Unit 8

A nurse is preoperative teaching with a client who is scheduled for a kidney transplant about rejection of a transplanted kidney. Which statements should the nurse include in the teaching? (sata)

"Expect an immediate removal of the donor kidney for a hyperacute rejection." "A fever is a manifestation of an acute rejection." "Fluid retention is a manifestation of an acute rejection."

A nurse is teaching a client who is postoperative following a kidney transplant and is taking cyclosporine. Which instructions should the nurse include?

"Monitor for and report a sore throat to your provider."

A nurse is teaching a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL). Which statements by the client indicates understanding of the teaching?

"Straining my urine following the procedure is important"

A nurse is teaching a client who will have an x-ray of the kidneys, ureters, and bladder. Which statements should the nurse include in the teaching?

"The procedure determines whether you have a kidney stone."

A nurse is caring for several clients. Which clients are at risk for developing pyelonephritis? (sata)

A client who is at 32 weeks of gestation A client who has kidney calculi A client who has a neurogenic bladder A client who has diabetes mellitus

A nurse is caring for a client who has a left renal calculus and an indwelling urinary catheter. Which assessment findings is the priority for the nurse to report to the provider?

Absent urine output for 1 hour

A nurse is caring for a client who has a UTI. Which is the priority intervention by the nurse?

Administer an antibiotic

A client who is scheduled for kidney transplantation surgery is assessed by the nurse for risk factors of surgery. Which findings increase the client's risk of surgery? (sata)

Age older than 70 years BMI of 41 Administering NPH insulin each morning Past history of lymphoma

A nurse is assessing a client who has end-stage kidney disease. Which findings should the nurse expect? (sata)

Anuria Marked azotemia Crackles in the lungs Proteinuria

A nurse is planning care for a client who has postrenal AKI due to metastatic cancer. The client has a serum creatinine of 5 mg/dL. Which interventions should the nurse include in the plan? (sata)

Assess for jugular vein distention Provide frequent mouth rinses Auscultate for a pleural friction rub Monitor for dysrhythmias

A nurse is caring for a client who develops disequilibrium syndrome after receiving hemodialysis. Which actions should the nurse take?

Assess level of consciousness

A nurse is preparing educational material to present to a female client who has frequent UTIs. Which information should the nurse include? (sata)

Avoid sitting in a wet bathing suit Empty the bladder when there is an urge to void Take a shower daily

A nurse is completing discharge instructions with a client who has spontaneously passed a calcium oxalate calculus. To decrease the chance of recurrence, the nurse should instruct the client to avoid which of the following foods? (sata)

Black tea Spinach

A nurse is planning postprocedure care for a client who received hemodialysis. Which interventions should the nurse include in the plan of care? (sata)

Check BUN and serum creatinine Administer medications the nurse withheld prior to dialysis Observe for signs of hypovolemia Assess the access site for bleeding

A nurse is completing the admission assessment of a client who has renal calculi. Which findings should the nurse expect?

Diaphoresis

A nurse is reviewing client laboratory data. The nurse should recognize that which findings is expected for a client who has Stage 4 chronic kidney disease?

Glomerular filtration rate (GFR) 20 mL/min

A nurse is teaching a client who has CKD and is to begin hemodialysis. Which information should the nurse include in the teaching?

Hemodialysis returns a balance to serum electrolytes

A nurse is monitoring a client who had a kidney biopsy for postoperative complications. Which complications should the nurse identify as causing the greatest risk to the client?

Hemorrhage

A nurse is caring for a client who has type 2 diabetes mellitus and will have excretory urography. Prior to the procedure, which actions should the nurse take? (sata)

Identify an allergy to seafood Withhold metformin for 24 hours Administer an enema Assess for asthma

A nurse is reviewing discharge instructions with a client who had spontaneous passage of a calcium phosphate renal calculus. Which instructions should the nurse include in the teaching? (sata)

Limit intake of food high in animal protein Reduce sodium intake Report burning with urination to the provider Increase fluid intake to 3L/day

A nurse administered captopril to a client during a renal scan. Which actions should the nurse take?

Monitor for orthostatic hypertension

A nurse is planning care for a client who will undergo peritoneal dialysis. Which actions should the nurse take? (sata)

Monitor serum glucose levels Report cloudy dialysate return Assess for shortness of breath Check the access site dressing for wetness

A nurse is reviewing the results of a client's urinalysis. The findings indicate the urine is positive for leukocyte esterase and nitrites. Which actions should the nurse take?

Obtain a clean-catch urine specimen for culture and sensitivity

A nurse is planning postoperative care for a client following a kidney transplant surgery. Which actions should the nurse include in the plan of care? (sata)

Obtain daily weights Assess dressings for bloody drainage Replace hourly urine output with IV fluids Monitor serum electrolytes

A nurse is reviewing urinalysis results for four clients. Which urinalysis results indicates a urinary tract infection?

Positive for leukocyte esterase

A nurse is planning care for a client who has prerenal acute kidney injury following abdominal aortic aneurysm repair. Urinary output is 60 mL in the past 2 hr, and blood pressure is 92/58 mm Hg. The nurse should anticipate which interventions?

Prepare to administer a fluid challenge

A nurse is planning care for a client who has postrenal AKI due to metastatic cancer. The client has a serum creatinine of 5 mg/dL. Which interventions should the nurse include in the plan? (sata)

Provide a high-protein diet Assess the urine for blood Monitor for intermittent anuria

A nurse is planning care for a client who has chronic pyelonephritis. Which actions should the nurse plan to take? (sata)

Provide a referral for nutrition counseling Palpate the costovertebral angle Monitor urine output Administer antibiotics

A nurse is assessing a client who has prerenal AKI. Which findings should the nurse expect? (sata)

Reduced urine output Elevated serum creatinine

A nurse is preparing to initiate hemodialysis for a client who has AKI. Which actions should the nurse take? (sata)

Review the medications the client currently takes Assess the AV fistula for a bruit Calculate the client's hourly urine output Measure the client's weight Check serum electrolytes