Renal stuff

How many mls in an ounce?

26

A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication? A. Hematocrit of 33% B. Platelet count of 400,000 C. White blood cells 6,000 D. Blood urea nitrogen level of 15

A - Epoetin alfa is a synthetic erythropoietin, which the kidneys produce to stimulate red blood cell production in the bone marrow. It is used to treat anemia associated with chronic kidney disease. The normal hematocrit level is 42-52% male, 37-47% female. Therapeutic effect is seen when the hematocrit reaches between 30-33%

The client is admitted to the emergency department after a gunshot wound to the abdomen. Which nursing intervention shoudlt eh nruse implement first to prevent acute renal failure (ARF)? A. Administer normal saline IV B. Take vital signs C. Place client on telemetry D. Assess abdominal dressing

A - Preventing and treating shock with blood and fluid replacement will prevent actue renal failure from hypoperfusion fo the kidneys. Significant blood loss is expected in the client with a gunshot wound.

The nurse is planning postprocedure care for a client who received hemodialysis. Which of the following interventions should the nurse include in the plan of care? (Select all that apply) A. Check BUN and serum creatinine B. Administeer medications the nurse withheld prior to dialysis C. Observe for signs of hypovolemia D. Assess the access site for bleeding E. Evaluate blood pressure on the arm with AV access

A,B,C,D A - The nurse should check the BUN and serum creatinine to determine the presence and degree of uremia or waste products that remain following dialysis B - The nurse should withhold medications the treatment can partially dialyze. After the treatment, the nurse should administer the medications. C - A client who is post-dialysis is at risk for hypovolemia due to a rapid decrease in fluid volume. D - The nurse should assess the access site for bleeding because the client receives heparin during the procedure to prevent clotting of the blood.

A nurse is planning care for a client who has Stage 4 chronic kidney disease. Which of the following actions should the nurse include in the plan of care? (Select all that apply) A. Assess for jugular vein distention B. Provide frequent mouth rinses C. Auscultate for a pleural friction rub D. Provide a high-sodium diet E, Monitor for dysrhythmias

A,B,C,E A - The nurse should assess for jugular vein distention, which can indicate fluid overload and heart failure. B - The nurse should provide frequent mouth rinses due to uremic halitosis caused by urea waste in the blood. C - The nurse should auscultate for a pleural friction rub related to respiratory failure and pulmonary edema. E - The nurse should monitor for dysrhythmias related to increased serum potassium caused by Stage 4 chronic kidney disease.

A nurse is preparing to initiate hemodialysis for a client who has acute kidney injury. Which of the following actions should the nurse take? (select all that apply) A. Review the medications the client currently takes B. Assess the AV fistula for a bruit C. Calculate the client's hourly urine output D. Measure the client's weight E. Check serum electrolytes F. Use the access site area for venipuncture

A,B,D,E A - By reviewing the medications the client currently takes, the nurse can determine which medications to withhold until after dialysis B - Assessing the AV fistula for a bruit determines the patency of the fistula for dialysis D - Measuring the client's weight before dialysis is essential for comparing it with the client's weight after dialysis E - Checking the serum electrolytes determines the need for dialysis

A nurse is planning care for a client who will undergo peritoneal dialysis. Which of the following actions should the nurse take? (select all that apply) A. Monitor serum glucose levels B. Report cloudy dialysate return C. Warm the dialysate in a microwave oven D. Assess for shortness of breath (sob) E. Maintain medical asepsis when accessing the catheter insertion site

A,B,D,E A - The nurse should monitor serum glucose levels because the dialysate solution contains glucose B - The nurse should monitor for cloudy dialysate return, which indicates an infection. Clear, light-yellow solution is typical during the outflow process. D - The nurse should assess for shortness of breath, which can indicate inability to tolerate a large volume of dialysate. E - The nurse should check the access site dressing for wetness and look for kinking, pulling, clamping, or twisting of the tubing, which can increase the risk for exit-site infections.

The client diagnosed with chronic kidney disease has been receiving dialysis for 10 years. The client is notified he will not be placed on the kidney transplant list. The client tells the nurse he will not be back for any more dialysis treatments. Which response by the nurse is most therapeutic? A. "You cannot just quit your dialysis. This is not an option." B. "You are angry at not being on the list, and youwant to quit dialysis?" C. "I will call your nephrologist right now so you can talk to the health care provider." D. "Make you funeral arrangements because you are going to die."

B - Reflecting the client's feelings and restating them are therapeutic responses the nurse should use when addressing the client's issues.

A nurse is reviewing client laboratory data. The nurse should recognize that which of the following findings is expected for a client who has Stage 4 chronic kidney disease? A. Blood urea nitrogen (BUN) 15 mg/dL B. Glomerular filtration rate (GFR) 20 ml/min C. Serum creatinine 1.1 mg/dl D. Serum potassium 5.0 mEq/L

B - The GFR is severely decreased to approximately 20 mL/min, which is indicative of stage 4 chronic kidney disease

The client diagnosed with acute renal failure (ARF) is experiencing hyperkalemia. Which medication should the nurse prepare to administer to help decrease the potassium level? A. Erythropoietin B. Calcium gluconate C. Regular insulin D. Osmotic diuretic

C - Regular insulin, along with glucose, will drive potassium into the cells thereby lowering serum potassium levels temporarily.

A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which of the following actions should the nurse take? A. Administer an opioid medication B. Monitor for hypertension C. Assess level of consciousness D. Increase the dialysis exchange rate

C - The nurse should assess the client's level of consciousness. A change in urea levels can cause increased intracranial pressure. Subsequently, the client's leve of consciousness decreases

The nurse is developing a nursing care plan for the client diagnosed with chronic kidney disease (CKD). Which nursing problem is a priority for the client? A. Low self-esteem B. Knowledge deficit C. Activity intolerance D. Excess fluid volume

D - Excess fluid volume is priority because fo the stress placed on the heart and vessels, which could lead to heart failure, pulmonary edema, and death

The client diagnosed with acute renal failure (ARF) has a serum potassium level of 6.8 mEq/L. Which collaborative treatment should the nurse anticipate for the client? A. Administer a phosphate binder. B. Type and crossmatch for whole blood. C. Assess the client for leg cramps. D. Prepare the client for dialysis.

D. Normal potassium level is 3.5 to 5 mEq/L. A level of 6.8 mEq/L is life threatening and could lead to cardiac dysrhythmias. Therefore, the client may be dialyzed to decrease the potassium level quickly. This requires a health-care provider order, so it is a collaborative intervention.

A nurse is teaching a client who has chronic kidney disease and is to begin hemodialysis. Which of the following information should the nurse include in this teaching? A. Hemodialysis restores kidney function B. HD replaces hormonal function in the renal system C. HD allows an unrestricted diet D. HD returns a balance to serum electrolytes.

D. The nurse should explain to the client that HD restores electrolye balance by removing excess sodium, potassium, fluids, and waste products and also resotres acid-base balance.