Urinary / Renal Disorders

A nurse teaches the signs of organ rejection to a client who had a kidney transplant. What should be included in the education?

Elevated blood pressure

Lab results: Potassium: 5.8 mEq/L, Sodium: 140 meq/L, Calcium: 9.0 mg/dL, Blood pressure: 180/100 A client is admitted to a medical unit with the diagnosis of acute kidney failure. The nurse reviews the client's laboratory data, performs a physical assessment, and obtains the client's vital signs. What should the nurse conclude the client is most likely experiencing?

Hyperkalemia

The nurse is caring for a client with a diagnosis of acute kidney failure associated with drug toxicity. When the client complains of thirst, the nurse should offer:

Hard candy

Which is the most serious complication for which the nurse must monitor a client with kidney failure?

Hyperkalemia

During the postoperative period after surgery for a kidney transplant, the client's creatinine level is 3.1 mg/dL. What should the nurse do first in response to this laboratory result?

Assess for decreased urine output

A client with acute renal failure moves into the diuretic phase after one week of therapy. For which signs during this phase should the nurse assess the client? (Select all that apply.)

Dehydration, Hypovolemia

A client with a history of chronic kidney disease is hospitalized. The nurse assesses the client for signs of related kidney insufficiency, which include:

Edema and pruritus

When a client returns from the postanesthesia care unit after a kidney transplant, the nurse should plan to measure the client's urinary output every:

One hour

A nurse is caring for a client who had a kidney transplant. Which test is most important for determining whether a client's newly transplanted kidney is working effectively?

Serum creatinine

A nurse is notified that the latest potassium level for a client in acute renal failure is 6.2 mEq. What action should the nurse take?

Take vital signs and notify the primary health care provider

A client with renal colic is scheduled for extracorporeal shock-wave lithotripsy. The night before the procedure, the client puts the call light on frequently and has many demands. Which would be an appropriate statement for the nurse to make?

"You are facing a new experience tomorrow; tell me what concerns you have."

A nurse is reviewing the laboratory reports of a client with a diagnosis of end-stage renal disease. What test result should the nurse anticipate?

Potassium of 6.3 mEq/L

The nurse is providing care to a client who is being treated for bacterial cystitis. Before discharge, it is most important for the client to:

Achieve relief of symptoms and to maintain kidney function

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for what complication?

Hepatitis B

A nurse is monitoring a client with renal failure for signs of fluid excess. Which finding does the nurse identify as inconsistent with fluid excess?

Orthostatic hypotension

A nurse teaches a client who is scheduled for a kidney transplant about the need for immunosuppressive medications. The nurse determines that the client understands the teaching when the client states, "I must take these medications:

For the rest of my life."

A client with chronic kidney disease is scheduled to begin peritoneal dialysis. When discussing the procedure, the nurse explains that the purpose of the dialysis is to:

Help do some of the work usually done by the kidneys

A client with chronic kidney disease is admitted to the hospital with severe infection and anemia. The client is depressed and irritable. The client's spouse asks the nurse about the anticipated plan of care. What is an appropriate nursing response?

"The intake of meat, eggs, and cheese will be restricted so the kidneys can clear the body of waste products."

Which clinical manifestation should a nurse expect a client with diabetes insipidus to exhibit?

Decreased urine osmolarity

A nurse assesses a newly admitted client with renal colic to determine the signs and symptoms that are present. The nurse assesses the client for which primary subjective symptom?

Flank discomfort

A client with chronic renal failure has been on hemodialysis for two years. The client communicates with the nurse in the dialysis unit in an angry, critical manner and is frequently noncompliant with medications and diet. The nurse can best intervene by first considering that the client's behavior is most likely:

A defense against underlying depression and fear

A client has a kidney transplant. The nurse should monitor for which signs associated with rejection of the transplant? (Select all that apply.)

Fever, Oliguria, Weight gain

A client who is 5 feet, 8 inches tall and weighs 220 pounds is admitted to the hospital with ureteral colic, blood in the urine, and a blood pressure of 150/90. The immediate objective of nursing care for this client is to decrease:

Pain

A nurse is providing postoperative care to a client who had a kidney transplant. What assessment is the best indicator of the functioning of the newly transplanted kidney?

Serum creatinine

A nurse is caring for a client with acute kidney failure who is receiving a protein-restricted diet. The client asks why this diet is necessary. What information should the nurse include in a response to the client's questions?

This supplies only essential amino acids, reducing the amount of metabolic waste products, thus decreasing stress on the kidneys.

A nurse concludes that the anemia that accompanies chronic kidney disease should be treated because it contributes to:

Chronic fatigue

A client arrives at a health clinic reporting hematuria, frequency, urgency, and pain on urination. What does the nurse suspect is the cause of these signs and symptoms?

Cystitis

A client is diagnosed as having kidney failure. During the oliguric phase the nurse should assess the client for:

Hyperkalemia

A client with acute kidney failure becomes confused and irritable. Which does the nurse determine is the most likely cause of this behavior?

An increased blood urea nitrogen level

A nurse is caring for a client with end-stage renal disease who has a mature arteriovenous (AV) fistula. What nursing care should be included in the client's plan of care? (Select all that apply.)

Auscultate for a bruit., Palpate the site to identify a thrill, Avoid drawing blood from the affected extremity.

A nurse is caring for a client with end-stage renal disease. Which clinical indicators of end-stage renal disease should the nurse expect? (Select all that apply.)

Azotemia, Hypertension

Which clinical manifestations does a nurse expect that a client with renal calculi might report? (Select all that apply.)

Blood in the urine, Frequency and urgency of urination

A client with the diagnosis of chronic kidney disease develops hypocalcemia. Which clinical manifestations should the nurse expect the client with hypocalcemia to exhibit? (Select all that apply.)

Chvostek sign, Muscle cramps

After a successful kidney transplant for a client with end-stage kidney disease, the nurse anticipates that laboratory studies will demonstrate:

Decreasing serum creatinine

A client with acute kidney failure is to receive peritoneal dialysis and asks why the procedure is necessary. The nurse's best response is, "It:

Helps perform some of the work usually done by the kidneys."

A nurse anticipates that dialysis will be necessary for a 12-year-old child with chronic kidney disease when the child begins to exhibit:

Hypervolemia

A nurse is caring for a client who is scheduled for cystoscopy. What should the nurse include in the client's postprocedure teaching plan?

Increase fluid intake for three to four days postoperatively

Prednisone (Meticorten), an adrenal steroid, is prescribed for a client with an exacerbation of colitis. When administering the first dose of the medication, the nurse should inform the client that the medication:

Is not curative but does cause a suppression of the inflammatory process

The nurse providing postoperative care for a client who had kidney surgery reviews the client's urinalysis results. The nurse concludes that the presence of what substance in the urine needs to be reported to the health care provider?

Large proteins

A nurse is caring for a client who had a nephrectomy because of cancer of the kidney. Which factor will influence the client's ability to deep breathe and cough postoperatively?

Location of the surgical incision

A health care provider prescribes furosemide (Lasix) for a client with hypervolemia. The nurse recalls that furosemide exerts its effects in what part of the renal system?

Loop of Henle

A nurse is caring for a client with a diagnosis of renal calculi secondary to hyperparathyroidism. Which type of diet should the nurse explore with the client when providing discharge information?

Low calcium

A nurse is caring for a 6-year-old child with a diagnosis of glomerulonephritis. The child's urine output decreases to less than100 mL/24 hr, the creatinine clearance is 60 mL/min, and there is an irregular apical pulse. A diagnosis of acute renal failure is made. Blood is drawn for testing. Which serum level requires immediate intervention?

Potassium 6.1 mEq/L

Lab results: Sodium 135 mEq/L, Potassium 6mEq/L, Hemoglobin 8.5 g/L, Creatinine clearance 20 ml/min An older adult client is admitted to the hospital with a diagnosis of chronic kidney disease. The nurse reviews the client's medical record. Which clinical finding is a priority to be communicated to the primary health care provider?

Potassium level

A nurse is caring for a client with chronic kidney failure. What should the nurse teach the client to limit the intake of to help control uremia associated with end stage renal disease (ESRD)?

Protein

A nurse plans to teach the signs of rejection to a client who just had a transplanted kidney. What sign of rejection should the nurse include?

Elevated blood pressure

A client with chronic kidney disease has been on hemodialysis for two years. The client relates to a nurse in the dialysis unit in an angry, critical manner and frequently does not follow the prescribed diet or take prescribed medications. What does the nurse identify as the most likely underlying cause of this behavior?

A defense against underlying depression and fear

What does the nurse determine is the most likely cause of renal calculi in clients with paraplegia?

Accelerated bone demineralization

For which clinical indicator should a nurse monitor a client with end-stage renal disease?

Azotemia Reason Why: Azotemia is an increase in nitrogenous waste (particularly urea) in the blood, which is common with end-stage renal disease. Excessive nephron damage in end-stage renal disease causes oliguria, not polyuria; excessive urination is common in early kidney insufficiency because of the inability to concentrate urine. Jaundice is common to biliary obstruction, not to end-stage renal disease. The blood pressure may be elevated as a result of hypervolemia associated with increased total body fluid.

A nurse teaches a client with calcium-based renal calculi about foods that can be eaten on a low-calcium diet (400 mg/day). The nurse concludes that the teaching was effective when the client selects what food items from the menu? (Select all that apply.)

Baked chicken, Roast beef with mashed potato

A client is admitted to the hospital with a diagnosis of chronic kidney disease. Which responses should the nurse expect the client to exhibit? (Select all that apply.)

Paresthesias, Hypertension

A 9-year-old child with chronic kidney disease is undergoing peritoneal dialysis. For which associated complication should the nurse monitor the child?

Cloudy return dialysate

A nurse is caring for a client with a diagnosis of chronic kidney failure who has just been told by the health care provider that hemodialysis is necessary. Which clinical manifestation indicates the need for hemodialysis?

Hyperkalemia

A nurse is caring for a client with chronic kidney failure. Which clinical findings should the nurse expect when assessing this client? (Select all that apply.)

Lethargy, Muscle twitching

A client who had a suprapubic prostatectomy returns from the post-anesthesia care unit and accidentally pulls out the urethral catheter. What should the nurse do first?

Notify the health care provider.

A lithotripsy to break up renal calculi is unsuccessful, and a nephrolithotomy is performed. Which postoperative clinical indicator should the nurse report to the health care provider?

Urine output of 20 to 30 mL/hr