Ch 54

A patient admitted with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What deficit does the nurse suspect the patient has?

Calcium

The nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium?

Citrus fruits

What is a characteristic of the intrarenal category of acute kidney injury (AKI)?

Increased BUN

When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?

Tea-colored urine

A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:

fatigue and weakness.

The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with this disorder?

pH 7.20, PaCO2 36, HCO3 14-

A client has been diagnosed with acute glomerulonephritis. This condition causes:

proteinuria.

A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?

Encourage use of incentive spirometer every 2 hours.

Which of the following causes should the nurse suspect in a client diagnosed with intrarenal failure?

Glomerulonephritis

The nurse recognizes which condition as an integumentary manifestation of chronic renal failure?

Gray-bronze skin color

A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?

Hyperphosphatemia

What is a hallmark of the diagnosis of nephrotic syndrome?

Proteinuria

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?

Recent history of streptococcal infection

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:

"As the disease progresses, you will most likely require renal replacement therapy."

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

"It is appropriate to warm the dialysate in a microwave."

An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?

"This type of dialysis will provide more independence."

The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL?

1,000 mL

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate [Kayexalate])

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?

Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?

Decrease in the blood flow through the kidneys

The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure?

Dehydration

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?

Risk for infection

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client?

SpO2 at 90% with fine crackles in the lung bases

The nurse is caring for a client with chronic kidney disease. The patient has gained 4 kg in the past 3 days. In milliliters, how much fluid retention does this equal? Enter your response as a whole number.

4000

Sevelamer hydrochloride (Renagel) has been prescribed for a client with chronic renal failure. The physician has prescribed Renagel 800 mg orally three times per day with meals to treat the client's hyperphosphatemia. The medication is available in 400 mg tablets. How many tablets per day will the nurse administer to the client?

6

A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?

A GFR of 30-59 mL/min/1.73 m2

The nurse is caring for a patient with a medical history of untreated CKD that has progressed to ESKD. Which of the following serum values and associated signs and symptoms will the nurse expect the patient to exhibit? Select all that apply.

Calcium 7.5 mg/dL; hypotension and irritability Potassium 6.4 mEq/L; dysrhythmias and abdominal distention Phosphate 5.0 mg/dL; tachycardia and nausea and emesis

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?

Hypovolemic shock caused by hemorrhage

The nurse cares for a client who underwent a kidney transplant. The nurse understands that rejection of a transplanted kidney within 24 hours after transplant is termed:

hyperacute rejection.

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?

Azotemia

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?

Urine output of 20 ml/hour

A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis?

Wear a mask when performing exchanges.

Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?

Fever

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?

Blood urea nitrogen (BUN) 100 mg/dL and serum creatinine 6.5 mg/dL

The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition?

Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20.

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?

The kidneys can improve over a period of months.

A patient is placed on hemodialysis for the first time. The patient complains of a headache with nausea and begins to vomit, and the nurse observes a decreased level of consciousness. What does the nurse determine has happened?

The patient is experiencing a cerebral fluid shift.

Which of the following is the most accurate indicator of fluid loss or gain?

Weight

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?

White blood cell (WBC) count of 20,000/mm3

One of the roles of the nurse in caring for clients with chronic renal failure is to help them learn to minimize and manage potential complications. This would include:

restricting sources of potassium usually found in fresh fruits and vegetables.