Exam3 CH26

Impaired skin integrity and skin manifestations are common in persons with chronic kidney disease. Pale skin and subcutaneous bruising are often present as a result of:

Impaired platelet function

Regardless of the cause, chronic kidney disease results in progressive permanent loss of nephrons and glomerular filtration, and renal:

Endocrine functions

A client with a recent diagnosis of renal failure who will require hemodialysis is being educated in the dietary management of the disease. Which of the client's following statements shows an accurate understanding of this component of treatment?

"I've made a list of high-phosphate foods, so that I can try to avoid them."

Which of the following individuals likely faces the greatest risk for the development of chronic kidney disease?

A client with a recent diagnosis of type 2 diabetes who does not monitor his blood sugars or control his diet

The primary care provider for a newly admitted hospital client has added the glomerular filtration rate (GFR) to the blood work scheduled for this morning. The client's GFR results return as 50 mL/minute/1.73 m2. The nurse explains to the client that this result represents:

A loss of over half the client's normal kidney function

A client who has developed stage 3 renal failure has been diagnosed with high phosphate levels. To avoid the development of osteodystrophy, the physician may prescribe a phosphate-binding agent that does not contain:

Aluminum

A client with a long-standing diagnosis of chronic kidney disease has been experiencing increasing fatigue, lethargy, and activity intolerance in recent weeks. His care team has established that his GFR remains at a low, but stable, level. Which of the following assessments is most likely to inform a differential diagnosis?

Blood work for hemoglobin, red blood cells, and hematocrit

As chronic kidney disease progresses, the second stage (renal insufficiency) is identified by:

Decrease in GFR of 60 to 89 mL/minute/1.73 m2

Client and family education regarding peritoneal dialysis should include assessing the client for:

Dehydration that may appear as dry mucous membranes or poor skin turgor

Manifestations of childhood renal disease are varied and may differ from adult-onset renal failure. A school-aged child with chronic kidney disease may exhibit:

Developmental delays such as uncoordinated gait and minimal fine motor skills

A client is beginning to recover from acute tubular necrosis. The nurse would likely be assessing which of the following manifestations of the recovery phase of ATN?

Diuresis

A client with significant burns on his lower body has developed sepsis on the 3rd day following his accident. Which of the following manifestations would the nurse anticipate for an ischemic acute tubular necrosis rather than prerenal failure? The client:

GFR does not increase after restoration of renal blood flow

The nurse is providing care for a client who has a diagnosis of kidney failure. Which of the following laboratory findings is consistent with this client's diagnosis?

Hypocalcemia

Reduced glomerular filtration rate (GFR), with a serum creatinine level that remains in the normal range, is associated with aging because elderly persons tend to have reduced:

Muscle mass

A drug abuser was found unconscious after shooting up heroin 2 days prior. Because of the pressure placed on the hip and arm, the client has developed rhabdomyolysis. The nurse knows this can:

Obstruct the renal tubules with myoglobin and damage tubular cells

While assessing a peritoneal dialysis client in his or her home, the nurse notes that the fluid draining from the abdomen is cloudy, is white in color, and contains a strong odor. The nurse suspects this client has developed a serious complication known as:

Peritonitis

An 86-year-old female client has been admitted to the hospital for the treatment of dehydration and hyponatremia after she curtailed her fluid intake to minimize urinary incontinence. The client's admitting laboratory results are suggestive of prerenal failure. The nurse should be assessing this client for which of the following early signs of prerenal injury?

Sharp decrease in urine output

A client had excessive blood loss and prolonged hypotension during surgery. His postoperative urine output is sharply decreased, and his blood urea nitrogen (BUN) is elevated. The most likely cause for the change is acute:

Tubular necrosis

A client with a diagnosis of chronic kidney disease (CKD) may require the administration of which of the following drugs to treat coexisting conditions that carry a high mortality?

Antihypertensive medications