PU Renal 54 (4+)

Donors are selected from compatible living or deceased donors.

A client is in end-stage chronic renal failure and is being added to the transplant list. The nurse explains to the client how donors are found for clients needing kidneys. Which statement is accurate?

Cardiac glycosides

A client requires hemodialysis. Which type of drug should be withheld before this procedure?

Assess the AV fistula for a bruit and thrill.

A client with a history of chronic renal failure receives hemodialysis treatments three times per week through an arteriovenous (AV) fistula in the left arm. Which intervention should the nurse include in the care plan?

It is accompanied by reduced blood flow to the nephrons.

A client with acute renal failure progresses through four phases. Which describes the onset phase?

"Very few symptoms are associated with renal cancer."

A client with newly diagnosed renal cancer is questioning why detection was delayed. Which is the best response by the nurse?

Signs and symptoms of transplant rejection

abdominal pain, hypertension, weight gain, oliguria, edema, fever, increased serum creatinine levels, and swelling or tenderness over the transplanted kidney site.

Wear a mask when performing exchanges.

A male client has doubts about performing peritoneal dialysis at home. He informs the nurse about his existing upper respiratory infection. Which of the following suggestions can the nurse offer to the client while performing an at-home peritoneal dialysis?

Dehydration

During the diuresis period of acute kidney injury (AKI), the nurse should observe the client closely for what complication?

Hyperacute rejection

Rejection of a transplanted kidney within 24 hours after transplant is termed

Relaxation of bladder wall

Sympathomimetics have which of the following effects on the body?

fluid retention.

The oliguric phase is characterized by

Increased BUN

What is a characteristic of the intrarenal category of acute kidney injury (AKI)?

Proteinuria

What is a hallmark of the diagnosis of nephrotic syndrome?

uremia

Which clinical finding should a nurse look for in a client with chronic renal failure?

fluid volume excess

Which of the following is the priority nursing diagnosis for the client in the oliguric phase of acute renal failure?

Septic shock

Which of the following would a nurse classify as a prerenal cause of acute renal failure?

Oliguria

defined as urine output less than 0.5 mL/kg/hr.

hyperkalemia

life-threatening effect of renal failure. The client can become apathetic; confused; and have abdominal cramping, dysrhythmias, nausea, muscle weakness, and numbness of the extremities.

Symptoms of hypocalcemia

muscle twitching, irritability, and tetany. Elevation in urea levels can result in azotemia, which can be exhibited in fluid and electrolyte and/or acid-base imbalance.

Chronic rejection

occurs after many years. The term simple is not used in the categorization of types of rejection of kidney transplants.

acute rejection

occurs within 3 to 14 days of transplantation.

White blood cell (WBC) count of 20,000/mm3

Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia. Which finding during this procedure signals a significant problem?

anemia

A change that occurs during chronic glomerulonephritis is termed

Urine output of 250 ml/24 hours

A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy. IV fluid is being infused at 150 mL/hour. Which assessment finding suggests that the client is experiencing acute renal failure (ARF)?

cardiac arrhythmia.

A client develops acute renal failure (ARF) after receiving IV therapy with a nephrotoxic antibiotic. Because the client's 24-hour urine output totals 240 mL, the nurse suspects that the client is at risk for:

Hypertension Pain from retroperitoneal bleeding Polyuria

A client has a family history of polycystic kidney disease. As the nurse gathers information and completes an assessment related to a polycystic kidney diagnosis, which findings would the nurse expect to find? Select all that apply.

"Increase your carbohydrate intake."

A client who has been treated for chronic renal failure (CRF) is ready for discharge. The nurse should reinforce which dietary instruction?

0.5 kg/day

A patient has acute kidney injury (AKI) with a negative nitrogen balance. How much weight does the nurse expect the patient to lose?

Renal calculi

A patient has been diagnosed with postrenal failure. The nurse reviews the patient's electronic health record and notes a possible cause. Which of the following is the possible cause?

Hydrating with saline intravenously before the test

A patient undergoing a CT scan with contrast has a baseline creatinine level of 3 mg/dL, identifying this patient as at a high risk for developing kidney failure. What is the most effective intervention to reduce the risk of developing radiocontrast-induced nephropathy (CIN)?

low-purine

A patient who has been treated for uric acid stones is being discharged from the hospital. What type of diet does the nurse discuss with the patient?

1 lb

At the end of five peritoneal exchanges, a patient's fluid loss was 500 mL. How much is this loss equal to?

transplanted kidney

Hyperacute rejection may require removal of the

Check daily for thrill and bruit. Avoid compression of the site. No IV or blood pressure taken on extremity with dialysis access. No tight clothing.

Patient education regarding a fistulae or graft includes which of the following? Select all that apply.

Cola-colored urine

The client is admitted to the hospital with a diagnosis of acute glomerulonephritis. Which clinical manifestation would the nurse expect to find?

Hemodialysis

The nurse cares for a client after extensive abdominal surgery. The client develops an infection that is treated with IV gentamicin. After 4 days of treatment, the client develops oliguria, and laboratory results indicate azotemia. The client is diagnosed with acute tubular necrosis and transferred to the ICU. The client is hemodynamically stable. Which dialysis method would be most appropriate for the client?

oliguria

The nurse cares for a client with acute kidney injury (AKI). The client is experiencing an increase in the serum concentration of urea and creatinine. The nurse determines the client is experiencing which phase of AKI?

Use an aseptic technique during the procedure.

The nurse instructs a client to perform continuous ambulatory peritoneal dialysis correctly at home. Which educational information should the nurse provide to the client?

Less than 400 mL

The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would be the daily urine output?

0.5

The nurse is caring for a patient that has developed oliguria. Oliguria is defined as urine output less than ___________mL/kg/hr.

Postrenal ARF

the result of an obstruction that develops anywhere from the collecting ducts of the kidney to the urethra. This results from ureteral blockage, such as from bilateral renal calculi or benign prostatic hypertrophy (BPH).

Hypertension

A client is diagnosed with polycystic kidney disease. Which of the following would the nurse most likely assess?

Blood urea nitrogen (BUN)-to-creatinine ratio (BUN:Cr) >20.

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?

The normal BUN:Cr ratio

is less than 15. Prerenal azotemia is caused by hypoperfusion of the kidneys due to a nonrenal cause. Over time, higher than normal blood levels of urea or other nitrogen-containing compounds will develop.

Sympathomimetics mimic

the sympathetic nervous system, causing increased heart rate and contractility, dilation of bronchioles and pupils, and bladder wall relaxation.

Tenderness over transplant site

A client has undergone a renal transplant and returns to the health care agency for a follow-up evaluation. Which finding would lead to the suspicion that the client is experiencing rejection?

Hyperkalemia

A client in chronic renal failure becomes confused and complains of abdominal cramping, racing heart rate, and numbness of the extremities. The nurse relates these symptoms to which of the following lab values?

Clean the catheter with antibacterial soap, thoroughly rinse and dry before reinsertion.

The nurse is educating a client who will be performing self-catheterization at home. What information provided by the nurse will help reduce the incidence of infection?

Perform hand hygiene prior to patient care. Assist the patients with frequent toileting. Provide careful perineal care

The nurse is providing an education program for the nursing assistants in a long-term care facility in order to decrease the number of UTIs in the female population. What interventions should the nurse introduce in the program? Select all that apply.

Hold the medications until after dialysis.

The nurse passes out medications while a client prepares for hemodialysis. The client is ordered to receive numerous medications including antihypertensives. What is the best action for the nurse to take?