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					                     Handout s for Chapter 33 or Chapter 7

Chapter 33 Quiz

Write the letter of the best answer in the space provided.

______    1.   An extreme failure of kidney function due to nephron loss is called:

               A. acute polynephritis.                            C. chronic nephritis.

               B. chronic renal failure.                          D. end-stage renal failure.

______    2.   Benign prostatic hypertrophy is:

               A. a noncancerous enlargement of the prostate associated with aging.

               B. a noncancerous enlargement of the prostate due to fluid/blood engorgement.

               C. tissue necrosis of the prostate due to decreased perfusion.

               D. infection caused by swelling of the prostate gland, which eventually compresses the

                    urethra.

______    3.   Pain arising in hollow organs such as the ureter and bladder is called:

               A. referred pain.                                  C. rebound pain.

               B. visceral pain.                                  D. inflammatory pain.

______    4.   Besides the OPQRST mnemonic used to obtain information about a patient’s pain, also ask

               about:

               A. changes in bowel habits or stool.               C. chest pain.

               B. weight loss.                                    D. all of these

______    5.   If your patient is suffering from peritonitis, his position of comfort will most likely be:

               A. standing erect.                                 C. seated, leaning forward.

               B. lying prone.                                    D. lying with knees drawn to the chest.
______   6.   Pain induced by percussion of the flanks indicates:

              A. ureter blockage.                              C. bladder infection.

              B. kidney infection.                             D. prostatic enlargement.

______   7.   Patients are considered surgical emergencies if their abdominal pain has lasted longer than:

              A. 24 hours.                                     C. 6 hours.

              B. 12 hours.                                     D. 4 hours.

______   8.   A sudden drop in urine output to less than 400–500 ml per day, or no urine output, is an

              indication of:

              A. renal calculi.                                C. chronic renal failure.

              B. acute renal failure.                          D. acute urinary tract infection.

______   9.   Acute renal failure due to decreased blood perfusion to the kidneys is called:

              A. postrenal ARF.                                C. prerenal ARF.

              B. renal ARF.                                    D. anurimic ARF.

______   10. Common causes of the condition described in question 19 include:

              A. hemorrhage.                                   C. shock.

              B. heart failure.                                D. all of these

______   11. More than half of all cases of end-stage renal failure are caused by hypertension and:

              A. heart failure.                                C. diabetes mellitus.

              B. infections.                                   D. alcoholism.

______   12. The dialysis procedure relying on vascular access to the blood and on an artificial membrane

              is known as:

              A. dialysate.                                    C. peritoneal dialysis.

              B. hemodialysis.                                 D. semipermeable dialysis.
______   13. Benign prostatic hypertrophy is a:

             A. cancerous shrinkage of the prostate.

             B. noncancerous shrinkage of the prostate.

             C. cancerous enlargement of the prostate.

             D. noncancerous enlargement of the prostate.

______   14. Priapism is a painful and prolonged erection of the penis affecting:

             A. only the corpora cavernosa.

             B. only the corpora spongiosum.

             C. both the corpora cavernosa and the corpora spongiosum.

             D. neither the corpora cavernosa and the corpora spongiosum.

______   15. Possible causes of priapism include:

             A. MDMA (ecstasy).                               C. carbon monoxide poisoning.

             B. sickle cell disease.                          D. all of these
CHAPTER 33 SCENARIO

Review the following real-life situation. Then answer the questions that follow.

Highland Medic 6 is dispatched for a sickness at the rest area on U.S. Highway 41. On arrival, they find a

48-year-old male complaining of excruciating pain in his back. He was driving to a vacation site in the

woods when the pain suddenly came upon him. No longer able to drive, he pulled into the rest area, and his

wife used the pay phone to call 911.

     Mr. Clark is a slightly overweight man with a history of gout (for which he takes Zyloprim) and high

blood pressure. Other than the chronic problems, he has been in excellent health until today.

     As the crew attempts to obtain a history on Mr. Clark, he is very restless and will not sit still. He keeps

asking for something for the pain, but the crew tells him that they have nothing to give him. After some

effort, they find that the patient is having difficulty urinating and there is some blood in his urine. The

patient also reports that he has felt very nauseous since the pain started.

     Except for the patient’s obvious distress and slightly elevated vital signs (BP is 150/100 and pulse

105), the crew can find nothing abnormal on their physical exam. The patient is placed in the ambulance

and an IV of normal saline is started and run at 100 mL/hour. The patient is transported to the hospital

without incident.

1.   What is Mr. Clark’s problem and what leads you to that conclusion?

2.   What prehospital treatment is indicated for this condition?

3.   How will this treatment help alleviate the problem?

4.   What will be Mr. Clark’s hospital course and what is his prognosis?
CHAPTER 33 REVIEW

Write the word or words that best complete the following sentences in the space(s) provided.

1.   __________ is the medical specialty dealing with the kidneys.


2.   An extreme failure of the kidneys due to the loss of nephrons is __________-__________ __________

     __________.


3.   The common term for renal calculi is __________ __________.

4.   The noncancerous enlargement of the prostate associated with aging is called __________ __________

     __________.


5.   __________ pain is pain arising in hollow organs such as the ureter and bladder.


6.   Pain felt in a location other than that of its origin is called __________ pain.

7.   Management of the patient with abdominal pain includes the administration of fluids or medication

     only by __________ or __________ routes. Give nothing by __________.

8.   __________ __________ __________ is indicated by the sudden onset of severely decreased urine production, or

     __________; urine output falling to zero is a condition called __________.


9.   Permanently inadequate renal function due to nephron loss is called __________ __________

     __________.


10. __________ dialysis is a dialysis procedure that relies on the peritoneal membrane as the

     semipermeable membrane.

11. __________ is an infection and inflammation of the urinary bladder.

12. UTI management should center on the __________ and __________ __________ .

13. Priapism affects only the __________ __________. The __________ __________ remains flaccid.

14. A __________ is a medical emergency and requires prompt intervention by a urologist to prevent permanent

     damage and penile dysfunction.
15. The __________ __________ maintains blood volume and the proper balance of water, electrolytes, and pH;

    enables the blood to retain key substances such as glucose and removes a variety of toxic wastes from the blood;

    plays a major role in regulation of arterial blood pressure; and controls maturation of red blood cells.
Chapter 33 Answer Key

Handout 33-2: Chapter 33 Quiz

1.   D                6.   B                 11. C

2.   A                7.   C                 12. B

3.   B                8.   B                 13. D

4.   D                9.   C                 14. A

5.   D                10. D                  15. D


Handout 33-3: Chapter 33 Scenario

1.   The problem is a kidney stone, indicated by excruciating back pain of sudden onset, history of gout,

     difficulty urinating, hematuria, nausea, and anxiousness/restlessness.

2.   Treatment is to make the patient as comfortable as possible, provide pain relief as directed by medical

     control, and provide IV fluids.

3.   The IV fluids will cause dilation of the ureter and help facilitate passage of the stone.

4.   The hospital will provide pain relief and fluids to help pass the stone. If it doesn’t pass, they will use

     lithotripsy to break up the stone or surgery to remove the stone. Prognosis is good, but possible

     complications include inflammation, infection, and partial or total urinary obstruction.

Handout 33-4: Chapter 33 Review

1.   Nephrology

2.   end-stage renal failure

3.   kidney stones

4.   benign prostatic hypertrophy

5.   Visceral

6.   referred
7.   IV, IM, mouth

8.   Acute renal failure, oliguria, anuria

9.   chronic renal failure

10. Peritoneal

11. Cystitis

12. ABCs, circulatory support

13. corpora cavernosa, corpora spongiosum

14. priapism

15. urinary system