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CNN Exam Flashcard Study System: CNN Test Practice Questions and Review for the Certified Nephrology Nurse Exam (2020)

CNN Exam Flashcard Study System: CNN Test Practice Questions and Review for the Certified Nephrology Nurse Exam (2020) is your go-to guide for passing the exam, covering critical concepts, solved problems, and exam-style questions.

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam Detail the arterial and venous circulation of the kidneys and explain the role of the vasa recta and peritubular capillaries.

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    Concepts of Kidney Disease The kidneys receive up to 25% of resting cardiac output. These highly vascular organs process an average of 1000 ml/min of blood. Circulation to each kidney begins with the renal artery, which branches from the abdominal aorta. The renal artery divides into interlobar arteries, which in turn supply the arcuate arteries. Interlobular arteries branch from the arcuates and further divide into afferent arterioles, which then become glomerular capillaries. The glomerular capillaries then merge to form efferent arterioles that disperse into vasa recta and peritubular capillaries. · The vasa recta (straight arterioles) and their branches surround the loops of Henle of the juxtamedullary nephrons in the renal medulla, where they function to maintain the concentration gradient of the urine. · The tiny peritubular capillaries lie adjacent to the nephrons permitting tubular secretion and reabsorption to take place.

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam Describe in detail the functions of a normal kidney.

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    Concepts of Kidney Disease Normal kidneys perform several functions including the following: · Excretion of waste products of metabolism, including urea, uric acid, and water · Maintenance of acid/base balance (pH) · Regulation of plasma volume and blood pressure · Maintenance of electrolyte balance · Production (synthesis) of hormones, including erythropoietin (which stimulates erythrocyte production in response to low levels of O 2 ) , renin (which regulates aldosterone), and calcitriol (which promotes the absorption of calcium) · Reception of hormones, including antidiuretic hormone (ADH) produced by the pituitary, which enhances water reabsorption; aldosterone (from the adrenal cortex), which causes the kidneys to retain water and sodium (increasing the b/p); and parathyroid hormone (produced by the parathyroid glands), which increases the calcium: phosphate ratio and results in an increase in calcium in the blood.

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam Define and list the five stages of chronic kidney disease.

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    Concepts of Kidney Disease Stage I —Glomerular filtration rate > 90 ml/min/1.73 m 2 Stage II —Glomerular filtration rate between 60 – 90 ml/min/1.73 m 2 Stage III —Glomerular filtration rate between 30 – 60 ml/min/1.73 m 2 Stage IV —Glomerular filtration rate between 15 – 30 ml/min/1.73 m 2 Stage V —Glomerular filtration rate <15 ml/min/1.73 m 2 (needs dialysis)

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam Define chronic kidney disease.

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    Concepts of Kidney Disease According to the National Kidney Foundation, chronic kidney disease is defined as those patients with glomerular filtration rates of less than 60 ml/min/1.73 m 2 for greater than 3 months. The reasoning behind this is that at a GFR of less than 60, approximately half of the nephrons have been damaged. This is also the GFR where manifestations of chronic kidney disease begin to manifest including anemia, early bone disease, and establishes an increased risk for coronary artery disease.

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam List the major risk factors for chronic kidney disease.

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    Concepts of Kidney Disease The major risk factors for chronic kidney disease include: · diabetes mellitus · hypertension · hyperlipidemia · smoking These are preventable and very treatable causes of both initiating and progressing kidney disease. They are also the most widely prevalent and present the greatest risk to public health. Other less common risk factors include: · autoimmune diseases (chiefly systemic lupus erythematosus) · chronic urinary tract infections · age, renal stones · systemic infections · family history

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam Screening for CKD is necessary for any patient considered in the high-risk category. Explain the American Diabetes Association (ADA) recommendations for screening and discuss other groups that should be evaluated. Describe the tests used to detect abnormal kidney function.

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    Concepts of Kidney Disease Kidney function and an evaluation of proteinuria are both important in assessing a patient for CKD. Since diabetics are at high risk for developing CKD, the American Diabetes Association (ADA) recommends that all patients diagnosed with type 2 diabetes be tested for microalbuminuria at the time of diagnosis. Type 1 diabetics should be tested 5 years after the initial evaluation. Any patient with hypertension or heart disease or who is in any other high-risk group should have routine examinations for kidney involvement. The dipstick test for albumin and blood cells is the first step in analyzing the patient for kidney disease. If positive for albumin, the next step is a protein- creatinine ratio test. If the dipstick is positive for blood or white cells, a more comprehensive microscopic analysis needs to be done.

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam Describe how metabolic acidosis occurs in patients with chronic kidney disease.

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    Concepts of Kidney Disease The kidneys are involved in excreting broken down proteins . Proteins break down into their component parts, which are amino acids. Amino acids are, in fact, acids. They are largely buffered in the bloodstream via the presence of the ubiquitous base bicarbonate. When renal failure ensues, the ability to excrete amino acids is hindered. With amino acid build up, the bicarbonate buffer is also exhausted. Therefore, the amino acid build up contributes to the acidosis present in all patients with chronic kidney disease. Renal replacement therapy with appropriate dialysate solutions aids in eliminating the acidosis. Thus, before each dialysis treatment patients are acidotic. Following dialysis, patients should ideally return to neutrality or a pH of 7.4.

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    Concepts of Kidney Disease © Mometrix Media - flashcardsecrets.com/cnn CNN Exam List the most common genetic diseases that can cause chronic renal disease.

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