Elimination EAQ pp2

A client is receiving epoetin (Epogen) for the treatment of anemia associated with chronic renal failure. Which client statement indicates to the nurse that further teaching about this medication is necessary? 1. "I realize it is important to take this medication because it will cure my anemia." 2. "I know many ways to protect myself from injury because I am at risk for seizures." 3. "I recognize that I may still need blood transfusions if my blood values are very low." 4. "I understand that I will still have to take supplemental iron therapy with this medication.

1. "I realize it is important to take this medication because it will cure my anemia."

A client with kidney dysfunction is about to undergo renal testing using a contrast medium. Which nursing interventions should be conducted before the procedure to ensure the client's safety?Assessing the client for a history of cirrhosis Asking the client if he or she has a known shellfish allergy Assessing the client for a history of lactic acidosis Assessing the client's hydration status by checking blood pressure and respiratory rate Asking the client to discontinue metformin 12 hours before the procedure

Assessing the client for a history of cirrhosis Asking the client if he or she has a known shellfish allergy Assessing the client's hydration status by checking blood pressure and respiratory rate

Which clinical response will the nurse assess to determine kidney damage in a client who develops a transfusion reaction?

Decreased urinary output

Which nursing assessment would perform by a nurse be administering IV infusion of potassium chloride 40 MEQ in 100ML of 5% dextrose and water to be infused over 2 hours?

Urinary output patency of the IV access last serum potassium level

What are the pharmacokinetic reasons for drug sensitivity in infants?

Medication absorption Renal drug excretion Protein binding of drugs Hepatic drug metabolism

The nurse reviews the medical record of an older adult client admitted with chronic kidney disease. Which clinical finding is the priority requiring collaboration with the primary health care provider? 1Sodium level: 135 2Potassium level: 6 3Creatinine results: 20 4Blood pressure results: 150/100

2 (The client has an increased potassium level outside the expected range for an adult, placing the client at risk for a cardiac dysrhythmia; the higher priority is treatment for the increased potassium, because elevated levels can be lethal. The serum sodium of 135 mEq/L (135 mmol/L) is expected because of the electrolyte imbalance and the anemia related to the decreased production of erythropoietin by the kidney in the presence of chronic kidney failure. A creatinine clearance of 20 mL/min (0.33 mL/s) is low (normal range 95 mL/min in young women; 120 mL/min in young men); however, the client has chronic renal disease and this value reflects the disease process. The priority is the high potassium level. Clients with chronic kidney disease usually have hypertension, and notification is unnecessary.)

A nurse is assessing a client in the oliguric phase of acute kidney injury. Which of the following findings should the nurse expect?

Hyperkalemia. (The nurse should expect the client to have an increase in the serum concentration of potassium during the oliguric phase. Potassium can rise to a life-threatening level during this phase and should be monitored closely.)

A child with a diagnosis of acute renal failure has additional blood drawn for laboratory testing. Which serum level requires immediate intervention?

Potassium 6.1 mEq/L

Which type of urinary condition would cholinergic agonist be prescribed for?

Urinary retention

What should the nurse monitor for when caring for a postoperative client who presents with 180 mL of urine in the urinary drainage bag from the past 8 hours?

renal failure

The nurse is assessing a pediatric client diagnosed with chronic renal failure exhibiting alterations in growth patterns. When educating the client's parents about the child's growth, which statement is accurate?

"Resistance to growth hormone associated with your child's diagnosis is causing poor growth."

What are common negligent acts of nurses found in the hospital setting? Select all that apply.

- Failure to notify the healthcare provider of problems - Failure to follow the six rights of medication administration - Failure to ensure the safety of a client with disequilibrium problems

The nurse identifies that the urinary output is less than 40 mL/hr over the past 3 hours. What action will the nurse take?- Assess breath sounds and obtain vital signs. -Assess breath sounds and obtain vital signs. - Decrease the intravenous flow rate and increase oral fluids - Insert an indwelling catheter to facilitate emptying of the bladder. - Check for dependent edema by assessing the lower extremities.

-Assess breath sounds and obtain vital signs.

When preparing to safely administer medications to newborns it is important for the nurse to recognize which factor as contributors to reduced renal medication excretion?

-Renal blood flow -glomerular filtration -active tubular secretion

Which physiologic characteristics of newborns affect drug dosage considerations? Select all that apply 1 A newborn's less regulated body temperature 2 Immature liver and kidneys 3 Thick and less permeable skin 4 Lungs with weaker mucous barriers 5 Bacteria-killing acid in the stomach

1 A newborn's less regulated body temperature 2 Immature liver and kidneys 4 Lungs with weaker mucous barriers

Arrange the pharmacokinetic factors that determine the concentration of medication at its side of action in neonates and infants in the order in which they occur

1.Absorption 2.Distribution 3.Metabolism 4.Excretion

Intravenous (IV) potassium is prescribed for a client with a diagnosis of hypokalemia. Which statement about administration of IV potassium is accurate? 1Oliguria is an indication for withholding IV potassium. 2Rapid infusion of potassium prevents burning at the IV site. 3Clients with severe deficits should be given IV push potassium. 4Average IV dosage of potassium should not exceed 60 mEq in 1 hour

1Oliguria is an indication for withholding IV potassium.

Which element would the nurse teach the client with chronic kidney disease to limit as an intervention to control uremia associated with end-stage renal disease?1Fluid 2Protein 3Sodium 4Potassium

2 (The waste products of protein metabolism are the main cause of uremia. The severity of the chronic kidney disease determines the degree of protein restriction. Fluid restriction may be necessary to prevent edema, heart failure, or hypertension; fluid intake does not directly influence uremia. Sodium restrictions control fluid retention, not uremia. Potassium restrictions prevent hyperkalemia, not uremia.)

The primary healthcare provider prescribed a diagnostic study with contrast medium for an older adult who has an endocrine disorder. Which assessment result should the nurse check before the study? 1Urinary pH 2Serum creatinine 3Urinary creatinine 4Creatinine clearance 2 Which

2Serum creatinine

A client is admitted to the hospital in the oliguric phase of acute kidney injury. The nurse estimates that the urine output for the last 12 hours is about 200 mL. The nurse reviews the plan of care and notes a prescription for 900 mL of water to be given orally over the next 24 hours. What does the nurse conclude about the amount of fluid prescribed?

3) It will compensate for both insensible and expected output over the next 24 hours.

Which statement explains the amount of prescribed fluid when the nurse estimates that a client admitted in the oligarch phase of acute kidney injury has a urinary output of 200ML over the past 12 hours and the client's plan of care indicates like fluid restriction of 900ML of free water per 24 hour?

3) The fluid compensates for insensible fluid loss and expected urinary output

Which disease increases the risk of hyperkalemia? 1. Crohn disease 2. Cushing disease 3. End-stage renal disease 4. Gastroesophageal reflux disease

3. End-stage renal disease

A client undergoing treatment for a medical condition gave birth to a baby with renal failure as a result of the teratogenic effect of the medications. Which medical condition is the client likely getting treated for? 1Cancer 2Epilepsy 3Hypertension 4Microbial infection

3Hypertension

An ultrasound scan of a baby shows that the proximal tubule in the kidney is not well developed. Which drug treatment in the mother during her pregnancy might have caused this condition in the baby?

Angiotensin-converting enzyme inhibitors

The nurse recalls that furosemide exerts its effects in what part of the renal system? 1.Distal tubule 2.Collecting duct 3.Glomerulus of the nephron 4.Loop of Henle

4.Loop of Henle

A client with renal failure receives prescriptions for vitamin D and calcium supplements. The client asked the nurse why do I need to take these? The nurse explains that with renal failure which condition exists?

A decrease in the active metabolite of vitamin D in the body

A client with kidney dysfunction reports anorexia, itching, nausea, vomiting, and muscle cramps. Which renal complication do these symptoms indicate? A. Uremia B. Nephritis C. Nephrosis D. Renal colic

A. Uremia

The client with congestive heart failure is receiving furosemide 80 mg once daily. Which data collection assessment would be performed to evaluate medication effectiveness? Select all that apply. One, some, or all responses may be correct. Daily weight Intake and output Monitor for edema Daily pulse oximetry Auscultate breath sounds

ALL

A client who had a kidney transplant develops leukopenia 3 weeks after surgery. What does the nurse conclude is the most probable cause of the leukopenia? A. Bacterial infection B. High creatinine levels C. Rejection of the kidney D. Antirejection medications

D. Antirejection medications

A client who has renal failure asks the nurse why anemia keeps recurring. Which reason would the nurse explain to the client?

Decrease in erythroprotien

A nurse is caring for a client receiving hemodialysis for chronic kidney disease. The nurse should monitor the client for what complication? 1Peritonitis 2Renal calculi 3Hepatitis B 4Bladder infection

Hepatitis B Hepatitis type B is transmitted by blood or blood products. The hemodialysis and routine transfusions needed for a client in end-stage renal failure constitute a high risk for exposure.

Which rationale accurately explains why insulin is prescribed for clients in acute renal failure?

It promotes transfer of potassium into cells to lower serum potassium levels.

Which principle explains how loop diuretics promote diuresis?

Osmosis

Which mechanism of action explains how hydrochlorothiazide increases urine output?

a: Increases the excretion of sodium

When ammonia is excreted by healthy kidneys, what mechanism usually is maintained? a. osmotic pressure of the body b. acid-base balance of the body c. low bacterial levels in the urine d. normal red blood cell production

b. acid-base balance of the body