CKD NGN Sherpath

The nurse reviews the recent bloodwork and urinalysis that performed to identify relevant cues related to current client presentation. Click to high the laboratory results that require immediate follow up by the nurse.

- BUN: 170 mg/dL - Potassium: 5.6 mmol/L

The nurse considers priority hypotheses based on admission data and laboratory results. Which finding supports the priority client problem of impaired perfusion? Select all that apply. - History of tobacco use - Hemoglobin 9 g/dL - Hematocrit 36% - Increasing fatigue - Paleness - Cool extremities - Body mass index (BMI) 31.9 kg/m2 - Difficulty starting urine stream

- History of tobacco use - Hemoglobin 9 g/dL - Hematocrit 36% - Increasing fatigue - Paleness - Cool extremities

The nurse reviews the client's current medication list while developing the plan of care. Choose the most likely options for the information missing from the statement by selecting from the lists of options provided. The nurse anticipates the healthcare provider will discontinue Select response to Select response and provides client education about this medication change. The nurse anticipated the healthcare provider will discontinue _____________ to _____________ and provides client education about this medication change.

- Spironolactone - decrease the chance for hyperkalemia

Health care provider is discussing future treatment options with client. Click to highlight the findings that indicate the client understands his treatment options during this follow-up visit. 1030: Patient verbalizes desire to forgo any type of treatment such as dialysis or kidney transplant at this time, stating that he understands that stage 5 of chronic kidney disease leads to end of life. He says "I just want to go peacefully because it's almost my time and I am OK with that." Client and spouse have asked questions about getting a referral to hospice. To enhance comfort, patient verbalizes that he will eat foods low in potassium, continue taking metformin and lisinopril, carefully manage fluid intake and weigh himself daily at the same time in the same clothing. Hospice referral provided. Prescriptions for medication refills written by provider. Client discharged from visit.

- stage 5 of chronic kidney disease leads to end of life. - "I just want to go peacefully because it's almost my time and I am OK with that." - Client and spouse have asked questions about getting a referral to hospice. - patient verbalizes that he will eat foods low in potassium, continue taking metformin and lisinopril, carefully manage fluid intake and weigh himself daily at the same time in the same clothing

Drag from Word Choices to complete the sentences. The client is at high risk for developing ________, __________, and ___________.

- syncope - uremia - end-stage renal failure

Client is an older adult woman brought to the emergency department (ED) by her daughter because of reports of increasing shortness of breath and an excruciating headache. Client has a history of obesity, diabetes mellitus, hyperlipidemia, and hypertension. The client is alert and oriented but extremely drowsy. The client states a 10-pound weight gain over the past 3 days, despite a poor appetite from nausea and several episodes of vomiting. The client reports increased swelling in her feet and hands, low urinary output, and dry, itchy skin. The daughter reports that the client has been sleeping all the time and barely leaves her room. The client stopped taking her medications of hydrochlorothiazide, regular insulin, and metformin 2 weeks ago stating that she could not afford to refill her prescriptions.

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The nurse is generating a plan of care for the client based on treatment options that have been discussed. Click to indicate which intervention the nurse identifies as indicated or contraindicated for the plan of care to support the expected outcome of maximizing quality of life at this time. Each row must have only one response option selected.

Intervention: - Administer morphine: contraindicated - Encourage reconsidering dialysis: contraindicated - Discuss client's future wishes: indicated - Provide information about hospice services: indicated - Teach about eating a diet high in potassium: contraindicated - Teach to weigh daily in same clothing at same time: indicated - Teach how to properly take supplemental iron: indicated - Teach to drink at least 3 L of water daily: contraindicated

Complete the diagram by dragging from the choices area to specify which condition the client is most likely experiencing, two actions the nurse should take the address that condition, and two parameters the nurse should monitor to assess the client's progress.

Potential Conditions: - Chronic kidney disease Actions to take: - Prepare the client for hemodialysis - Request a prescription for calcium acetate Parameters to monitor: - Urinary output - Muscle weakness