Prep U 3 - management of patients with kidney disorders
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?
fever
After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?
"It is appropriate to warm the dialysate in the microwave"
A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?
A GFR of 30-59 mL/min/1.73 m^2
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
BUN 100 mg/dL and serum creatinine 6.5 mg/dL
What is a characteristic of the intrarenal category of acute kidney injury (AKI)?
Increased BUN
The nurse recognizes which condition as an integumentary manifestation of chronic renal failure?
Gray-bronze skin color
What is a hallmark of the diagnosis of nephrotic syndrome?
Proteinuria
The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?
administration of sodium polystyrene sulfonate [Kayexalate]
A client who agreed to become an organ donor is pronounced dead. What is the most important factor in selecting a transplant recipient?
compatible blood and tissue types
A client who suffered hypovolemic shock during a cardiac incident has developed acute renal failure. Which is the best nursing rationale for this complication?
decrease in the blood flow through the kidneys
A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?
encourage use of incentive spirometer every 2 hours
A client has been diagnosed with acute glomerulonephritis. This condition causes:
proteinuria
A patient is placed on hemodialysis for the first time. The patient complains of a headache with nausea and begins to vomit, and the nurse observes a decreased level of consciousness. What does the nurse determine has happened?
the patient is experiencing a cerebral fluid shift
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?
urine output of 20 mL/hour
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of:
water and sodium retention secondary to a severe decrease in the glomerular filtration rate
The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:
"as the disease progresses, you will most likely require renal replacement therapy"
An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?
"this type of dialysis will provide more independence"
The nurse weighs a patient daily and measures urinary output every hour. The nurse notices a weight gain of 1.5 kg in a 74-kg patient over 48 hours. The nurse is aware that this weight gain is equivalent to the retention of:
1,500 mL of fluid
The nurse cares for a client diagnosed with chronic glomerulonephritis. The nurse will observe the client for the development of
Anemia Hyperkalemia Metabolic acidosis Hyperphosphatemia
The presence of prerenal azotemia is a probable indicator for hospitalization for CAP. Which of the following is an initial laboratory result that would alert a nurse to this condition?
BUN-to-creatinine ratia (BUN:Cr) >20
The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?
Brief, hot daily showers
Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?
WBC of 20,000/mm^3
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:
fatigue and weakness
A client with chronic renal failure complains of generalized bone pain and tenderness. Which assessment finding would alert the nurse to an increased potential for the development of spontaneous bone fractures?
hyperphosphatemia
The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?
hypovolemic shock caused by hemorrhage
A client has end-stage renal failure. Which of the following should the nurse include when teaching the client about nutrition to limit the effects of azotemia?
increase carbohydrates and limit protein intake
A nurse cares for an acutely ill client. The nurse understands that the most accurate indicator of fluid loss or gain in an acutely ill client is:
weight
Which of the following is the most accurate indicator of fluid loss or gain?
weight
