Question

Read scenario II. Then decide which of sentences A – K are correct (there are 6 correct ones) and which are incorrect. Answer questions 13 – 15 as they apply to scenario II. Scenario II:

Over a few years, Ms. Umbridge goes on to develop chronic kidney disease (CKD). Her S&S are numerous, and include edema, SOB, HTN, and pruritis. Choose the correct statements about the patient’s current status.

A. The edema is caused by the pathological retention of Na & water as the diseased tubules lose the ability to appropriately “choose” what to hold onto & what to get rid of.

B. An RN assessing this patient may expect to hear crackles in the lungs due to pulmonary edema related to pathologically increased preload.

C Assessment findings on this patient may include a BP of 180/110 because renin secretion from the JGA is pathologically decreased.

D. In CKD the tubules lose the ability to respond appropriately to aldosterone, resulting in a high preload that contributes to the patient’s edema.

E. Lab results consistent with this patient picture would typically include, for example, a BUN of 29 and creatinine of 1.1. F. Urinalysis results consistent with this patient picture may include low specific gravity because the kidneys lose the ability to concentrate urine appropriately.

G. Because the patient likely has a high BUN, she is considered to be in a state of uremia.

H. In CKD the tubules lose the ability to respond appropriately to aldosterone, resulting in accumulation of aldosterone in the blood; this is called azotemia.

I. The nurse taking care of this patient finds her to be confused and is not surprised, since this symptom is sometimes found in uremic patients.

J. The pruritis is likely due to salt-like deposits of urea on the skin related to the patient’s uremia.

K. Uremic encephalopathy may be seen in this patient as a result of osmotic changes that include shift of fluid from brain cells to the hyperosmolar blood.

13. Which one of the following is correct about the patient in the scenario?

a. G

b. E

c. C

d. D

14. All of the following are correct EXCEPT:

a. A

b. B

c. C

d. I

15. Which one of the following is correct about the patient in the scenario?

a. J

b. H

c. K

d. C

Answer 1

The statements which are correct in the Scenario II are as follows :-

A) The edema is caused by the pathological retention of Na & water as the disease tubules lose the ability to appropriately " choose" what to hold onto & what to hold onto & what to get rid of.

B) An RN assessing this patient may expect to hear crackles in the lungs due to pulmonary edema related to pathological increased preload.

D)In CKD the tubules lose the ability to respond appropriately to aldosterone, resulting in a high preload that contributes to the patient's edema.

F) Urinalysis results consistent with this patient picture may include low specific gravity because the kidneys lose the ability to concentrate urine appropriately.

I) The nurse taking care of this patient finds her to be confused and is not surprised since this symptoms is sometimes found in uremic patients.

J) The pruritis is likely due to salt - like deposits of urea on the skin related to the patient's azotemia.

The statements which are incorrect are :-

C) Assessment findings on this patient may include a BP of 180/ 110 because renin secretion from the JGA is pathologically decreased.

E) Lab results consistent with this patient would typically include , for example , a BUN of 29 and creatinine of 1.1.

G) Because the patient likely has a high BUN , she is considered to be in a state of uremia.

H) In CKD the tubules lose the ability to respond appropriately to aldosterone , resulting in accumulation of aldosterone in the blood ; this is called azotemia.

K) Uremic encephalopathy may be seen in this patient as a result of osmotic changes that include shift of fluid from brain cells to the hyperosmolar blood.

13) Option ( d) is correct. (D)

14) option (c) is correct option.( C)

15) option ( a) is correct. (J)