Med surg 1 exam
A patient is admitted with a history of peptic ulcer disease and vomiting for several days. His arterial blood gas results are: pH:0.52 CO2 47, HCO3 40 mEq/L. He has a nasogastric tubeinserted. What condition is the patient experiencing?
Metabolic alkalosis
............ is responsible or regulating the amount of water in hte blood and is released from the pituitary gland based on signals from the hypothalamus, which detects the water level of the blood
Antidiuretic hormone
What controls the amount of water absorption
Antidiuretic hormone (vasopressin)
A football player is bought o have sustained an injury to his kidney from being tackled from behind. The ER nurse caring for the patient reviews the initial orders written by the physician and notes that a order to collect all voided urine and send it to thlaboratory for analysis. The nurse understands that this nurse intervention is important for what reason?
Hematuria is the most common manifestation of Renal and blood losses may be microscopic, so laboratory analysis is essential
A patient with chronic kidne disease is beginning hemodialysis. Which of the following should the nurse include in the teaching?
Hemodialysis returns a balance to seru electrolytes
A patient wth a history of progressively worsening fatigue is undergoing a comprehensive assessment which includes test f real funcation relating to erytropoiesis. When assessing the oxygen transport ability of the bloo the nurse should prioritize the review of wat blood value?
Hemoglobin
The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose insulin insulin, and sodium bicarbonate to be used to treat.
Hyperkalemia
You are caring for a patient with acute renal failur. What is the most common clinical manifestation of acute renal failure.
Oliguria
A client has been receiving 2500 ml of fluids and 300 to 400 of oral intake daily for two days. The client urine output has been decreasing and now has been less than 40 ml per hou or the past thee hours. The nurse should initially: ~the imbalance in I & O with decreasing urine output may indicate renal failure with an increase in body fluid and the resulting development of heart allure, assessing breast sound and ital signs are the first steps when monitoring there complications.
Assess breathounds an assess vital signs
A 68 year old female patient admitted to the hospital with dehydration is confused and incontinet of urine. Which nursing action lol be best to include in the plan of care? ~assisting patient to the restroom every two hours is best for patient with Changes in mental status who can ambulate.
Assist the patient to the bathroom every two hours
A patient admitted o the medical unit with impaired renal funcaton is complaint of severe stabbing pain in the flank and lower abdomen. The patient is being assesse or renal calculi. The nurse recognizes that the stone is most likely in wat an atomic location.
Bladder
Which assessment finding for a patient who has just been admitted with acute pyelonephritis is most important for the nurse to report o the health care provider?
Blood pressure 90/48 mm Hg
A patient who has acute glomerulonephritis i hospitalized with hyperkalemia. Which information will the nurse monitor to evaluate the effectiveness of the prescribed calcium gluconate IV?
Cardiac rhythm
............ renal failure is a slow, insidious process of kidney destruction. It may go unrecognized fo years as nephrons are destroyed and renal mass is reduced
Chronic
A female client with acute renal failure is undergoing dialysis for the first time. The nurse in charge monitors the client closely for Italy's is equilibrium syndrome, a complication that is most common during the first few dialysis sessions . Typically, dialysis equilibrium syndrome causes:
Confusion, headache, and seizures
A 5 year old patient is scheduled to undergo ideal conduit surgery. When plannng this patients discharge education, wha is the most plausible diagnosis that the nurse should address
Deficient knowledge related to care of the ileal conduit
A nurse is airing for a patient who is in the diuresis phase of AKI. The nurse should closely monitor the patient or what complication using this phase.
Dehydration
A chronic dialysis patient is admitted for ericardial effusion and drainage. Dialysis is scheduled for noon today. All the patients daily medication are scheduled for 10 am. The day shift nurse should:
Determine which medication are affected by dialysis and change the medication schedule accordingly
Whic instruction by the nurse woul be correct in teaching a 6 year old women to prevent the recurrence of renal calculi?
Drinking 2000 to 3000 mL of fluid a day
The nurse is caring for a patient suspected having renal dysfunction. When reviewing laboratory results for this patient the nurse interprets the presence of which substances in the urine are most suggestive of pathology.
Glucose and protein
Real failure can have prerenal , renal, or postrenal causes. Patient with acute kidney injury is being assessed to determine where, physiologically the cause is. If the cause is found to b prerenal which condition most likely caused it?
Heart failure
The nurse is assessing a patent suspected of having developed acute glomerulonphritis. The nurse should expect to address what clinical manifestation that is characteristic of this health problem?
Hematuria
A female client is admitted with a diagnosis of acute rena failure, she is awake, alert,oriented and omplaining of severe back pin, nausea and vomiting and abdominal cramps. Her vital signs are blood pressure 100/70 mm Hg, pulse 110, respiration 30, and oral temperature 100.4 degrees F. Her electrolytes are sodium 120 mEq/L , potassium 5.2 mEq/L, her urinary output for the fo the first 8 hours is 50 ml. The client is displaying signs of which electrolyte imbalance.
Hyperkalemia
What physiological abnormalities ndatethe development of chronic kidney disease. (Select all that apply)
Hyperkalemia
The nurse assesses a client with a diagnosis of parathyroid disease. The client is having abdominal cramping, positive chovsteks and trousseaus signs and tingling in the extremities. The nurse knows that these findings could be signs ad symptoms of which of the following?
Hypocalcemia
You are th surgical caring for a 65 year old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment, the patient complains of tingling in her lips and fingers. She tells you that she has an intermittent spasm in her writ and hand and she exhibits increase muscle tone. Wat electrolyte imbalance should you rise suspect.?
Hypocalcemia
You are the surgical nurse caring for a 65 year old female patient who is postoperative day 1 following a thyroidectomy. During your shift assessment the patient complains of tingling in her lips ad fingers. She tells you that she has an intermittent spasm in her wrist and hand and she exhibits increased muscle tone. What elctrolyte imbalance should you first suspect?
Hypocalcemia
After 1 week a client with acute renal failure moves into the diuretic phase. During this phase the client must be carefully assssed or the signs of
Hypovolemia
After 1 week a client with acute renal failure moves, into the diuretic phase. During this phase the client must be carefully assessed for signs of:
Hypovolemia
A client with acute renal failure is aware that the most serious complication of this condition is.
Infection
When admistering albumin intravenously the nurse i aware that body water will gift from the
Intracellular compartment to the intravascular compartment
Mr. Miller is brought into the emergency room with new onset confusion and night tremors. As he i placed on the cardiac monitor you notice for a brief moment an abnormal rhythm of torsades de pointe. As you take mr. millers blood pressure you notice his wrist flexes with cuff inflation. His lab results are in which lab value is most concerning after your assessment of mr. miller?
Magnesium 0.5 mg/L
A patient th severe vomiting has arterial blood gas drawn. The nurse would expect which acid- base imbalance as a result of vomiting for 24 hour?
Metabolic alkalosis
A older patient receiving continuous tube feeding develops restlessness , agitation, and weakness. Which laboratory result should the nurse report to the health care provider immediately
Na+ 154 mEq/L (154 mmol/L)
A patient wit renal failure has been taking aluminum hydroxide/ magnesium hydroxide suspension (maalox) at home or indigestion. The patient arrives for outpatient hemodialysis and is unresponsive to question and decreased deep tendon reflexes. Which actio should the dialysis nurse take first.
Notify the patients health care provider
A patient with real failure has been taking aluminum hydroxide/ magnesium hydroxide suspension (Maalox) at home for indigestion. The patient arrive for outpatient hemodialysis and is unresponsive to questions and has decreased deep tendon reflexes. Which action hold the dialysis nurse take first?
Notify the patients health care provider
The nurse i caring for a patient who underwent percutaneous lithotripsy earlier in the day. What instruction should the nurse give the patient
Notify the physician abou cloudy or foul smelling urine
The nurse is aware that the shift of body fluids associated with the intravenous administration of albumin occurs by th process of:
Osmosis
The nurse is reviewing an arterial blood gas report for a client with type 1 diabete. The nurse understands that the resul that reflects diabetic keto acidosis would b ~ low pH an bicar level=metabolic acidosis.
PH~ 7.28, CO2~ 28, HCO3 18
A patient with a recent history of nephrolithiasis has presented to the ED. After determining that the patient's cardiopulmonary status is stable, what aspect of care should the nurse prioritize
Pain management
............ allure is caused by obstruction o urine flow (urethral construction by enlarged prostate or tumor, ureteral or kidney pelvis obstruction y calculi)
Postrenal
Our patient with chronic kidney disease is scheduled for dialysis in the morning. While examining the patients telemetry strip, you note tall peaked t-waves. You notify the physician who orders a STAT basic metabolic panel (BMP). What result from the BMP confirms the ekg abnormality?
Potassium 7.1 mEq/L
A 55 year old male patient is admitted with a massive GI bleed. The patient is at risk for what type of acute kidney injury?
Pre renal
The cause of ........ failure is impaired blood supply to the kidney (fluid volume deficit, hemorrhage, heart failure, shock)
Prerenal
A patient with prerenal AKI would b expected to have the following findings (select all that apply)
Reduced urine output Elevated serum creatinine Elevated serum calcium
The nurse is caring for a patient who underwent percutaeous lithotripsy earlier in the day. What instruction should the nurse give the patient?
Report any pink tinged ruin within 24 hours after the procedure
After the insertion o an arteriovenous gaff (AVG) in the right forearm, a 54 year old patient complains o pain an coldness of the right fingers. Which action should the nurse take.
Report the patients symptoms to the health care provider
Before administration of calcium carbonate (caltrate) to a patien with chronic kidney disease, the nurse should check which laboratory results?
Serum phosphate
The nurse is reviewing laboratory results on a clien with acute real failure. Which one of the following shoul be reported IMMEDIATELY?
Serum potassium 6 mEq/L
A patient with kidney stones is scheduled for extracorporeal shock wave (lithotripsy) (ESWL). What should the nurse include in the patients post-procedure care?
Strain the patients ruin following the procedure
Which of the following nurse actions is ost appropriate when caring for a client with a nursing diagnosis of excess fluid volume
Teaching client about sodium contents of food
The nurse is caring for acutely I'll patient. Which assessment finding should prompt the nurse to inform the physician that the patient may be exhibiting signs of auto kidney injury (AKI)
The patient average urne output has bee 10 ml/hr for several hours.
A nurse colleague has applied an incontinence pad to an older adult patient who has experienced occasional Enid's of functional incontience. What principle should guide the nurses management of urinary incontinence in older adults?
Urinary incontinence is not considered a normal consequence of aging
The nurse is caring for a patient with massive run injury and possible hypovolemia. Which assessment data will be of the most concern to th nurse?
Urine output is 10 mL for the last 8 hours
A58 year old male patient who weight 242 lb undergoes a nephrectomy for massive kidney trauma due to moto vehicle crash. Which postoperative assessment funding is most important to communicate to the surgeon
Urine output is 20 mL/hr for 2 hours
