NUR 810 Exam 1 - Correct Answers Rated A+ Nephrotic syndrome: De...

NUR 810 Exam 1 Newest Latest Update Questions and Correct Answers Rated A+

Nephrotic syndrome: Definition -ANSWER--Kidney filtration disorder

where too much protein is filtered out of the blood -Results in hypoalbumin, edema, and hyperlipidemia

Nephrotic syndrome: Casue -ANSWER-Congenital

Secondary Idiopathic (Most common)

What is the most common cause of idiopathic nephrotic syndrome? - ANSWER-Minimal change disease

What is the presentation of minimal change disease? -ANSWER-> 6 years old, < 12 years old Edema Proteinuria No hematuria No HTN Normal renal function

Common causes of nephrotic syndrome -ANSWER-Infectious -Hep B -Hep C -HIV -Malaria -Post-strep GN or Post-infectitious GN

Drugs

-NSAIDS

-Comitrinate

Immunologic/Allergic Disorders -SLE -HSP -DM -Allergic reactions

Malignancies -Leukemia -Lymphoma

Genetic Disorders -SSD -Alagille Syndrome Charcot-Marie-Tooth Mitochondrial disorders

Glomerular hyperinfiltration

What is the presentation of nephrotic syndrome? -ANSWER--Edema (number one S/S) -Can be mistaken for an allergic reaction bc it commonly starts around the eyes -Edema is gravity dependent and will move to the sacral areas and lower extremities (soft and non-pitting) -HTN -Increase wt -Impaired immune system -Hypoalbumin

How is nephroitic syndrome diagnosed and what labs should you get?-ANSWER-Based upon clinical suspicion in the presence of edema, hypoalbumin, and proteinuria

Urine dipstick that would be + for protein

24-hour urine collection -Will show >50mg/kg of protein per day

Protein/creatinine ratio for first morning void

• Will show >300mg protein per mmol of creatinine

Serum albumin -<2.5

Complement levels might be elevated (specifically C3)

FLP -Might see elevated cholesterol levels

***Consider ANA to r/o SLE or Hep B, C, or HIV test to r/o cause

Who is considered for a renal biopsy in children with nephrotic syndrome? -ANSWER-Children over the age of 12 bc they are at risk for focal segmental glomerulosclerosis or minimal change disease

Nephrotic syndrome: TX -ANSWER-Steroids

-2 mg/kg/day (max of 80/day) for 4-6 weeks then 1.5 mg/kg/day for 2-

• mos

-Can be divided BID or TID

GI prophylaxis

NA restric to 1500-2000 mg/day

Pts with severe edema might need 25% albumin followed by a loop diuretic

BP meds to manage HTN -1st line tx is with loop diuretics and if unresponsive, can add on an Ace or ARB

Monitor for relapse

How long do you treat nephrotic syndrome -ANSWER-Until the reach remission

What is considered remission? -ANSWER-3 Consecutive zero trace protein via urine dip stick or a Pr/cre reatio of < 0.2

What is a risk associated with nephrotic syndrome? -ANSWER-Kids are at risk for infection from incapsulated organisms r/t immune system involvement

What are the bacteria that these pts are at risk of acquiring? - ANSWER-Strep pneumo Neisseria

• flu

What is nephritis? -ANSWER-Inflammation within the kidney and is often used interchangeably with glomerulonephritis

What are the 4 categories of nephritis commonly seen in hospitalized pts? -ANSWER-Asymptomatic hematuria