Fluid Electrolytes and Infection

A client is admitted with a diagnosis of viral gastroenteritis. The client has an elevated blood urea nitrogen and creatinine and is oliguric with a blood pressure of 74/30 mmHg. Which order from the healthcare provider should the nurse carry out first? Administer an antiemetic. Collect stool samples. Administer an antipyretic. Administer intravenous fluids.

Collect stool samples.

A client who is septic has started shivering violently. Which nursing intervention is necessary to care for this client? Maintain the client in a supine position with legs elevated 12 inches. Keep the client dry and covered. Control the shivering. Place the client on a warming blanket.

Control the shivering.

A client is to have an amputation. The client is acutely ill and diagnosed with a gangrenous limb and related fever, disorientation, and electrolyte imbalances. Which of the following would be most important for the nurse to monitor in this client? Occurrence of allergic reactions Signs of sepsis Reduced urine output Signs of nausea and vomiting

Signs of sepsis

A client asks the nurse why epoetin alfa is administered during dialysis sessions. Which response by the nurse is accurate? "When clients are on a renal diet, this medication produces products to stimulate increased renal output." "The medication is given to eliminate the rise of creatinine, a naturally occurring electrolyte excreted by the kidneys." "The medication is a form of erythropoietin that stimulates red blood cell production." "The medication will assist in your activity level when you are not in the hospital."

"The medication is a form of erythropoietin that stimulates red blood cell production."

A nurse is caring for a client diagnosed with acute kidney injury with an indwelling urinary catheter. The nurse notes that the total urine output for the previous 24 hours is 35 ml. What action should the nurse perform first? Insert an intravenous catheter, and encourage the client to increase oral intake. Notify the healthcare provider that the client meets the criteria for anuria. Scan the client's bladder to determine if residual volumes are present. Teach the client about what to expect during hemodialysis treatments.

Notify the healthcare provider that the client meets the criteria for anuria.

A client with decreased urine output refractory to fluid challenges is evaluated for renal failure. Which condition may cause the intrinsic (intrarenal) form of acute renal failure? damage to cells in the adrenal cortex obstruction of the urinary collecting system nephrotoxic injury secondary to use of contrast media poor perfusion to the kidneys

nephrotoxic injury secondary to use of contrast media

A nurse is advising a client who has just had her first menses on how to use a tampon. Instructions include using the least absorbent tampon and changing tampons frequently, at least every 4 to 6 hours. Which condition is the nurse most likely trying to prevent? pelvic inflammatory disease cervicitis vaginitis toxic shock syndrome

toxic shock syndrome

The nurse would observe an elevated leukocyte count and a fever accompanied by warm, flushed skin during the assessment of the client with an overwhelming bacterial infection. who has had an overdose of opioids. who has lost blood during birth. who has had severe allergic reaction to a bee sting.

with an overwhelming bacterial infection.

A nurse is caring for a client in renal failure who fell and sustained a head injury. The nurse is educating the client on the upcoming computed tomography (CT) scan of the brain requiring radiopaque dye. Which statement by the nurse is correct? "Blood will be drawn and analyzed before the test to ensure your kidneys can remove the dye." "Flushing, itching, shortness of breath, and dizziness after injection of the dye is common." "Your hearing aids may stay in during the scan so you can accurately hear the instructions." "It is important to lie still for 2 hours during the scan as movement can interfere with the results."

"It is important to lie still for 2 hours during the scan as movement can interfere with the results."

The parents of a 4-month-old diagnosed with sepsis tell the nurse that the physician explained sepsis to them but they don't really understand it. The parents state, "Could you please explain it to us?" What is the best response by the nurse? "The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys." "The pathophysiology of sepsis is complex." "The pathogens cause an overproduction of proinflammatory cytokines. These cytokines are responsible for the clinically observable effects of the sepsis." "Sepsis results in systemic inflammatory response syndrome (SIRS) due to infection."

"The infection your child has causes the release of toxins into the system, which can lead to impaired function in the lungs, liver, and kidneys."

Which is a sign or symptom of septic shock? Hypertension Warm, moist skin Altered mental status Increased urine output

Altered mental status

A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this client? Pericarditis Anemia Acidosis Hyperkalemia

Anemia

A nurse is assessing a neonate with sepsis. The nurse understands that most commonly the cause involves: Protozoa Herpes virus Enterovirus Bacteria

Bacteria

The nurse is talking to the parents of an 2-month-old infant who has been admitted to the hospital with sepsis. The parents report being confused since their older children also had the flu but they recovered without incident. What information can the nurse provide to the parents? Infants to not have adequate amounts of immunoglobulin G (IgG)to fight infections. Infants have fewer white blood cells available to fight infection. Children this young do not have mature immune systems to fight infection. Passive immunity does not protect the child from infection if the mother has not had the particular infection.

Children this young do not have mature immune systems to fight infection.

A nurse is teaching the parents about the kidney transplant their child is going to receive. What would be included in the teaching? As long as the medications are used properly, the transplant will not be rejected. Immunosuppression is common after a kidney transplant. Induction therapy medication will prevent infection with the transplant. The child can stop medication after 3 months of therapy.

Immunosuppression is common after a kidney transplant.

The nurse is required to manage and minimize sepsis in a client with severe infection. Which would be an appropriate nursing intervention? Limit the client's fluid intake. Limit the client's food intake. Monitor the client's vital signs. Encourage the client to perform mild activity.

Monitor the client's vital signs.

When describing the signs and symptoms associated with renal failure, what would be most important for a nurse to keep in mind? Renal failure reflects injury to the protective layers of the kidneys. Renal failure suggests that extensive kidney damage has already occurred. A small number of nephrons usually are affected when manifestations develop. Most signs and symptoms are unrelated to nephron damage.

Renal failure suggests that extensive kidney damage has already occurred.

The nurse is concerned that the child is developing septic shock. Which findings are consistent with this condition? Select all that apply. The child is pale and lethargic. C-reactive protein is decreased. White blood cell count is elevated. The child's blood pressure is reduced. The child's respiratory rate is elevated.

White blood cell count is elevated. The child's blood pressure is reduced. The child's respiratory rate is elevated.

A client was admitted to the hospital unit with an elevated leukocyte count and a fever accompanied by warm, flushed skin. These symptoms suggest that the client has: had an overdose of opioids. had a severe allergic reaction to a bee sting. an overwhelming bacterial infection. lost blood from frequently using NSAIDs.

an overwhelming bacterial infection.

A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering: sodium polystyrene sulfonate (Kayexalate) IV dextrose 50% Sorbitol Calcium supplements

sodium polystyrene sulfonate (Kayexalate)

The client with chronic renal failure is exhibiting signs of anemia. Which is the best nursing rationale for this symptom? Diminished erythropoietin production Impaired immunologic response Azotemia Electrolyte imbalances

Diminished erythropoietin production

The nurse is monitoring the patient in shock. The patient begins bleeding from previous venipuncture sites, in the indwelling catheter, and rectum, and the nurse observes multiple areas of ecchymosis. What does the nurse suspect has developed in this patient? Stevens-Johnson syndrome from the administration of antibiotics Disseminated intravascular coagulation (DIC) Stress ulcer Septicemia

Disseminated intravascular coagulation (DIC)

A client with kidney failure has been admitted to the hospital for severe anemia. The client has refused a blood transfusion. The nurse anticipates administering which drug to stimulate the production of red blood cells? Filgrastim Sargramostim Erythropoietin (EPO) Cyanocobalamin (vitamin B12)

Erythropoietin (EPO)

The nurse is caring for a child on a pediatric unit who has hemodialysis 3 times per week due to renal failure. On the days between dialysis treatment, which meal would be acceptable for the child? Tomato soup, crackers, and diet soda Grilled chicken, half of a banana, and flavored water Three egg omelet, bacon, and orange juice Cheeseburger, french fries, and lemonade

Grilled chicken, half of a banana, and flavored water

A client in acute renal failure has been prescribed 2 units of packed red blood cells (PRBCs). The nurse explains to the client that the blood transfusion is most likely needed for which reason? Hypervolemia Increases the effectiveness of dialysis Preparation for likely nephrectomy Lack of erythropoietin

Lack of erythropoietin

The nurse is caring for a client newly diagnosed with sepsis. The client has a serum lactate concentration of 6 mmol/L and fluid resuscitation has been initiated. Which value indicates that the client has received adequate fluid resuscitation? Central venous pressure of 6 mm Hg Urine output of 0.2 mL/kg/hr Mean arterial pressure of 70 mm Hg ScvO2 of 60%

Mean arterial pressure of 70 mm Hg

A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF? increased pH with decreased hydrogen ions uric acid analysis 3.5 mg/dl and phenolsulfonphthalein (PSP) excretion 75% blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl increased serum levels of potassium, magnesium, and calcium

blood urea nitrogen (BUN) 100 mg/dl and serum creatinine 6.5 mg/dl

A 35-year-old client is diagnosed with acute kidney injury (AKI) and is started on hemodialysis. The client is concerned with the diagnosis and wants to know what to expect in the progression of this disorder. Which statement best addresses the client's concern? "You will need to have a renal transplant to live a productive, healthy life." "The occurrence of acute kidney injury will always eventually result in chronic renal failure." "Once your condition improves you can be placed on peritoneal dialysis for the rest of your life." "Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

"Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

The nurse is explaining to a client the difference between hemodialysis and continuous renal replacement therapy (CRRT). What statement by the client leads the nurse to determine that additional education is needed? "CRRT is used to treat acute kidney injury." "CRRT causes less electrolyte changes." "CRRT is faster than hemodialysis." "CRRT is used for hemodynamically unstable clients."

"CRRT causes less electrolyte changes."

A newborn is prescribed gentamicin for suspected neonatal sepsis. The newborn weighs 1600 grams, and the drug is to be given at 2.5 mg/kg every 12 hours. What is the correct dosage to be administered every 12 hours? Record your answer using a whole number.

1818

The nurse is caring for a 3-year-old child with acute kidney injury. Which laboratory finding should the nurse immediately report to the healthcare provider? creatinine 2.5 mg/dL (221 umol/L) blood urea nitrogen (BUN) 40 mg/dL (urea 14.3 mmol/L) potassium level of 6.5 mEq/L (6.5 mmol/L) sodium 130 mEq/L (130 mmol/L)

potassium level of 6.5 mEq/L (6.5 mmol/L)

You are the nurse caring for a client in septic shock. You know to closely monitor your client. What finding would you observe when the client's condition is in its initial stages? A slow but steady pulse A weak and thready pulse A slow and imperceptible pulse A rapid, bounding pulse

A rapid, bounding pulse

The nurse is caring for a client in the early stages of sepsis. The client is not responding well to fluid resuscitation measures and has a worsening hemodynamic status. Which nursing intervention is most appropriate for the nurse to implement? Begin a continuous IV infusion of insulin per protocol. Administer norepinephrine as prescribed. Initiate enteral feedings as prescribed. Administer recombinant human activated protein C (rhAPC) as prescribed.

Administer norepinephrine as prescribed.

When explaining the underlying mechanisms associated with renal failure, which would be most important for the nurse to keep in mind? Renal failure typically involves some injury to the protective layers of the kidneys. Manifestations occur when a small number of nephrons become nonfunctional. Nephron damage is not associated with the development of signs and symptoms. Extensive kidney damage has usually occurred by the time the patient is symptomatic.

Extensive kidney damage has usually occurred by the time the patient is symptomatic.

A 9-month-old child has been admitted to rule out sepsis. Which finding offers the most support to the presence of this disorder? The child has had 7 wet diapers in the past 24 hours. The child's birth history indicates he was born at 42 weeks' gestation. The child cries when his mother is not in sight. The child has had 8 ounces of formula in the past 24 hours.

The child has had 8 ounces of formula in the past 24 hours.

The nurse is caring for a client with a stage IV leg ulcer. The nurse is closely monitoring the client for sepsis. What would indicate that sepsis has occurred and that the nurse should notify the physician of immediately? The client's respiratory rate is less than 20 breaths per minute. The client feels restless and hungry. The client's heart rate is greater than 90 beats per minute. The client exhibits an increased urinary output.

The client's heart rate is greater than 90 beats per minute.

What priority intervention can the nurse provide to decrease the incidence of septic shock for patients who are at risk? Insert indwelling catheters for incontinent patients. Have patients wear masks in the health care facility. Use strict hand hygiene techniques. Administer prophylactic antibiotics for all patients at risk.

Use strict hand hygiene techniques.

A client who has been brought to the ED is unresponsive, and has an elevated temperature and flushed skin. Physical assessment reveals a rapid, bounding pulse. The high school where the client is employed has had a significant increase in cases of staphylococcal and streptococcal infections among student athletes. The client's labs show an elevated white blood cell count; cultures are forthcoming. What does the nurse suspect may be the cause of the client's present condition? anaphylactic shock cardiogenic shock neurogenic shock septic shock

septic shock

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: a decreased serum phosphate level secondary to kidney failure. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. metabolic alkalosis secondary to retention of hydrogen ions. an increased serum calcium level secondary to kidney failure.

water and sodium retention secondary to a severe decrease in the glomerular filtration rate.

A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: metabolic alkalosis secondary to retention of hydrogen ions. an increased serum calcium level secondary to kidney failure. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. a decreased serum phosphate level secondary to kidney failure.

water and sodium retention secondary to a severe decrease in the glomerular filtration rate.