Renal EAQs
To prepare for hemodialysis, a client schedules his or her surgical procedure for an internal arteriovenous fistula in one arm and placement of an external arteriovenous shunt in the other arm. Which considerations would the nurse integrate into this client's postoperative plan of care? a: The graft has a higher risk of hemorrhage, clotting, and infection than the fistula does. b: Staff will obtain blood pressure readings from the arm with the fistula, but not the one with the shunt. c: Administer intravenous (IV) fluids in the arm with the shunt, but not the one with the fistula. d: Cover the fistula with a light dressing, and cover the shunt thoroughly with a heavy dressing.
a: The graft has a higher risk of hemorrhage, clotting, and infection than the fistula does.
A client reports swelling of the scrotum with no pain. Which condition would the nurse anticipate in the client? a) Chancroid b) Hydrocele c) Spermatocele d) Incarcerated hernia
b) Hydrocele Unilateral or bilateral swelling of the scrotum without pain is a clinical manifestation of a hydrocele; therefore this is what the nurse anticipates the client to have. Chancroid manifests as papular or irregularly shaped nonindurated, pus-filled ulcers on the penis. A translucent, wormlike appearance of the scrotum is a characteristic of spermatocele. Swelling and pain in the scrotum are the clinical manifestations of incarcerated hernia.
The nurse teaches a group of student nurses about the function of the loop of Henle. Which function would the nurse include? a) Secretion of ammonia in the descending limb b) Secretion of hydrogen in the descending limb c) Reabsorption of sodium in the ascending limb d) Reabsorption of water in the ascending limb
c) Reabsorption of sodium in the ascending limb
A client fears pregnancy despite the use of oral contraceptives. The nurse anticipates that which blood test will be prescribed? a) Prolactin test b) Testosterone test c) Progesterone test d) Human chorionic gonadotropin (hCG) test
d) Human chorionic gonadotropin (hCG) test
A client is diagnosed with a pathology in the medulla of the kidney. Which part of the nephron is the region affected by the pathology?
The descending loop of Henle (D) is located in the medulla of the kidney. The loop of Henle is most probably affected by the pathology. The Bowman capsule (A) is located in the cortex of the kidney, the glomerulus (B) is a part of the nephron that lies in the cortex of the kidney, and the distal convoluted tubule (C) of the nephron is also located in the cortex.
Which hormone elevations indicate Turner syndrome? Select all that apply. One, some, or all responses may be correct. a) Lutropin b) Prolactin c) Follitropin d) Testosterone e) Progesterone
a) Lutropin c) Follitropin Elevation of lutropin and follitropin indicates Turner syndrome. Elevation of prolactin indicates possible galactorrhea, pituitary tumor, disease of hypothalamus or pituitary gland, and hypothyroidism. Elevated testosterone levels in women indicate adrenal neoplasm, ovarian neoplasm, and polycystic ovary syndrome. Elevated progesterone levels in men indicate possible testicular tumors and hyperthyroidism. Elevated progesterone levels in women indicate possible ovarian luteal cysts.
The primary health care provider suspects pituitary gland dysfunction in a female client. The nurse anticipates that which diagnostic test will be prescribed? a) Estradiol test b) Prolactin test c) Postcoital test (PCT) d) Papanicolaou (Pap) test
b) Prolactin test A prolactin test is used to detect pituitary gland dysfunction that causes amenorrhea. The primary health care provider would suggest that the client have a prolactin test to determine if the client does or does not have any pituitary gland dysfunction. Estradiol is tested to determine functioning of the ovaries. In men the estradiol test is used to detect testicular tumors. The Postcoital test (PCT) is used to evaluate the hostility of the cervix for passage of sperm from the vagina into the uterus. The Pap test detects malignancies, particularly cervical cancer.
Which information would the nurse include in response to a client's questioning a protein-restricted dietary change required for his or her acute kidney injury? a: 'A high-protein intake ensures an adequate daily supply of amino acids to compensate for losses.' b: 'Essential and nonessential amino acids are necessary in the diet to supply materials for tissue protein synthesis.' c: 'This diet supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.' d: 'Currently, your body is unable to synthesize amino acids, so the nitrogen for amino acid synthesis must come from the dietary protein.'
c: 'This diet supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.' The amount of protein permitted in the diet depends on the extent of kidney function; excess protein causes an increase in urea concentration, excess metabolic waste, and added stress on the kidneys. The restricted protein diet prevents overburdening the client's kidneys at this time. When experiencing acute kidney injury, the kidneys are unable to eliminate the waste products of a high-protein diet. The body is able to synthesize the nonessential amino acids. Urea is a waste product of protein metabolism; the body is able to synthesize the nonessential amino acids.
