PATHOS EXAM 3

The nurse is caring for a client who has had acute blood loss from ruptured esophageal varices. What does the nurse recognize is an early sign of prerenal failure?

Baseline urine output of 50 mL/hr that is now 10 mL/hr

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed: a. Adult-onset medullary cystic disease b. Acute nephritic syndrome c. Acute postinfectious glomerulonephritis d. Autosomal recessive polycystic kidney disease (ARPKD)

Acute postinfectious glomerulonephritis

Chronic kidney disease impacts many systems in the body. What is the most common hematologic disorder caused by CKD?

Anemia

In addition to progressive permanent loss of nephrons, chronic kidney disease can result in which other consequence? You Selected: Tubule dysplasia Correct response: Loss of endocrine functions Explanation:

Chronic kidney disease results in loss of nephrons, tubule, and endocrine functions such as erythropoietin production.

Which conditions have the potential to cause chronic kidney disease? Select all that apply. Diabetes Cardiomyopathy Glomerulonephritis Hypertension

Diabetes Glomerulonephritis Hypertension

What is the most common cause of a lower urinary tract infection?

E. coli

The nurse caring for four male clients recognizes which client is at highest risk for developing postrenal kidney failure? You Selected: Client with intratubular obstruction Correct response: Client with prostatic hyperplasia

Explanation: The most common cause of postrenal kidney failure is prostatic hyperplasia. Postrenal failure results from conditions that obstruct urine outflow. The obstruction can occur in the ureter, bladder, or urethra. Intratubular obstruction and acute pyelonephritis are intrarenal causes of kidney failure, and severe hypovolemia is a prerenal cause.

During an assessment of an older adult client, the nurse notes an increase in pulse and respiration rates, and notes that the client has warm skin. The nurse also notes a decrease in the client's blood pressure. Which medical diagnosis may be responsible? hypovolemia edema circulatory overload hypervolemia

Hypovolemia

A client in renal failure has marked decrease in renal blood flow caused by hypovolemia, the result of gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which form of acute renal injury does this client have?

PRE-failure

Which assessment finding would lead the nurse to suspect the client has developed nephrotic syndrome?

Proteinuria and generalized edema

An obese client with a history of gout and a sedentary lifestyle has been advised by the primary health care provider to avoid organ meats, certain fish, and other foods that are high in purines. This treatment would be advised for which type of kidney stones?

Uric acid stones

What are appropriate interventions in the care of a client diagnosed with renal calculi? Select all that apply.

You Selected: Addressing the client's pain Straining the client's urine Keeping track of intake and output

Select the manifestations of renal cell carcinoma. Select all that apply.

You Selected: Hematuria Often silent in the early stages Palpable flank mass

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

You Selected: Increased blood pressure

A pregnant woman who is beginning her third trimester has been diagnosed with a urinary tract infection (UTI). Which factors most likely predisposed this client to the development of a UTI?

You Selected: Increased urine alkalinity during pregnancy Correct response: Dilation of the upper urinary structures Explanation: Normal changes in the functioning of the urinary tract that occur during pregnancy predispose to UTIs. T

The nurse recognizes that acute renal injury is characterized by which of the following?

You Selected: Low incidence of mortality Correct response: Rapid decline in renal function

A 9-year-old boy has just been diagnosed with the nephritic syndrome. The first stage of his disease will result in:

You Selected: increased permeability to proteins. Correct response: glomerular damage

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

Most common uncomplicated urinary tract infections are caused by ____ that enter through the urethra.

e. coli

The nurse is reviewing the laboratory results for a client. Which laboratory findings would the nurse correlate with nephrotic syndrome?

elevated urine protein level (>3.5 g/day) and hypoalbuminemia

Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

hematuria

Unilateral obstruction of the urinary tract may result in renin secretion, thereby leading to which manifestation?

increased BP

A client sustained acute tubular injury approximately 2 hours ago. Which cause of acute kidney injury (AKI) would the nurse suspect the client is experiencing?

intrrenal

An 86-year-old client is being treated for dehydration and hyponatremia after curtailing fluid intake to prevent urinary incontinence. Given these findings, the nurse recognizes that this client is likely in what phase of acute kidney injury?

prerenal

Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client:

will not undergo an acute kidney injury by decreasing renal blood flow.

Prior to undergoing diagnostic testing with contrast, it is recommended that older adult clients have their creatinine level checked. The rationale for this is to ensure the client: a. does not have a kidney stone obstructing the urethra. b. is not allergic to shell fish or iodine. c. will not undergo an acute kidney injury by decreasing renal blood flow. d. is in good enough health to withstand a walking on a treadmill.

will not undergo an acute kidney injury by decreasing renal blood flow.