Elsevier Acute Kidney and Chronic Kidney Disease: Chapter 47
The nurse is teaching a patient with acute kidney injury about lifestyle modifications. Which actions by the patient indicate effective teaching? 1 Consuming less salt 2 Eating foods rich in protein 3 Increase intake of fluids 4 Consuming potassium-rich foods
Consuming less salt - Sodium causes fluid and water retention and thereby increases blood volume; thus, the patient should consume less salt. Patients with renal impairment should decrease protein intake because proteins break down into urea, which is dangerous if it accumulates in the brain. Increasing the intake of fluid will increase the volume of fluid in the body. Because the kidney function is impaired, excess fluid cannot be eliminated and it accumulates in the body leading to edema and congestive cardiac failure.
Which clinical manifestation of acute kidney injury may cause changes in an electrocardiogram? 1 Hyperkalemia 2 Fluid overload 3 Hyponatremia 4 Metabolic acidosis
Hyperkalemia
The dialysis nurse is administering hemodialysis to a patient with chronic kidney failure. For what common complication should the nurse carefully monitor in this patient? 1 Hernias 2 Pneumonia 3 Hypotension 4 Lower back pain
Hypotension
A patient has renal failure. The nurse, reviewing the lab results, recognizes which finding as indicative of the diminished renal function associated with the diagnosis? 1 Hypokalemia 2 Increased serum urea and serum creatinine 3 Anemia and decreased blood urea nitrogen 4 Increased serum albumin and hyperkalemia
Increased serum urea and serum creatinine
The nurse is caring for a patient with chronic kidney disease who is undergoing hemodialysis. What is an appropriate diet for this patient? 1 High-protein and low-calcium 2 Low-protein and low-potassium 3 High-protein and high-potassium 4 Low-protein and high-phosphorus
Low-protein and low-potassium
While caring for a patient with kidney failure, the patient has three episodes of vomiting and diarrhea. Which action should the nurse perform as a priority? 1 Administer antiemetic. 2 Record the blood pressure. 3 Record the volume of fluid lost. 4 Administer water with a high salt content.
Record the volume of fluid lost.
The nurse is caring for a patient undergoing peritoneal dialysis. What finding should the nurse report to the primary health care provider that would indicate peritonitis? 1 Oliguria 2 Hyperkalemia 3 Hyponatremia 4 Abdominal pain
Abdominal pain - Peritonitis is caused by either a Staphylococcus aureus or a Staphylococcus epidermidis infection. It is manifested by abdominal pain, cloudy peritoneal effluent, and increased white blood cell count.
Which is the most common cause of acute kidney injury? 1 Bladder cancer 2 Prostate cancer 3 Acute tubular necrosis 4 Malignant hypertension
Acute tubular necrosis
The patient admitted with sepsis is at risk of developing what renal pathology? 1 Nephritis 2 Glomerular nephritis 3 Acute tubular necrosis 4 Chronic kidney disease
Acute tubular necrosis - Acute tubular necrosis is a result of an acute shock on the renal system and is recoverable, but the patient is likely to develop acute kidney impairment (AKI).
The nurse recognizes that which medication is appropriate to give to patients with kidney failure? 1 Magnesium antacids 2 Aluminum preparations 3 Angiotensin receptor blockers 4 Nonsteroidal antiinflammatory agents
Angiotensin receptor blockers - Hypertension is a common finding in a patient with kidney failure due to retention of sodium and water. This is treated with angiotensin receptor blockers.
A patient has Stage 3 chronic kidney disease (CKD) and is being taught about a low potassium diet. The nurse knows the patient understands the diet when the patient selects which foods to eat? 1 Apple, green beans, and a roast beef sandwich 2 Granola made with dried fruits, nuts, and seeds 3 Watermelon and ice cream with chocolate sauce 4 Bran cereal with a half of a banana, milk, and orange juice
Apple, green beans, and a roast beef sandwich
During hemodialysis, the patient develops light-headedness and nausea. What is the priority action by the nurse? 1 Administer hypertonic saline 2 Administer a blood transfusion 3 Decrease the rate of fluid removal 4 Administer antiemetic medications
Decrease the rate of fluid removal
A patient with a glomerular filtration rate (GFR) of 30 mL/min has a hemoglobin of 5 g/dL. The peripheral smear tests show that the red blood cells are normocytic and normochromic. The nurse suspects that which physiologic change led to this condition? 1 Reduced excretion of potassium 2 Increased extracellular fluid volume 3 Defective reabsorption of bicarbonate 4 Decreased production of erythropoietin
Decreased production of erythropoietin
The nurse caring for a patient with heart failure notes the patient has decreased urine output of 200 mL/day. Which laboratory finding aids in the diagnosis of prerenal azotemia in this patient? 1 Elevated blood urea nitrogen (BUN) 2 Normal creatinine level 3 Decreased sodium level 4 Decreased potassium level
Elevated blood urea nitrogen (BUN)
The nurse is planning an educational course on risk factors for chronic kidney disease. Which factors should the nurse identify as nonmodifiable risk factors? Select all that apply. 1 Hypertension 2 Type II diabetes 3 Family history of chronic kidney disease (CKD) 4 Age greater than 60 5 Exposure to nephrotoxic drugs
Family history of chronic kidney disease (CKD) Age greater than 60
Which intervention should the nurse perform for a patient with acute kidney injury who is on hemodialysis? 1 Monitor bilirubin levels 2 Monitor the color of feces 3 Monitor blood glucose levels 4 Monitor for discharge at access site
Monitor for discharge at access site
The nurse instructs a patient with hyperphosphatemia to avoid what food item? 1 Yogurt 2 Soy sauce 3 Canned soup 4 Salad dressing
Yogurt - Yogurt is rich is phosphate and should be avoided by patients with hyperphosphatemia.
The nurse provides information to a nursing student about the administration of erythropoietin (EPO) therapy to a patient with chronic kidney disease (CKD). Which statement made by the nursing student indicates effective learning? 1 "EPO benefits a patient with plasma ferritin concentrations less than 100 mg/mL." 2 "EPO should be administered in higher doses to a patient with low hemoglobin levels." 3 "EPO, iron, sucrose, and folic acid of 1 mg/day should be administered to patients undergoing hemodialysis." 4 "EPO can be safely given to a patient that takes an antihypertensive and maintains a blood pressure of 150/90 mm Hg."
"EPO, iron, sucrose, and folic acid of 1 mg/day should be administered to patients undergoing hemodialysis."
The nursing instructor asks the student nurse about fluid and electrolyte changes that occur in a patient with an acute kidney injury. Which statement by the student nurse indicates effective learning? 1 "The patient will have hypokalemia." 2 "The patient will have hypernatremia." 3 "The patient will have increased serum creatinine levels." 4 "The patient will have decreased levels of blood urea nitrogen."
"The patient will have increased serum creatinine levels." - Creatinine is a waste product of muscle catabolism. Patients with acute kidney injury cannot remove body waste and it accumulates in the blood, which raises the serum creatinine level. Acute kidney injury is associated with an increased level of potassium, a decreased level of sodium, and a decreased level of blood urea nitrogen.
Which patient is most likely to develop chronic kidney disease (CKD) and should be taught preventive measures by the nurse? 1 A 50-year-old white female with hypertension 2 A 61-year-old Native American male with diabetes 3 A 40-year-old Hispanic female with cardiovascular disease 4 A 28-year-old African American female with a urinary tract infection
A 61-year-old Native American male with diabetes
The nurse is planning an education program on chronic kidney disease. Which ethnic group would the nurse target for promoting this event? 1 African Americans 2 Asian descent 3 Caucasian males 4 Hispanics
African Americans
The patient has had type 1 diabetes mellitus for 25 years and now is reporting fatigue, edema, and an irregular heartbeat. On assessment, the nurse finds that the patient has newly developed hypertension and difficulty with blood glucose control. The nurse should know that which diagnostic study will be most indicative of chronic kidney disease (CKD) in this patient? 1 Serum creatinine 2 Serum potassium 3 Microalbuminuria 4 Calculated glomerular filtration rate (GFR)
Calculated glomerular filtration rate (GFR) - The best study to determine kidney function or CKD that would be expected in the patient with diabetes is the calculated GFR that is obtained from the patient's age, gender, race, and serum creatinine. It would need to be abnormal for three months to establish a diagnosis of CKD.
The nurse performs an admission assessment of a patient with acute renal failure. For which common complication does the nurse assess the patient? 1 Polyphagia 2 Hypernatremia 3 Hypotensive shock 4 Cardiac dysrhythmias
Cardiac dysrhythmias - Because the kidneys are not effectively removing waste products, including electrolytes, an increased potassium level (hyperkalemia) of more than 5.0 mEq/L is common in acute renal failure and places the patient at risk for cardiac arrhythmias.
A patient has a glomerular filtration rate (GFR) of 50 mL/minute and a serum potassium level of 8 mEq/L? The nurse should monitor the patient for what complication? 1 Hypotension 2 Respiratory failure 3 Metabolic acidosis 4 Cardiac dysrhythmias
Cardiac dysrhythmias - The patient's glomerular filtration rate (GFR) of 50 mL/min is indicative of stage 3 chronic kidney disease and the patient's serum potassium level of 8 mEq/L indicates hyperkalemia, which may lead to cardiac dysrhythmias.
A patient with chronic kidney disease has an arteriovenous (AV) graft in the right forearm. What is the nurse's priority in determining the patency of the graft? 1 Determine the range of motion of the right arm and shoulder 2 Observe for clubbing of the fingers on the right hand of the AV graft site 3 Compare radial pulses by checking the right and left pulses simultaneously 4 Check for a bruit by listening over the right arm AV graft site with a stethoscope
Check for a bruit by listening over the right arm AV graft site with a stethoscope - The arteriovenous (AV) graft is an artificial connection between an artery and vein to provide access for hemodialysis. Thrombosis may occur; therefore the need to determine patency is an essential assessment. Palpation of the site should indicate a thrill, which also indicates that the graft is patent. Listening over the AV graft should reveal a bruit sound, indicating patency. A bruit sounds similar to the impulse beat heard when measuring blood pressure.
When assessing the mental status of a patient in acute renal failure, the nurse recognizes that abnormal findings are most likely caused by: 1 Anger related to denial of chronic illness 2 Delirium-related to hypoxia of brain cells 3 Confusion related to an increased urea level 4 Aggression related to possible underlying comorbidities
Confusion related to an increased urea level - In renal disease, urea is not filtered out of the blood by the kidneys and therefore accumulates in the blood. This results in toxicity to brain tissue, causing confusion.
The student nurse is preparing a dietary chart for a patient with acute kidney injury. Which foods included by the nurse in the diet chart need correction? 1 Foods rich in fiber 2 Foods rich in potassium 3 Foods rich in fatty acids 4 Foods rich in carbohydrates
Foods rich in potassium
The nurse recognizes which laboratory data as the most significant indicator that a patient is responding positively to peritoneal dialysis? 1 Creatinine of 7 mg/dL 2 Potassium of 4.1 mEq/L 3 A below-normal calcium level 4 Increased level of blood urea nitrogen
Potassium of 4.1 mEq/L
What causes prerenal acute kidney injury? 1 Release of nephrotoxins 2 Reduced renal blood flow 3 Urine reflux into renal pelvis 4 Presence of extrarenal tumors
Reduced renal blood flow
A patient is being administered 15 g sodium polystyrene sulfonate (Kayexalate) orally for hyperkalemia. Which intervention should the nurse perform? 1 Observe the patient for iron overload. 2 Inform the patient that constipation is an expected side effect. 3 Provide magnesium-containing antacids. 4 Report peaked T waves in electrocardiogram (ECG).
Report peaked T waves in electrocardiogram (ECG).
When caring for a patient during the oliguric phase of acute kidney injury (AKI), what is an appropriate nursing intervention? 1 Weigh patient three times weekly 2 Increase dietary sodium and potassium 3 Provide a low-protein, high-carbohydrate diet 4 Restrict fluids according to previous daily loss
Restrict fluids according to previous daily loss
While caring for a patient who is undergoing peritoneal dialysis on a regular basis, the nurse finds that the patient has redness and drainage at the exit site of the peritoneal catheter. What does the nurse anticipate the culture results will reveal? 1 Candida infection 2 Aspergillus infection 3 Cryptococcal infection 4 Staphylococcus aureus infection
Staphylococcus aureus infection
A patient had the surgical creation of an arteriovenous graft for the administration of hemodialysis. For what complication should the dialysis nurse monitor during hemodialysis? 1 Hernia 2 Bronchitis 3 Pneumonia 4 Steal syndrome
Steal syndrome
A patient with end-stage chronic kidney disease is scheduled for hemodialysis. What recommendation should the nurse give to the patient? 1 Drink more fluids 2 Eat protein-rich foods 3 Take folic acid supplementation 4 Take phosphate supplementation
Take folic acid supplementation
The nurse recognizes that which recommendation is appropriate for a patient with chronic kidney disease (CKD)? 1 Eat prunes and raisins. 2 Take phosphate binders with meals. 3 Drink plenty of water. 4 Take calcium and iron supplements on an empty stomach.
Take phosphate binders with meals.
While providing postoperative care for a live kidney donor, the nurse monitors the hematocrit levels. What rationale does the nurse provide to the patient for this action? 1 To assess for bleeding 2 To assess for impairment 3 To assess for hypokalemia 4 To assess for hyponatremia
To assess for bleeding
Which condition should the nurse suspect in a patient with chronic kidney disease (CKD) who develops osteomalacia? 1 Asterixis 2 Uremic frost 3 Gastroparesis 4 Uremic red eye
Uremic red eye - Chronic kidney disease mineral and bone disorder (CKD-MBD) is a common complication of CKD and results in both skeletal and extraskeletal complications. Osteomalacia is a skeletal complication. Calcium deposition in the eye may create irritation leading to uremic red eye, an extraskeletal complication.
Which finding indicates oliguria? 1 Urinary output of 350 mL/day 2 Urinary output of 450 mL/day 3 Urinary output of 550 mL/day 4 Urinary output of 650 mL/day
Urinary output of 350 mL/day - A urinary output rate of less than 400 mL/day indicates oliguria; thus a urinary output of 350 mL/day suggests oliguria. Urine outputs of 450, 550, or 650 mL/day are considered normal.
The patient is in the diuretic phase of acute kidney injury. What education should the nurse provide to the patient regarding this phase? Select all that apply. 1 Urine output is increased. 2 The kidney has become fully functional. 3 The electrolyte imbalance will be normalized. 4 This phase will last no more than three weeks 5 There is a possibility that the fluid volume will be reduced in the body.
Urine output is increased. This phase will last no more than three weeks There is a possibility that the fluid volume will be reduced in the body.
The nursing instructor is teaching a student nurse about continuous renal replacement therapy (CRRT). Which statement by the student nurse indicates effective learning? 1 "CRRT is provided over approximately 24 hours." 2 "CRRT does not require the addition of an anticoagulant." 3 "CRRT cannot be used in conjunction with hemodialysis." 4 "CRRT has a faster blood flow rate than hemodialysis."
"CRRT is provided over approximately 24 hours." - Continuous renal replacement therapy (CRRT) is a physiologic therapy that simulates kidney function day and night. CRRT is done either by cannulating an artery and a vein or by cannulating two veins. CRRT is provided continuously for approximately 24 hours. CRRT involves the flow of blood from the body through a filter and carries an increased risk of clotting; thus an anticoagulant must be added. CRRT can be performed along with hemodialysis. CRRT has a slower blood flow rate than intermittent hemodialysis.
The patient with end stage renal disease (ESRD) has decided to terminate dialysis treatments. Which is the best response by the nurse? 1 "I respect your decision. Would you like me to ask the health care provider for a palliative care consult?" 2 "I respect your decision, but believe you need to discuss options with your health care provider. Would you like me to page the health care provider to come speak with you?" 3 "You cannot stop now; you have so much to live for." 4 "Are you sure this is the right decision? How about if I ask a psychiatrist to come speak with you?"
"I respect your decision, but believe you need to discuss options with your health care provider. Would you like me to page the health care provider to come speak with you?"
The registered nurse is teaching a student nurse about the preoperative care to be provided to a patient before kidney transplantation. Which statement made by the student nurse indicates effective learning? 1 "I should label the access site as 'Dialysis access, no procedures.'" 2 "I should not explain the need of immunosuppressant drugs before surgery." 3 "I should inform the patient that dialysis is not required after transplantation." 4 "I should not empty the peritoneal cavity of patients undergoing peritoneal dialysis."
"I should label the access site as 'Dialysis access, no procedures.'"
The nursing instructor is teaching a student nurse about the therapies for hyperkalemia associated with acute kidney injury. Which statement by the student nurse indicates effective learning? 1 "Insulin infusion is a permanent therapy." 2 "Sodium bicarbonate is a permanent therapy." 3 "Calcium gluconate infusion is a permanent therapy." 4 "Sodium polystyrene sulfonate is a permanent therapy."
"Sodium polystyrene sulfonate is a permanent therapy." - a cation-exchange resin that completely removes extra potassium; it is considered a permanent therapy.
The nurse just received an urgent laboratory value on a patient in renal failure. The potassium level is 6.3. The telemetry monitor is showing peaked T waves. Which prescription from the primary health care provider should be implemented first? 1 Administer regular insulin intravenously (IV) 2 Restrict dietary potassium intake to 40 meq daily 3 Administer kayexalate enema 4 Educate the patient on dietary restriction of potassium
Administer regular insulin intravenously (IV) - This patient is showing signs of hyperkalemia, which could be fatal and lead to myocardial damage. Regular insulin IV is needed to quickly force potassium into the cells.
The nurse reviews lab tests that have been prescribed for a patient in acute renal failure. Which is the best indicator of renal function? 1 Potassium 2 Creatinine 3 BUN (blood urea nitrogen) 4 ALT (alanine aminotransferase)
Creatinine - Creatinine is the best indicator of renal function. Creatinine is a waste product of the skeletal muscles and is excreted through the kidneys. In renal failure, the kidneys are unable to excrete creatinine, leading to a serum level greater than the normal range of 0.2 to 1.0 mL/dL. Potassium excretion and regulation are impaired in acute renal failure, and potassium may therefore be increased. However, potassium may be increased for reasons other than renal disease, whereas increased creatinine is specific to renal disease. Blood urea nitrogen (BUN) is also used to measure kidney function, but other disorders such as dehydration may cause an increase in BUN. Alanine aminotransferase (ALT) is related to liver dysfunction, not renal dysfunction.
A patient donated a kidney via a laparoscopic donor nephrectomy to a nonrelated recipient. The patient is experiencing a lot of pain and refuses to get up to walk. How should the nurse handle this situation? 1 Have the transplant psychologist convince the patient to walk. 2 Encourage even a short walk to avoid complications of surgery. 3 Tell the patient that no other patients have ever refused to walk. 4 Tell the patient that he or she is lucky it was not necessary to have an open nephrectomy.
Encourage even a short walk to avoid complications of surgery. - Because ambulating will improve bowel, lung, and kidney function with improved circulation, even a short walk with assistance should be encouraged after pain medication.
Which clinical action plan is most appropriate for a patient in stage 3 of chronic kidney disease? 1 Diagnosis and treatment 2 Estimation of progression 3 Renal replacement therapy 4 Evaluation and treatment of complications
Evaluation and treatment of complications - A patient in stage 3 of chronic kidney disease has a moderate decrease in the glomerular filtration rate (GFR). The most appropriate clinical action plan for this patient is evaluation and treatment of complications.
The nurse is caring for a patient with severe burns in the emergency department. His laboratory values reveal serum creatinine level of 5 mg/dL, and the glomerular filtration rate (GFR) has decreased by 75%. What stage of acute kidney failure is this patient exhibiting? 1 Risk 2 Injury 3 Failure 4 Loss
Failure - As per the RIFLE (Risk, Injury, Failure, Loss, and End-stage) classification for staging acute kidney injury, this patient is at the Failure stage. When the GFR has decreased by 25%, the patient is at the Risk stage. The patient with a GFR that has decreased by 50% is at the Injury stage. The patient with persistent acute kidney failure experiences a complete loss of kidney function and is at the Loss stage.
What is an intrarenal cause of acute kidney injury? 1 Renal artery thrombosis 2 Neuromuscular disorders 3 Benign prostatic hyperplasia 4 Hemolytic blood transfusion reaction
Hemolytic blood transfusion reaction
While caring for a patient with an acute kidney injury, the patient complains of severe weakness and palpitations. The electrocardiogram reveals widening of the QRS complex and an elevated T wave. What complication does the nurse suspect in this patient? 1 Hyperkalemia 2 Hypercalcemia 3 Hypernatremia 4 Hyperchloremia
Hyperkalemia
A patient with chronic kidney failure (CKD) has a paralytic ileus and laboratory findings of a serum potassium level of 7 mEq/L and a phosphate level of 3.5 mg/dL. The nurse anticipates that what medication will be prescribed? 1 Calcium carbonate 2 Lanthanum carbonate 3 Sodium polystyrene sulfonate 4 Intravenous 10% calcium gluconate
Intravenous 10% calcium gluconate
The nurse should monitor for which adverse effect of erythropoietin in patients with kidney failure? 1 Paralytic ileus 2 Iron deficiency 3 Hyperparathyroidism 4 Systemic lupus erythematosus
Iron deficiency - Erythropoietin (EPO) helps replenish EPO stores in the body and promotes erythropoiesis in a patient with kidney failure. A side effect of EPO is iron deficiency anemia from increased demand for iron to support erythropoiesis.
The nurse provides discharge instructions to a patient with chronic kidney disease (CKD). Which action by the patient indicates effective learning? 1 Maintains a pillbox organizer at home 2 Takes over-the-counter medications for pain 3 Takes aluminum-based laxatives for constipation 4 Includes sweet potatoes and chocolates in the diet
Maintains a pillbox organizer at home - A patient with chronic kidney disease has to take many medications, and maintaining a pillbox organizer at home helps the patient in medication compliance. The nurse should instruct the patient to avoid over-the-counter drugs, because most of these drugs are nephrotoxic, which leads to further deterioration of kidney function. The patient must avoid aluminum-based laxatives, because aluminum is accumulated in the body, leading to bone disease such as osteomalacia. Sweet potatoes and chocolates are rich in potassium and, therefore, they must be avoided to prevent hyperkalemia and fatal dysrhythmias.
Assessment findings of a patient with chronic kidney failure include a glomerular filtration rate (GFR) of 10 mL/min, numbness and burning sensation in the legs, and a blood urea nitrogen level (BUN) of 26 mg/dL. The nurse anticipates that which intervention will be included on the patient's plan of care? 1 Make a referral for dialysis. 2 Administer sodium polystyrene sulfonate. 3 Restrict sodium bicarbonate. 4 Provide a magnesium-containing antacid.
Make a referral for dialysis. - Numbness and burning sensation in the legs are manifestations of peripheral neuropathy caused by nitrogenous waste accumulation in the brain. A patient with a chronic kidney disease (CKD), increased blood urea nitrogen (BUN) levels, and a very low glomerular filtration rate of 10 mL/min should undergo dialysis to remove nitrogenous wastes and prevent fluid accumulation due to impaired excretion.
The patient has a form of glomerular inflammation that is progressing rapidly. The patient is gaining weight and the urine output is declining steadily. What is the priority nursing intervention? 1 Monitor the patient's cardiac status 2 Teach the patient about hand washing 3 Obtain a serum specimen for electrolytes 4 Increase direct observation of the patient
Monitor the patient's cardiac status
The nurse is caring for a patient who had a surgery for an arteriovenous fistula (AVF) in preparation for hemodialysis. What precautionary step should the nurse follow when caring for this patient? 1 Perform venipuncture in the extremity only after three months. 2 Allow insertion of IV lines in the extremity only after six months. 3 Never take blood pressure measurements in the extremity. 4 Initiate hemodialysis after four weeks.
Never take blood pressure measurements in the extremity.
Which is a clinical manifestation of acute kidney injury? 1 Oliguria 2 Uremia 3 Anemia 4 Pruritus
Oliguria - Oliguria is a sign of acute kidney injury. Uremia, anemia, and pruritus are signs of chronic kidney injury.
The nurse is educating a donor who is willing to donate a kidney to a family member. The nurse explains the positioning during the procedure and describes that the flank will be exposed. For what surgical procedure will the nurse prepare the donor? 1 Cholecystectomy 2 Open nephrectomy 3 Ureteroneocystostomy 4 Laparoscopic nephrectomy
Open nephrectomy
A patient who has been on peritoneal dialysis for two years reports nausea, vomiting, diarrhea, and fluid discharge from the catheter exit to the nurse. The laboratory reports reveal an increased white blood cell count (WBC). Which condition does the nurse suspect in the patient? 1 Hernia 2 Peritonitis 3 Intraperitoneal bleeding 4 Displacement of diaphragm
Peritonitis
The nurse preparing to administer a dose of calcium acetate to a patient with chronic kidney disease (CKD) should know that this medication should have a beneficial effect on which laboratory value? 1 Sodium 2 Potassium 3 Magnesium 4 Phosphorus
Phosphorus - Phosphorus and calcium have inverse or reciprocal relationships, meaning that when phosphorus levels are high, calcium levels tend to be low. Therefore, administration of calcium should help to reduce a patient's abnormally high phosphorus level, as seen with CKD.
Which nursing interventions in a patient with kidney injury would be beneficial in providing safe and effective care? 1 Provide spicy food 2 Provide mouth care 3 Provide plenty of fluids 4 Provide ibuprofen if the patient experiences pain
Provide mouth care - Patients with acute kidney injury experience mucous membrane irritation because of the production of ammonia in the saliva. Therefore, the nurse should provide oral care to prevent stomatitis.
A patient has a glomerular filtration rate (GFR) of 40 mL/minute and a blood pressure of 140/90 mm Hg. The nurse suspects that which medication will increase the patient's blood pressure? 1 Gemfibrozil 2 Darbepoetin alfa 3 Pseudoephedrine 4 Aluminum antacids
Pseudoephedrine
A patient has a glomerular filtration rate (GFR) of 70 mL/minute, a blood pressure of 140/100 mm Hg, and fluid accumulation in the legs. To help prevent heart failure, the nurse should provide the patient with which instruction? 1 Limit protein intake. 2 Restrict sodium to 2 g/day. 3 Take vitamin D supplements. 4 Avoid magnesium-containing laxatives.
Restrict sodium to 2 g/day. -A patient with a glomerular filtration rate of 70 mL/min has stage 2 chronic kidney disease. A blood pressure of 140/100 mm Hg along with fluid accumulation in the legs indicates that the patient has hypertension and edema. Patients with increased blood urea nitrogen levels should limit protein intake to prevent neurologic complications. High sodium retention may lead to heart failure, so the patient should restrict sodium intake to 2 grams per day.
