice A reason: The serum creatinine test measures the amount of creatinine in the blood and provides information about kidney function. Normal ranges for serum creatinine levels are 0.74 to 1.35 mg/dL for adult men and 0.59 to
1.04 mg/dL for adult women. This test is a common way to assess renal function and can indicate if the kidneys are not filtering waste effectively.
Choice B reason: While a serum creatinine test can indicate severe renal impairment, it does not diagnose a specific disease. Further testing would be required to determine the presence of a particular renal disease.
Choice C reason: The serum creatinine test does not directly show if medications are affecting kidney function. However, if a patient is on medications known to affect the kidneys, such as certain steroids, changes in creatinine levels can suggest an impact on renal function.
Choice D reason: It is part of the nurse's role to provide information about tests and procedures. Telling a patient to ask the doctor does not offer immediate support or information, which can be important for patient care and understanding.
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