Which of the following would NOT be a cause of prerenal failure?
Hemorrhage (bleeding out)
Cirrhosis
Kidney disease
Narrowing of the blood vessels leading to the kidneys
The Correct Answer is C
A. Hemorrhage: Hemorrhage leads to significant blood loss, resulting in decreased blood volume and reduced renal perfusion, which is a common cause of prerenal acute kidney injury (AKI).
B. Cirrhosis: Cirrhosis can cause systemic vasodilation and reduced effective circulating volume, leading to decreased renal blood flow and prerenal failure due to impaired kidney perfusion.
C. Kidney disease: Kidney disease itself is an intrinsic (renal) cause of kidney failure, involving direct damage to the kidney tissue, rather than prerenal failure caused by decreased perfusion.
D. Narrowing of the blood vessels leading to the kidneys: Renal artery stenosis reduces blood flow to the kidneys, causing prerenal failure by impairing kidney perfusion despite adequate circulating volume.
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Related Questions
Correct Answer is B
Explanation
A. Atrophy of the remaining kidney: In cases of unilateral kidney loss, the remaining kidney typically does not atrophy but instead adapts to compensate for the lost function. Atrophy would be unlikely unless there is an underlying disease affecting the remaining kidney.
B. Compensatory hypertrophy of the remaining kidney: When one kidney is removed or nonfunctional, the remaining kidney often undergoes compensatory hypertrophy, increasing in size and function to handle the body's metabolic needs. This process helps maintain adequate renal function despite loss of one kidney.
C. Renal failure: While loss of one kidney reduces overall renal mass, a healthy remaining kidney usually compensates sufficiently to prevent renal failure. Renal failure is unlikely unless the remaining kidney has preexisting damage or disease.
D. Dysplasia in the remaining kidney: Dysplasia refers to abnormal development or growth of tissue, typically congenital. It is not an expected response to removal of the opposite kidney. The remaining kidney usually develops normally unless affected by a congenital abnormality.
Correct Answer is []
Explanation
Potential Condition: Hepatic Encephalopathy
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The client has very high ammonia levels (236 mcg/dL), elevated liver enzymes, and low albumin, all pointing toward hepatic encephalopathy. Additional signs include a history of alcohol abuse, cirrhosis, and altered liver function, which commonly contribute to ammonia accumulation and neurotoxicity.
Actions to Take:
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Administer lactulose: Helps lower serum ammonia by promoting its excretion via the GI tract.
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Assess for asterixis: A classic sign of hepatic encephalopathy characterized by a flapping tremor of the hands.
Parameters to Monitor:
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Neurologic status: To detect changes in mental status or worsening encephalopathy.
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Safety measures: Clients with hepatic encephalopathy are at high risk for confusion, falls, and injury, necessitating close supervision and safety interventions.
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