Certified Nephrology Nurse Flashcards

Cease having dialysis. Which of the following claims regarding their choice is true?

Answer: If the patient decides to withdraw from dialysis, it is not considered euthanasia

Patients have the fundamental right to autonomy and can refuse or withdraw from medical treatment, even life-sustaining therapies like dialysis, at any point. This decision is considered an exercise of patient rights and is distinct from euthanasia, which involves a physician actively administering a lethal substance to end a patient's life. Withdrawing from treatment is a passive act of allowing the natural course of illness to proceed.

Which of the following statements about acute renal failure would be judged to be the most accurate?

Answer: Acute renal failure comes on suddenly and typically lasts only a short period

Acute renal failure (ARF), also known as acute kidney injury (AKI), is characterized by a sudden and rapid decline in kidney function. Unlike chronic kidney disease, which develops slowly over months or years, ARF typically has an abrupt onset and can often be reversible with timely and appropriate medical intervention, meaning its duration is usually short-term.

What are the three layers of the glomerular membrane made up of?

Answer: All of the above

The glomerular membrane, which functions as the primary filtration barrier in the kidneys, is intricately composed of three distinct layers. These layers are the fenestrated endothelial cells of the glomerular capillaries, the glomerular basement membrane (GBM), and the podocytes (epithelial cells) that form the visceral layer of Bowman's capsule. All three layers work together to regulate the passage of substances from blood into the filtrate.

For more than 30 years, renal replacement therapy (RRT) has been in use. Which of the following is accurate for the approximate mortality rate of the patient with ARF (acute renal failure) despite the time this therapy has been used?

Answer: 50%

Despite significant advancements in renal replacement therapy (RRT) over several decades, the mortality rate for patients experiencing acute renal failure (ARF) remains remarkably high. Clinical studies and data consistently indicate that approximately 50% of patients, particularly those with severe ARF or in critical care settings, do not survive, underscoring the serious nature and challenges in treating this condition.

Which of the following would be valid with using EPO (epoetin alfa) during hemodialysis?

Answer: To stimulate red blood cell production

Epoetin alfa (EPO) is a synthetic form of erythropoietin, a hormone naturally produced by healthy kidneys. In patients with chronic kidney disease, the damaged kidneys often fail to produce sufficient erythropoietin, leading to anemia. Administering EPO during hemodialysis stimulates the bone marrow to produce red blood cells, effectively treating or preventing anemia and improving patient well-being.

Which would be the best test to establish whether a person's kidneys operate within normal ranges?

Answer: Glomerular filtration rate

The Glomerular Filtration Rate (GFR) is widely considered the most accurate and comprehensive measure of overall kidney function. It estimates the volume of blood filtered by the glomeruli per unit of time, directly reflecting the kidneys' ability to remove waste products. While serum creatinine is a component used in GFR calculations, the GFR itself provides a more precise assessment of kidney health than isolated blood markers.

Which of the following assertions regarding renal illness is not true?

Answer: Being over the age of 40 is considered a risk factor

While kidney function naturally declines with age, being over the age of 40 itself is not typically classified as a primary risk factor for developing kidney disease. Instead, major risk factors include conditions like hypertension (high blood pressure) and diabetes mellitus, which can damage the kidneys over time. Other significant risk factors include heart disease and a family history of kidney failure.