renal 15

A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the best response by the nurse?

"Even a perfect match does not guarantee organ rejection."

what is the minimum amount of urine needed to rid the body of normal metabolic waste products.

400 mL

Positive Chvostek's sign

sharp tapping over the facial nerves just in front of the parotid gland and anterior to the ear causes spasm or twitching of the mouth nose and eye

Aminoglycerides nephrotoxic drugs

tobramycin neomycin gentamicin

As glomerular filtration decreases, which of the following occurs? Select all that apply.

• Serum creatinine increases • Blood urea nitrogen (BUN) increases • Creatinine clearance decreases

A chronic renal failure client 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

When assessing the impact of medications on the etiology of ARF, the nurse recognizes which of the following as the drug that is NOT nephrotoxic?

Penicillin

Which of the following is the hallmark of the diagnosis of nephrotic syndrome?

Proteinuria exceeding 3.5 g per day

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. I.V. fluid is being infused at 150 ml/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?

Urine output of 250 ml/24 hours

nephrotoxic drugs are

aminoglycerides.

positive Trousseau's sign

carpopedal spasm is induced by occluding the blood flow to the arm for 3 minutes with a blood pressure cuff

Metabolic acidosis occurs in ESKD because the kidneys are unable to

excrete ammonia (NH3-) reabsorb sodium bicarbonate (HCO3-)

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

Calcium

Osteodystrophy is a condition in which

bone becomes demineralized due to hypocalcemia and hyperphosphatemia.

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."

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.

Tall peaked T waves Characteristic ECG signs of hyperkalemia are tall, tented, or peaked T waves, absent P waves, and a widened QRS complex.

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

A nurse identifies a nursing diagnosis of Risk for Ineffective Breathing Pattern related to incision 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 nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?

Fever Fever is an indicator of infection or transplant rejection

The nurse is caring for a patient with ESKD. Which of the following acid-base imbalances is associated with this disorder?

pH 7.20, PaCO2 36, HCO3 14-

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

Citrus fruits Foods and fluids containing potassium or phosphorus ( bananas, citrus fruits and juices, coffee) are restricted.

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.

what causes a positive Chvostek's sign and Trousseau's sign

low serum calcium levels

Hypocalcemiais associated with

abd/muscle cramps stridor carpopedal spasm hyperactive reflexes tetany +Chvostek's or Trousseau's sign tingling of fingers/around mouth ECG changes

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 The nurse will administer 2 tablets per dose (800 mg/400 mg per tablet). The client receives a total of 3 doses per day or 6 tablets (2 tablets per dose x 3 doses).

A client is diagnosed with polycystic kidney disease. Which of the following would the nurse most likely assess?

Hypertension Hypertension is present in approximately 75% of clients with polycystic kidney disease at the time of diagnosis.