For each condition, click to specify whether the condition causes a pre-renal, intra-renal, or post-renal acute kidney injury.
Nephrotoxic drugs
Kidney stones
Severe blood loss
Pyelonephritis
Bladder tumor
The Correct Answer is {"A":{"answers":"C"},"B":{"answers":"C"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"C"}}
|
Conditions |
Pre-renal |
Intra-renal |
Post-renal |
|
Nephrotoxic drugs |
|
✔ |
|
|
Kidney stones |
|
|
✔ |
|
Severe blood loss |
✔ |
|
|
|
Pyelonephritis |
|
✔ |
|
|
Bladder tumor |
|
|
✔ |
• Nephrotoxic drugs: Certain medications, such as aminoglycosides or NSAIDs, can directly damage renal tubular cells, causing intra-renal AKI. The injury occurs within the kidney itself, leading to impaired filtration and tubular dysfunction. Intra-renal AKI may result in elevated creatinine and reduced urine output.
• Kidney stones: Obstruction of urine flow by stones in the ureters or bladder increases back pressure on the kidneys, resulting in post-renal AKI. This prevents normal urine excretion and can cause hydronephrosis. Removal of the obstruction typically resolves the AKI if detected early.
• Severe blood loss: Pre-renal AKI occurs when decreased renal perfusion reduces glomerular filtration rate (GFR) without direct kidney damage. Severe blood loss leads to hypovolemia, lowering renal perfusion pressure. This triggers compensatory mechanisms like renin-angiotensin activation but can progress to ischemic injury if not corrected.
• Pyelonephritis: Acute pyelonephritis is an infection of the renal parenchyma that causes inflammation and tubular injury. This leads to intra-renal AKI because the kidney tissue itself is affected. The infection disrupts normal filtration, reabsorption, and secretion functions of the nephrons.
• Bladder tumor: A tumor in the bladder can obstruct urinary outflow, leading to increased intratubular pressure and post-renal AKI. Persistent obstruction impairs renal function and may cause hydronephrosis or renal parenchymal damage. Relieving the obstruction is key to restoring renal function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Peripheral vascular disease:Peripheral vascular disease primarily affects arteries supplying the extremities, leading to reduced blood flow to the limbs. Although it reflects systemic atherosclerosis risk, it does not directly impair coronary artery blood flow. Myocardial perfusion depends specifically on coronary circulation rather than peripheral vessels.
B. Deep vein thrombosis:Deep vein thrombosis involves clot formation in the deep venous system, usually in the lower extremities. It affects venous return rather than arterial supply and does not interfere with coronary artery perfusion. While complications such as pulmonary embolism can occur, DVT does not directly reduce myocardial blood flow.
C. Rheumatoid arthritis:Rheumatoid arthritis is a chronic autoimmune inflammatory disorder affecting synovial joints. Although long-term inflammation may increase cardiovascular risk, it does not directly cause acute impairment of coronary blood flow. Myocardial perfusion is not immediately compromised by joint inflammation.
D. Coronary artery vasospasm:Coronary artery vasospasm causes transient constriction of the coronary arteries, reducing or temporarily blocking blood flow to the myocardium. This decrease in oxygen delivery can result in ischemia, chest pain, and ECG changes. Reduced coronary lumen diameter directly impairs myocardial perfusion.
Correct Answer is ["B","C","D","E"]
Explanation
A. Cramping and diarrhea:Cramping and diarrhea are gastrointestinal symptoms and are not typical warning signs of a myocardial infarction. While some cardiac events can cause nausea, generalized GI cramping and diarrhea are not reliable indicators of cardiac ischemia.
B. Sudden dyspnea:Sudden shortness of breath can occur during a myocardial infarction due to left ventricular dysfunction, pulmonary congestion, or reduced oxygen delivery. Dyspnea may be an early or primary symptom, especially in women, older adults, or those with diabetes.
C. Anxiety and fear:Anxiety, restlessness, or a sense of impending doom is a common neuropsychological response to myocardial ischemia. It results from sympathetic nervous system activation in response to cardiac stress and inadequate perfusion.
D. Excessive sweating:Diaphoresis is a classic autonomic response to myocardial infarction, caused by sympathetic activation. It is often cold and clammy, reflecting the body’s stress response and perfusion compromise.
E. Chest pressure:Chest discomfort, pressure, tightness, or pain is the hallmark symptom of myocardial infarction. It typically occurs in the substernal region and may radiate to the arm, jaw, neck, or back, indicating myocardial ischemia and injury.
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