nur 116 - Davis Advantage / Edge - Renal Failure

What is the duration of the oliguric phase in acute kidney injury? Hours to days 15 to 35 days 1 to 3 weeks Several months to 1 year

15 to 35 days Rationale: The duration of the oliguric phase is a smaller window of time than 15 to 35 days. Test Taking Tips: Know the length of each stage.

The nurse should recognize which situations as risk factors for acute kidney injury? Select all that apply. Dehydration Trauma Edema Hypovolemia Hypervolemia

Dehydration Trauma Hypovolemia

The nurse is teaching about the nursing recommendations while assessing an elderly patient with urinary tract infections and delirium. Which statement made by the nursing student indicates the need for further teaching? "I should consider the presence of neurological deficits." "I should assess the baseline cognitive function." "I should assess for symptoms of dysuria and urinary frequency." "I should administer antibiotics before sampling for laboratory tests."

"I should administer antibiotics before sampling for laboratory tests." Rationale: The nurse should send the patient's samples to the laboratory for testing before administering antibiotics. Test Taking Tips: Identify the nursing actions that may be beneficial to the patient.

The nurse is teaching about this type of dialysis in patients with end-stage renal disease. Which statements indicate the need for further teaching? Select all that apply. "Patients can opt for peritoneal dialysis treatment at home. " "The metabolic clearance of wastes occurs quickly in peritoneal dialysis." "Peritoneal dialysis requires strict dietary restrictions by the patient." "Longer training sessions are required to teach the patient and his or her family members about peritoneal dialysis." "Peritoneal dialysis is suggested for patients who respond poorly to hemodialysis."

"The metabolic clearance of wastes occurs quickly in peritoneal dialysis." "Peritoneal dialysis requires strict dietary restrictions by the patient." "Longer training sessions are required to teach the patient and his or her family members about peritoneal dialysis." Rationale: The clearance of metabolic wastes occurs slowly but continuously in peritoneal dialysis. Rationale: Very fewer dietary restrictions are recommended for patients undergoing peritoneal dialysis. Rationale: Peritoneal dialysis requires shorter training sessions to teach patients and their family members. Test Taking Tips: Peritoneal dialysis is the treatment provided for patients who are in end-stage renal disease.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Sudden increase in BUN and creatinine ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

ACUTE KIDNEY INJURY (AKI) CORRECT. A sudden increase in BUN and creatinine is associated with AKI. A gradual increase in BUN and creatinine is associated with CKD.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Result of dehydration ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

ACUTE KIDNEY INJURY (AKI) CORRECT. AKI is usually caused by an event that leads to kidney injury, such as dehydration. CKD is caused by a long-term disease process that leads to decreased renal function over time.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Sudden reduced glomerular filtration rate GFR ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

ACUTE KIDNEY INJURY (AKI) CORRECT. An acute event to the kidney from a prerenal, intrarenal, or post renal cause leads to a sudden reduction of the GFR and AKI.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Rapid and reversible ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

ACUTE KIDNEY INJURY (AKI) CORRECT. There are two types of renal failure, AKI and CKD. AKI is a rapid, acute disease process that is often reversible if addressed in a responsive and timely manner. AKI can lead to CKD, which develops more slowly than AKI, usually over several months or years.

The nurse should recognize that which assessment findings are consistent with chronic kidney disease? Select all that apply. Slow manifestation of symptoms Decreased hemoglobin levels Increased hematocrit levels Trace of protein in the urine History of hypertension

Slow manifestation of symptoms Decreased hemoglobin levels Trace of protein in the urine History of hypertension

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Long-term dialysis ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

CHRONIC KIDNEY DISEASE (CKD) CORRECT. CKD often requires long-term dialysis or a renal transplant as part of the collaborative management strategy. AKI may require dialysis on a short-term basis, but extended treatment is not typically necessary.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Hemoglobin 8.6 and hematocrit 30% ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

CHRONIC KIDNEY DISEASE (CKD) CORRECT. CKD, which indicates very little kidney function, is associated with decreased hemoglobin and hematocrit levels. Normal hemoglobin values range from 11.7 to 17.3 whereas normal hematocrit values range from 35% to 49%. This clinical manifestation is not associated with AKI.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Result of malnutrition ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

CHRONIC KIDNEY DISEASE (CKD) CORRECT. One specific etiology for CKD is malnutrition, which can occur for patients who have anorexia nervosa or other conditions. By contrast, causes for AKI include dehydration, hypovolemia, surgery, infection, medications, injury, and trauma.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Renal transplantation ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

CHRONIC KIDNEY DISEASE (CKD) CORRECT. Renal transplantation is a collaborative management strategy for the patient with CKD that has progressed to end stage renal disease (ESRD). This treatment is not an option for AKI unless it progresses to CKD.

The healthcare provider alerts the nurse that a client is at risk for chronic kidney disease. Which risk factors should the nurse expect to find in this client's chart? Select all that apply. Diabetes mellitus Recent surgery Hypertension Obesity Acute urinary tract infection

Diabetes mellitus Recent surgery Hypertension

The nurse manager has taught a new staff nurse about assessing and caring for an arteriovenous graft. The staff nurse demonstrates understanding of appropriate care when performing which action? Feeling for buzzing sensation Auscultating carotid pulses Palpating for a bruit Accessing graft for labs

Feeling for buzzing sensation

The nurse is caring for a client diagnosed with chronic kidney disease whose hemoglobin level is 10 g/dL yet remains asymptomatic. The nurse should anticipate the administration of which treatments? Select all that apply. Folic acid supplements Oral iron supplements Daily blood transfusion Erythropoietin subcutaneously Aminoglycoside therapy

Folic acid supplements Oral iron supplements

The laboratory reports of a patient with kidney disease indicate an increase in the blood urea nitrogen (BUN) levels. Which could be the reason behind this condition? Decreased erythropoietin production Decreased gastrointestinal absorption Increased protein intake and breakdown Increased production of nonvolatile acids

Increased protein intake and breakdown Rationale: The BUN levels can increase in patients with kidney disease due to an increased intake of protein and breakdown. Test Taking Tips: Kidney impairment can lead to a loss of function of the kidney in the gastrointestinal system.

The nurse should include which information in the discharge teaching plan for a patient who underwent peritoneal dialysis catheter placement? Select all that apply. Notify the provider if fluid appears cloudy. Review numerous dietary restrictions. Purulent drainage is expected at insertion site. Notify provider if any redness is noted. Pain at the insertion site may indicate infection.

Notify the provider if fluid appears cloudy. Notify provider if any redness is noted. Pain at the insertion site may indicate infection.

The nurse is assessing the clinical manifestation reports of four patients. Which patient is most likely to have renal trauma? Patient A Patient B Patient C Patient D

Patient D Rationale: Hypotension, gross hematuria, and flank bruising indicate renal trauma. Test Taking Tips: Know the symptoms.

The nurse is caring for a client diagnosed with acute kidney injury. Which medication order should the nurse question? Furosemide Potassium chloride Mannitol Bumetanide

Potassium chloride

A client experiences severe blood loss and hypovolemia following a motor vehicle crash. The nurse should assess for signs and symptoms of which condition most likely to affect the client? Prerenal acute kidney injury Intrarenal acute kidney injury Postrenal acute kidney injury Chronic kidney disease

Prerenal acute kidney injury

The nurse is caring for a patient with an injury to the renal system. Which should be included in the initial treatment of the patient? Promoting urinary drainage Encouraging the patient to rest Administering IV fluids Determining the extent of damage

Promoting urinary drainage Rationale: The initial intervention is promoting urinary drainage by carefully monitoring the patient's vital signs and assessing the level of bleeding. Test Taking Tips: Urination is the priority.

Which stage of renal carcinoma involves the metastasis to other sites of the body according to Robson's system? Stage I Stage II Stage III Stage IV

Stage IV Rationale: According to Robson's system of staging renal carcinoma, stage IV involves the metastasis of the carcinoma to the other parts of the body. Test Taking Tips: Understand the stages.

How is a grade 2 renal trauma described? Superficial lacerations Laceration of the renal artery Hematuria and contusions Renal lacerations above 1 cm in depth

Superficial lacerations Rationale: The occurrence of superficial lacerations is considered grade 2 according to the renal trauma grading scale. Test Taking Tips: Understand the levels.

What is the priority teaching point when the nurse is discussing the treatment regimen with a client who has received a kidney transplant for end-stage renal disease? To take medications daily at the same time To keep all follow-up appointments as scheduled The need for meticulous immediate and lifelong care To inform client of scarring at the incision site

The need for meticulous immediate and lifelong care

Which assessment findings should the nurse report to the healthcare provider as being indicative of possible kidney injury? Select all that apply. Urine output less than 400 mL/day Decreased potassium level Increasing glomerular filtration rate Dyspnea Fixed specific gravity 1.010

Urine output less than 400 mL/day Dyspnea Fixed specific gravity 1.010

The nurse is teaching about the process involved in hemodialysis. Arrange the correct steps of hemodialysis chronologically. -The blood is pumped through a dialyzer. -The waste products are diffused into the dialysate. -Negative pressure should be maintained to allow fluid removal. -The blood moves through an artificial semipermeable membrane. -Bicarbonate is added to the dialysate for acidosis corrections. -A dialysate solution is pumped on the other side of the membrane.

1. The blood is pumped through a dialyzer. 2. The blood moves through an artificial semipermeable membrane. 3. A dialysate solution is pumped on the other side of the membrane. 4. The waste products are diffused into the dialysate. 5. Bicarbonate is added to the dialysate for acidosis corrections. 6. Negative pressure should be maintained to allow fluid removal. Rationale: Hemodialysis is provided for patients with end-stage renal disease. It removes waste products, electrolytes, and excess water from the body by diffusion and filtration. This first and foremost step is to pump the blood to the dialyzer through a vascular device. Next, the blood moves through an artificial semipermeable membrane in the dialyzer. After that, a dialysate solution is warmed and pumped on the other side of the membrane by maintaining a concentration similar to the normal extracellular fluid. Then, the solvent molecules cross the membrane according to the concentration gradient by the diffusion process. Waste products such as urea and creatinine are diffused into the dialysate across the membrane. To correct for acidosis, bicarbonate is added into the dialysate. Finally, negative pressure should be maintained on the side of the dialysate to allow the removal of excess fluid by hydrostatic pressure. The frequency for the dialysis depends on the renal function in the patient.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Result of poorly controlled blood pressure ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

CHRONIC KIDNEY DISEASE (CKD) CORRECT. Poorly controlled blood pressure places pressure on the kidney and decreases the GFR over time, leading to CKD.

This or That? For each topic (etiology, clinical manifestation, or collaborative management strategy), select the correct type of renal failure: acute kidney injury (AKI) or chronic kidney disease (CKD). Result of poorly controlled diabetes ACUTE KIDNEY INJURY (AKI) or CHRONIC KIDNEY DISEASE (CKD)

CHRONIC KIDNEY DISEASE (CKD) CORRECT. Poorly controlled diabetes leads to problems of the microcirculation of the nephron and CKD as the GFR drops over time.

A patient reports anorexia along with cloudy and foul-smelling urine. Which condition should the nurse suspect? Renal cancer Renal trauma Pyelonephritis Glomerulonephritis

Pyelonephritis Rationale: Foul-smelling, cloudy urine and anorexia indicate pyelonephritis.