kidney

A nurse is monitoring a client following hemodialysis. The nurse should recognize that which of the following factors place the client at risk for seizures

A rapid decrease in fluid bc it can result in cerebral edema and increased icp, placing the client at risk for seizures. This complication is called dialysis disequilibrium syndrome.; hypokalemia places the client at risk for paralysis and coma

A nurse is providing discharge teaching for a client who has chronic kidney disease. Which of the following statemetns should the nurse identify as an indication that the client understands the teaching

A will decrease my intake of foods that are high in phorphorus ; to prevent bone damage

A nurse is planning care for a group of clients. Which of the following clients should the nurse plan to monitor for signs of nephrotoxicity

Aminoglycoside antibiotics can damage the cells of the proximal renal tubules, causing acute tubular necrosis. The nurse should plan to monitor this client for nephrotoxicity and acute kidney injury. gentamycin

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

BUN 100 mg/dL and serum creatinine 6.5

A nurse is reviewing the laboratory report of a client who has acute kidney injury. Which of the following findings should the nurse expect

BUN 30 UO 30 ml in the last 3 hrs hct of 30%

A nurse is caring for a client who has AKI. which of the following serum laboratory findings should the nurse report to the provider

Creatinine 4.0

A nurse is reviewing the medical records of four clinets. the nurse should identify which of the following disorders as a risk factor for chronic pyelonephritis

DM

The nurse is giving discharge instructions to the client following a bladder ultrasound. Which of the statements by the client indicates the client understands the instructions?

I can resume my usual activities without restriction; A bladder ultrasound is a non-invasive procedure.

A nurse is providing teaching to a client who has chronic kidney disease. Which of the following statements by the clien indicates an understanding of the teaching

I will weigh myself every morning

A female client who suffers from urethral strictures undergoes a dilation procedure and experiences a burning sensation while voiding. Which nursing instruction would be the most helpful

Instruct the use of a warm sitz baths Taking warm sitz baths and non-narcotic analgesics can relieve the client's discomfort while voiding.

A nurse is caring for a client immediately following a kidney transplant. The nurse should identify which of the following findings as a possible indication of a delay in functioning of the transplanted kidney

Urine output 30 in the past 2 hours

A nurse in an emergency department is caring for a client who reports costovertebral angle tenderness, nausea, and vomiting. Which of the following lab results should the nurse report to the provmider

WBC 15.000

The nurse observes a client's uric acid level of 9.3 mg/dL. when teaching the client about ways to decrease the uric acid level, which diet would the nurse suggest

a low purine diet; avoid anchovies, animal organs and sardines

What are the clinical manifestations of peritonitis?

abdominal pain, distension, absence of bowel sounds, nausea, and vomiting, fever and changes in vital signs

A client comes to the emergency department complining of severe pain in the right flank, nausea, and vomitting. The physician tentatively diagnoses right ureterolithiasis. When planning care for the client, the nurse should assign the highest priority to which of the fllowing

acute pain

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 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

adminsitration of sodium polystyrene sulfonate (kayexalate); the elevated potassium levels may be reduced by administering cation excahnge resins or by retention enema. kayexalate works by excahnging ions for potassium in the intestinal tract

A nurse is caring for a postoperative client following AV fistula creation in her left arm. Which of the following acitons should the nurse take

auscultate for bruits in the client's fistula every 4 hrs

A nurse is teaching a client who has a new diagnosis of acute pyelonephritis, Which of the following instructions should the nurse include in the teaching

avoid the use of NSAIDS for pain

The nurse is teaching a client how to perform self-catheterization. Which direction should the nurse include

catheterizations hould occur every 4 to 6 hours before bedtime

What are urinary irritants

coffee, tea, alcohol, and colas. It is better to drink fruit juice, milk, and ginger ale

An older adult's most recent laboratory finding indicates a decrease in creatinine clearance. When performing an asessment related to poteintial causes, the nurse should

confirm that all medications and supplements are normally taken.

A nurse is caring for a client who is schedules for an intravenous urography. Which of the following intertions is the nurse's priority

determine if the client has an allergy to shellfish or iodine

A client is in the end stage chronic renal failure and is being added to the transplant list. The nurse explains to the client how donots are found fore clients needing kidneys. Which statement is accurate?

donors are selected from compatible living or deceased donors

A nurse is providing instructions for reducing the dietary intake of potassium to a client who has chronic kidney disease. whcih of the following food selecons shoujld the nurse recommend

foods high in potassium: cantaloupe, spinach, baked potato. The answer is one alrge apple

what acid base imbalance occurs in ESKD

metabolic acidosis ; this is because the kidneys are unable to excrete the loads of acid and cannot excrete ammonia and cannot reabsorb sodium bicarbonate

Which period of acute renal failure is accompanied by an incrwase in the serum concentration of substances ususally excreted by the kidneys

oliguria

retention of which electrolyte is the most lifethreatening effect of renal failure?

potassium ;

A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate. upon detecting an output obstruction, which of the following actions should the nurse take first

Check the irrigation tubing for any kinks

A female client presents to the health clinic for a routine physical examination. The nurse observes that the client's urine is bright yellow. Which questions is most appropriate for the nurse to ask the client?

Do you take multiple vitamin preparations

The nurse is preparing the client for MRI imaging of the kidney. Which statement by the client requires action by the nurse?

I took my blood pressure medication with my morning coffee an hour ago; The client should not eat for at least 1 hour before an MRI. alcohol, caffeine-containing beverages, and smoking should be avoided for at least 2 hours before an MRI. The client can take his or her usual medications except for iron supplements prior to the procedure

The client with PCKD 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; Medical management includes therapies to control blood pressure, urinary tract infections, and pain.

A nurse is planning care for a client who is postoperative following a nephrecotomy. Which of the following assessments is the nurses priority

blood pressure

Common tests of renal function include which of the following?

creatinine clearance renal clearance serum clearance bUN

A nurse is performing an admission assessment of a client who has acute glomerulonephritis. The nurse would expect which of the following findings

dark colored urine

An older adult client is being evaluated for suspected pyelonephritis and is ordered kidney, ureter, and bladder x-ray. The nurse understands the significance of this order is related to which rationale?

detects calculi, cysts, or tumors; urinary obstruction is the most common cause of pyelonephritis

A male client who is admitted with the diagnosis or urianry calculi compains of excrutiating pain. The pain is suspected to be caused by increased pressure in the renal pelvis. Which measure would be most appropriate to provide pain reflief

encourage frequent ambulation

The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client?

hemodialysis; the client is hemodynamically stable

The nurse is caring for a patient in the oliguic phase of AKI. What does the nurse know would be the daily urine output

less than 400 mL

A patient is postoperative day 3 following the successful transplantation of a kidney. THe nurse is aware of the importance of assessing the patient for signs and symptoms of rejection. Consequently, the nurse is constantly monitoring the patient for

oliguria and edema; the nurse should also be aware of edema, fever, increasing blood pressure, weight gain, and swelling or tenderness of the transplant or graft.

A nurse is caring for a client who has nephrotic syndrome and has been taking prednisone for three days. which of the following findings should the nurse report to teh provider as an adverse effect of prednisone

sore throat

A nurse is preparing to assess a client who recieved hemodialysis 1 hr ago. Which of the following assessments should the nurse perform first

vital signs

A client with chronic renal failure is receiving a hemodialysis treatment. The nurse knws that the client is most ikely to experience

weight loss

A nurse is providing education regarding cyclosporine for a client who had a kidney transplant 2 days ago. Which of the following statements should the nurse make

you will need to continue taking this medication to protect your new kidneys

Bladder retraining following removal of an indwelling catheter begins with

instructing the client to follow a 2 to 3 hour time voiding schedule

The nurse working with a client after an ileal condiut notices that the pouching system is a leaking small amounts of urine. WHat is the appropraite nursing intervention

change the wafer and the pouch

A client in a short-procedure unit is recovering from renal angiography in which a femoral puncture site was used. When providing postprocedure care, the nurse shoud

check the client's pedal pulses frequently

A nurse is caring for a client who had a stroke. Which nursing intervention promotes urinary continenct?

encouraging intake of t least 2 L of fluid daily

A nurse is reviewing the medical hx of a client who has end stage kidney disease. The nurse should identify that which of the followng factors in the client's history is a contraindication for recieving hemodialysis

hx of hemophilia

A client with renal dysfunction of acute onset comes to the emergency department complaining of fatigue, oliguria, and coffee-colored urine. When obtaining the client's history to check for significant findings, the nurse should ask about

recent steptococcal infection; a skin or upper respiratory infection of streptococcal origin may lead to acute glomerulonephritis.

A nurse is caring for a client following extracorporeal shock wave lithotripsy for the treatment of calcium phosphate kidney stones. Which of the following actions should the nurse take

strain all of the client's urine to monitor for stone fragments

A nurse is performing an admission assessment of a client who has severe chronic kidney disease. Which of the following findings should the nurse expect

tachypnea dt metabolic acidosis

A client presents to the ED reporting left flank pain and lower abdominal pain. The pain is severe, sharp, stabbing and colick inn nature. THe client has also experienced nausea and emesis. THe nurse suspets the client is experiencing

uretal stones ; The findings are constant with ureteral stones, edema, or stricture, or a blood clot.

The nurse is employed in a urologist's office. Which classification of medication is anticipated for clients having difficulty with urinary incontinence?

anticholinergics because they improve bladder retention, emptying, and control.

A nurse is planning care for a client who is scheduled extracorporeal shock wave lithotripsy to treat urolithiasis. Which of the following acitons should the nurse plan to take

apply electrodes for cardiac monitoring ; The nurse should apply electrodes for continuous monitoring of the client's cardiac rhythm during ESWL. This monitoring allows the provider to synchronize shock waves with the R wave.

A client comes to the clinic for a follow up visit. During the interview, the client states "sometimes when I have to urinate, I can't control it and do not reach the bathroom in time." The nurse suspects that the client is experiencing which type of incontinence

urge; this occurs when the client experiences the sensation to void but cannot control voiding in time to reach the toilet

A nurse is planning care for a client who has acute glomerular nephritis. The nurse should plan to provide which of the following interventions

weight the client daily ; the nurse should monitor for fluid retenion

A nurse is assessing a client who has CKD and has completed her thirs peritoneal dialysis treatment. which of the following findings should the nurse report to the provider

cloudy dialysate effluent ; loudy or opaque drainage is an early manifestation of peritonitis. The nurse should notify the provider immediately, because infection can be a life-threatening complication. The nurse should expect a greater outflow of dialysate fluid. Dialysate fluid is hypertonic; therefore, it draws fluid from the body.

A nurse is teaching a client who has urge urinary incontinence about bladder retraining. which of the following isntructions should the nurse include

increase the intervals between urinarion 15 minutes per day when able to remain continent

A client is prescribed amitryptyline, an antidepressant for incontinenance. The nurse understands that this drug is an effective treatment for which reason? SATA

increases bladder neck resistance, decreases involuntary bladder contractions;

A nurse is planning care for a client who has CKD and a potassium level of 7.3. Which of the following interventions should the nurse plan to take

infuse regular insulin in detrose 10% water

A nurse is obtaining a urine specimen for culture and sensitivity from a client who has manifestations of a UTI. whcih of the following actions should the nruse take

instruct the client to start urinaring then pass the container into the stream

A client with urinary incontinence asks the nurse for suggestions about managing this condition. Which suggestion would be most appropriate?

make sure to eat enough fiber to prevent constipation

A client is scheduled for a renal arteriogram. When the nurse checks the chart for allergies to shellfish or iodine, she finds no allergies recorded. The client is unable to provide the information. During the procedure, the nurse should be alert for which finding that may indicate an allergic reaction to the dye used during the arteriogram?

pruritis; The nruse should be alert for pruritis and urticaria, which may indicate a mild anaphylactic reaction to the dye.

Which condition or alboratory result supports a diagnosis of pyelonephritis

pyuria; pyelonephritis is diagnosed by the presence of pyuria, leukocytosis, hematuria, and bacteriukira. The client exhibits fever, chills, and flank pain.

A nurse in a women's health clinic is caring for a client who reports urinary urgency and dysuria. Which of the following additional findings should the nurse identify as an indication of a UTI

pyuria; wbc in the urine

A nurse is providing teaching to a male client who has a continent internal ileal reservoir following surgery to treat bladder cancer. Which of the following statements should the nurse make?

you must insert a catheter through your stoma to drain the urine