NCLEX Adult Renal System

A client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily does of enalapril (Vasotec) The nurse should plan to administer this medication when

antihypertensive medications such as enalpril are given to the client follwing hemodialyis

A client is being evaluated as a potention kidney donor for a family member. The donor asks the nurse why a different team of people other than the team working with the potentioal recipient is doing the evaluation. IN formulating a response the nurse understands that this is being done to

avoid a conflict of interest by the team evaluating the recipient and the team evaluating the donor

A nurse is assigned to care for a client who has returned to the nursing unit following left nephrectomy. The nurse places the highest priority on monitoring which of the following

highest priority is monitoring hourly urine output and the second thing to do is monitor vitals signs

After renal biopsy the nurse ensures that the patien:

remains in bed for at least 24 hours. take vital signs and inspect puncture site often.encourage fluids to reduce possible clot formation in the kidney and urinary tract. a hematest evalutes bleeding. Analgesics are often needed

what is a nephrectomy

removal of kidney

BUN (blood ureas nirtogen test) is often used to determine what

renal function.

A client has been diagnosed with pyelonephritis. The nurse interprets that which of the following health problems has placed the client at risk for this disorder

risk factors include Diabete Mellitus, hypertension, chronic renal calculi, chronic cystits, structural abnormalities of the urinary tract, urinary stones, indwelling or frequent urinary catherization

what is urolithiasis

stones present in the urinary tract (i.e., the kidneys, bladder, and/or urethra). Predisposing factors include dehydration and high uric acid (increased by some medications). Also called nephrolithiasis or

A nures is assiting in planning a teaching session with a femal client diagnosed wit hurethritis caused by infection with chlamydia. The nurse would plan to include what in teaching

the most serious complication of chlamydial infection is sterility. The infection can be prevented with use of condoma. May be treated with doxycycline or azithromycin(Zithromax). All sexual partners during last 30 days should be notified and examined

A nurse is assessing a client with suspected acute renal failure. Which of the following findings support a diagnosis of acute intrarenal failure

urine analysis positive for casts and cellular debris

S&S of disequilibrim syndrome

vomiting and headaches, confusion, restlessness, twitching,muscle cramps, seizures

Individuals with polycystic disease

waste rather that retain sodium. Thus they need an increased sodium and water intake. aggressive control of hypertension is essential, gentic counseling is advisable because of the hereditary nature of the disease

what is glomerulonephritis

Glomerulonephritis (gloe-mer-u-lo-nuh-FRY-tis) is inflammation of the tiny filters in your kidneys (glomeruli). Glomeruli remove excess fluid, electrolytes and waste from your bloodstream and pass them into your urine. Also called glomerular disease, glomerulonephritis can be acute — a sudden attack of inflammation — or chronic — coming on gradually.

Hyperkalemia will occur along metabolic acidosis because the cells will draw hydrogen into the cell and in exchange will push potassium out of the cell into the blood. What is normal potassium level

3.5-5 meq/l

Specific gravity is a measure of the concentration of particles in the urine. NOrmal range is what

1.005 to 1.030

Normal Blood SOdium Level

135-145mEQ/L

After renal biopsy the nurse ensures that the client stays in bed for at least

24 hours

Normal Potassium level in blood

4.5-5mEQ/L

what is a cystourethrogram

A cystourethrogram is an X-ray test that takes pictures of your bladder and urethra while your bladder is full and while you are urinating. A thin flexible tube (urinary catheter ) is inserted through your urethra into your bladder. A liquid material that shows up well on an X-ray picture (contrast material) is injected into your bladder through the catheter, then X-rays are taken with the contrast material in your bladder. More X-rays may be taken while urine flows out of your bladder, in which case the test is called a voiding cystourethrogram (VCUG

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitors this client for which manifestation of this disorder?

Arterial steal syndrom results from vascular insufficiency after creation of a fistula. The client exhibits Pallor, Dimished puls distal to the fistula, and pain in the left hand

what is a cystoscopy

Cystoscopy is a procedure used to see inside your urinary bladder and urethra — the tube that carries urine from your bladder to the outside of your body. During a cystoscopy (sis-TOS-kuh-pee) procedure, your doctor uses a hollow scope (cystoscope) equipped with a lens to carefully examine the lining of your bladder and your urethra. The cystoscope is inserted into your urethra and slowly advanced into your bladder.

What is dialysate

Dialysate is one of the two fluids used in dialysis. The other fluid being blood. The term dialysate is borrowed from physical chemistry and refers to fluids and solutes which have crossed a membrane. The main function of the dialysate, is to remove waste material from the blood and to keep useful material from leaving the blood. Electrolytes and water are some materials included in the dialysate so that thier level in the blood can be controlled

what is Enalapril

Enalapril is a drug that is used for treating high blood pressure

What is Enalapril

Enalapril is used alone or in combination with other medications to treat high blood pressure. It is also used in combination with other medications to treat heart failure. Enalapril is in a class of medications called angiotensin-converting enzyme (ACE) inhibitors. It works by decreasing certain chemicals that tighten the blood vessels, so blood flows more smoothly and the heart can pump blood more efficiently.

what is epididymitis

Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Pain and swelling are the most common signs and symptoms of epididymitis. Males of any age can get epididymitis, but it's most common in men between the ages of 20 and 39.

What is an epdidymitis

Epididymitis is swelling (inflammation) of the epididymis, the tube that connects the testicle with the vas deferens.

what is hemodialysis

In hemodialysis, a machine filters wastes, salts and fluid from your blood when your kidneys are no longer healthy enough to do this work. Hemodialysis is the most common way to treat advanced, permanent kidney failure. The procedure can help you carry on an active life despite failing kidneys.

what is phyelonephritis

Kidney infection (pyelonephritis) is a specific type of urinary tract infection (UTI) that generally begins in your urethra or bladder and travels up into your kidneys

what is peritoneal dialysis

Peritoneal dialysis (per-ih-tuh-NEE-ul di-AL-uh-sis) is a way to remove waste products from your blood when your kidneys can no longer do the job adequately. During peritoneal dialysis, blood vessels in your abdominal lining (peritoneum) fill in for your kidneys, with the help of a fluid (dialysate) that flows into and out of the peritoneal space.

what is peritonitis

Peritonitis is a bacterial or fungal infection of the peritoneum, a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen

what is peritonitis

Peritonitis is a bacterial or fungal infection of the peritoneum, a silk-like membrane that lines your inner abdominal wall and covers the organs within your abdomen. Peritonitis can result from any rupture (perforation) in your abdomen, or as a complication of other medical conditions

A client with acute renal failure(ARF) has been treated with sodium polystyrene sulfonate (kayexalate) by mouth. The nurse evalutes this therapy as effective if which of the following values is noted on follow-up laboratory testing 1.potassium 4.9 mEq/L 2.Sodium 142 mEq/L 3.Phosphorus 3.9 mg/dl 4.Calcium 9.8 mg/L

Potassium 4.9 mEq/L potassium level rises in acute renal failure the normal potassium level is 3.5 to 5 mEq/L

what is prostatitis

Prostatitis is swelling and inflammation of the prostate gland, a walnut-sized gland located directly below the bladder in men. The prostate gland produces fluid (semen) that nourishes and transports sperm. Prostatitis often causes painful or difficult urination. Other symptoms of prostatitis include pain in the groin, pelvic area or genitals, and sometimes, flu-like symptoms.

what is urethritis

Urethritis is inflammation of the urethra. The most common symptom is painful or difficult urination.

what is renal colic

When sufferers refer to the excruciating pain of a kidney stone attack, they are actually referring to a condition known as renal colic

A client arrives at the ambulatory care clinic with low abdominal pain. A routine urine specimen reveals hematuria. The client does not have fever. The nurse should next ask the client what

about any blow or trauma to the bladder or abdomean.

what is an acid ash diet

acid-ash diet one of meat, fish, eggs, and cereals with little fruit or vegetables and no cheese or milk.

A client who suffured a crush injury to the leg has a highly positive urine myoglobin level. (normal urine myoglobin level is negative) THe nurse plans to monitor this particular client carefully for signs of

acute tubular necrosis

What is allowed in an alkaline-ask diet

all fruits EXCPET cranberries, prunes, and plums

An alkaline-ash diet is prescribed for the client with renal calcul. what food is allowed

all fruits are allowed except cranberries, prunes, and plums

A client with chronic renal failure has been on dialysis for 3 years. The client is receiving the usual combination of medications for the disease, including aluminum hydroxide as a phosphate-binding agent. The client now has menatal cloudiness, dementia, and complaints of bone pain. The nures interprets that these data are compatible with what

aluminum intoxication may occur when there is accumulation of aluminum, and ingredient in many phonsphate-binding antacids

A client diagnosed with chronic renal failure is being treated at home with continuous ambulatory peritoneal dialysis. The client notes that there is a decrease in the catheter outflow following the prescribed 6 hour dwell time and calls the nurse to report this occurrence. The nurse should instruct the client to take which action

ambulate in his home

A nurse is reviewing the client's record and notes that the physician has documented that the client had a renal disorder. ON review of the laboratory results, the nurse would most likely expect to note which of the following

an elevatd blood urea nitrogen (BUN) level

Dietary needs of client with chronic renal failure

protein restriction usually restricted to 40g of daily protein restriction avoid salt, a salt substitue is not okay avoid too much caffeine milk is not ok a bage is ok avoid eggs avoid salt, soy sauce

What are some common interventions used in the treatment of epidymitis

bedrest ice packs antibiotics analgesics elevation of the scrotum DO NOT USE HEAT it can increase swelling

Following a renal biopsy, the client complains of pain at the biopsy site, which radiates to the front of the abdomen. Based on this complaint, the nurse further monitors the client for what

bleeding

TUR syndrome is caused by increased absorption of nonelectrolyte irrigating fluid used during surgery. The client may show signs of what

cerebral edems and increased intracrancial pressure such as increased BP, bradycardia, confusion, disorientation, muscle twitching, visual disturbances, nausea, and vomitting

A nurse is monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. what should the nurse do

check the level of the drainage bag reposition the client to his or her side place the client in good body alignment check the peritoneal dialysis system for kinks

A client's kidneys are retaining greater amount of sodium. The nurse anticipates that the kidney are also retaining greater amounts of

chloride and bicarbonate. Sodium is a cation. WHen there is increased retention of sodium, the kidney also had increased reabsorption of chloride and bicarbonate which are anions

The use of peritoneal dialysis for the treatment of chronic renal failure would be contrainicated for which client

client with severe emphysema

A client with acute glomerulonephritis has a urinalysis sent to lab. The report reveals that there is hematuria and proteinuria in the urine. The nurse interprets that these results are

consistent with glomerulonephrits

A nurse is collecting data from a client who has had benign protatci hyperplasia(BPH) in the past. To determine if the client is currently experiencing exacerbation of BPH, the nurse asks the client about the presence of which early symptom

decreased force in the stream of urine is an early sign of BPH. The stream later becomes weak and dribbling. The client may develop hematuria, frequency, urge incontinecne, and nocturia. If untreated complete obstruction and urinary retention can occur

A client is schedulted for intraveonous pyelography (IVP) before the test the priority nursing action would be to:

determine a history of allergies

Risk factore associated with pyelonephritis include

diabetes mellitus, hypertension, chronic renal calcuili, chronic cystitis, structural abnormalitiies of the urinary tract, presence of urinary stones, and indwelling or frequen urinary catheterization

A nures notes that a client's urinalysis contains a notation of positive red blood cells. The nurse interprets that this finding is unrelated to which of the following items that is part of the client's medical record

diabetes mellitus. It does not cause hematuria

A male client has a tentative diagnosis of urethritis. The nurse collects data from the client, knowing that which of the following are manifestations of the disorder

dysuria and penile discharge

A client newly diagnosed with renal failure will be receiving peritoneal dialysis. During the infusion of the dialysate, the client complains of abdominal pain. What action by the nurse is appropriat

expain that the pain will subside after the first few exchanges

a nurse is caring for a client with epidiymitis. The nurse anticipates which of the following fidings on data collection

fever nausea and vomiting and painful scrotal edema

A nurse is caring for a client with epididymitis. The nurse anticipate noting which of the followin findings on data collection

fever, nausea and vomiting, and painful scrotal edema

A nurse is providing instruction to the client regarding complication of peritoneal dialysis. The nurse instructs the client that which manifestation is likely associated with the onset of peritonitis

fever, nausea, malaisem reboung abdominal tenderness, and cloudy dialystate indication of peritonits

describe potassium

found in large qualities in intracellular fluids. Sources include banana, tomatoes,potatoes, K+

Describe Sodium

found in large quantities in extracellular fluid, source:table salt and processed foods, Na+, main function to mainatin fluid balance

the spouse of a client with acute renal failure secondary to hear failure asks the nurse how this could happen . The nurse plans to base her response in part on the fact that the kidneys

generally require and receive about 20% ti 25% of the resting cardiac output

remember

glomerulonephritis and pyelonephirties would be accompanied by fever b/c they are infections. renal cancer would cause pain in the flank but not lower abdomen

A nurse if performing an admission assessment on a cient with a diagnosis of bladder cancer. Which of the following would the nurse most likely expect to note on data collection of this client

groos painless hematuria is most frequently the first manifestation of bladder cancer.

A client who is performing peritoneal ialysis at home calls the clinic and reports that the outflow from teh dialysis catheter seems to be decreasing in amount. THe nurse appropriately asks which of the following questions first

have you been constipated recently. Reduced outflow from teh dialysis catheter may be du to catheter position, infection, or constipation

A client newly diagnosed with chronic renal failur has recently begun hemodialysis. Knowing that the client is at risk for disequilibrium syndrome, the nurse monitors the client during dialysis for:

headache mental confusion nausea vomiting possible seizure activity deteriotating level of consciousness twitching

A nurse is caring for a client with epididymitis. THe nurse avoids which of the following treatemnt modalities in the care of the client bedres sitz bath heating pad scrotal elevation

heating pad

A client is seen in the health care clinic and acute phyelonephritis is expected. The nurse reviews the client's record and would expect to note which associated signs and symptoms documented

high fever chills vomiting flank pain on affected side with costovertebral angle tendrness general weakness headache

The diet for the client with acute glomerulonephritis is generally

high in calories and low in protein. sodium MAY be limited. No specific recommendations for fiber, potassium or magnesium food types

The nurse is instructing a client with diabetes mellitus about peritoneal dialysis. The nurse tells the client that it is important to maintain the dwell time for the dialysis at the prescribed time because of the risk of

hyperglycemia. An extended dwell time increases the risk of hyperglycemia in the client with diabetes mellitus as a result of absorption of glucose from the dialysate and electrolyte changes. Diabteric clients may require extra insulin when receiving peritoneal dialysis

The client with diabetes melitus receiving peritoneal dialysis asks the nurse why it is important to leave the dialysate infused only for a specific amount of time. The nurse responds that not adhering to the dwell time can increase the risk of the client experiencing

hyperglycemia. Dialysate contains glucose which gleps remove fluid through an osmotic gradient. An extended dwell time increases rick of hyperglycemia in diabetic clients as a result of the absortption of glucose from the dialysate and electrolyte changes.diabetic clients may require extra insulin during peritoneal dialysis

A nurse is admitting a client with chronic renal failure (CRF) to the nursing unit. The nurse monitore the client for which frequent cardiovascular sign that occurs in CRF

hypertension is the most common cardiovascular finding in the client with CRF

A nurse is monitoring an 88 year old woman suspected of having a UTI for signs of infection. Which of the following would alert the nurse to the possibillity of the presence of a UTI

in an older client, the only symptom of a UTI may be something as vague as increasing mental confusion or frequent unexplained falls

A nurse is assiting in planning a diet for the client with actue renal failure (ARF). the nurse plans to restrict which of the following dietary components from this client's diet

in renal failre, potassium intake MUST be restricted as much as possible (30-50 mEq/day)

A client who has a cold is seen in the ER with inability to void. B/C the client has a Hx of beingn prostatic hyperplasia (BPH) the nurse question the cient about what medicatin

in the client with BPH episodes or urinary retention can be triggered by certain medications such as decongestants, aniticholinergics, antidepressants

TUR (transurethral resection of the prostat) is caused by what

increase absorption of nonelectrolyte irrigatin fluid usedduring surgery. Onset of the syndrome would include bradycardia and confusion

what precaution follow a renal scan

no special precaution, exept wear gloves if coming into contact with the client's urine

when drainage from cather becomes cloudy, peritonitis is suspected. what should be done by nurse

notify RN to obtain a C&S of the drainage

A nurse is caring for a client undergoing peritoneal dialysis. The nurse checks the client and notes that the drainage from the outflow catheter is cloudy. THe nurse notifies the RN and plans to take which action

obtain a C&S of the drainage. Peritonits is suspected

A hemodialysis client with a left arm fistula is at risk for arterial steal syndrome. The nurse monitor this client for which manifestastation of this disorder?

pallor, diminished pulse, and pain in the left hand

A nurse is assessing the patency of an arterioenous fistula in the left arm who is receiving hemodialysis for the treatment of chronic renal failure. Which finding indicates that the fistula is patent

palpation of a thrill and bruit indicates patnecy of the fistula

What condition places the clietn at risk for developing acute postrenal failure

postrenal failure is caused by an obstruction in the urinary tract. Some causes of obstruction include calculi, tumors, prostatic hypertrophy, or strictures, wich impede the normal flow of urine

Involved in muscle contractions, especially the heart

potassium