Renal quiz 10#

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

Abdominal pain

you have been asked to add nursing care plan of a patient w/ acute pyelonephritis, you would include what important interventions?

Advising patient of fluid intake of 3-4L per day

Patient goes to surgery for insertion of arteriovenous fistula for dialysis. Patient asks nurse why cannot insert graft instead. What explanation is best by the nurse on advantages of fistula over a graft?

Fistulas have better record of remaining patent

After diagnostic tests such as intravenous pyelogram or cystoscopy, MD may order extra fluids to?

Flush out remaining dye

A nurse is told that client w/ hx of heart failure who is undergoing dialysis 3x per week has developed crackles in the lower lung fields. Nurse interprets that this finding is most likely related to?

Intake greater than output

After an angiography, a pressure dressing to femoral area of patient has been applied. As part of post op procedure care, why should nurse assess pressure dressing frequently? SATA

Note for hematoma Note for frank bleeding

A patient who undergoes retrograde pyelogram has been transferred to post procedure care, at this stage, nurse should monitor for signs of pyelonephritis in the patient. Which of following measures should nurse taken when she notes signs of pyelonephritis?

Notify Physician

A pt is admin dialysate solution through abdominal catheter. During instillation phase, nurse notices flow rate is slow, so nurse advises patient to from side to side, however the maneuver is unsuccessful. What will the nurse do next?

Notify the MD

A patient has undergone renal angiography, what should nurse do?

Palpate bilateral lower extremities every hour

Given below are some profiles of older patients. Who have highest risk developing pyelonephritis?

Patient w/ chronic urinary obstruction

A patient is undergoing peritoneal dialysis, which of following is major complication of procedure that nurse should monitor?

Peritonitis

Because of impaired urine elimination, nurse is concerned about what potential skin problems that will require additional planning for patient in renal failure?

Pronounced itching (pruritus)

A patient is encouraged to drink a lot of fluids for a kidney infection. When asked the reason, the nurse gives this rationale

To flush out organisms from the urinary tract

Before cystoscopy, nurse checks for fever and chills in patient because may indicate what?

Urinary Infection

A patient w/ severe flank pain, general weakness, and fever is hospitalized. He has hx of recurrent UTI and renal calculi is suspected. On second hospital day patient urine output drops to 300mL / 24H, and he has distension and pain in suprapubic area. Nurse would evaluate which of following for likely cause for this sudden change?

Urinary obstruction

What is an important intervention for nurse to carry out before and after hemodialysis?

Weight patient before and after

During physical exam of patient, nurse assess for signs of a renal system disorder. Which of following signs indicate patient may have pyelonephritis?

flank pain, tenderness, chills, fever, and malaise

When asked at post conference for cause of polycystic kidney disease, the student correctly answers that the disorder is?

Congenital and familial

A patient aged 66 is admitted following nephrolithotomy. One of her lab tests reveals UTI. Which intervention is best for her?

Encourage fluid intake

Client w/ chronic renal failure is exhibiting signs of anemia. Which is best nursing rationale for this symptom?

Diminished erythropoietin production

Nurse should monitor patient who has undergone cystoscopy because patient Hx indicates urinary infection. Which of following symptoms should observe and report to MD?

Flank pain, chills, fever

Chronic renal failure client complains of generalized bone pain and tenderness. Which assessment finding would alert nurse of an increased potential for development of spontaneous bone fractures?

Hyperphosphatemia

A client has been admitted to hospital w/ acute glomerulonephritis. Nurse plans to collect data and initially asks client about recent history of?

Streptococcal infection

A client who suffered hypovolemic shock during cardiac incident has developed acute renal failure. Which is best nursing rationale for this complication?

Decreased in blood flow to kidneys

Older patient receiving vancomycin, a nephrotoxic antibiotic. It is important to report signs of nephrotoxicity to the MD. Which of following signs of nephrotoxicitiy should be reported by nurse?

Decreased urine output

A male pt admitted w/ dx of renal calculi c/o of flank pain. The pain is suspected to be caused by increased pressure in renal pelvis. Which of following measures, besides admin pain med, can nurse take to provide relief to patient?

Encourage ambulation and liberal fluid intake.

A client w/ chronic glomerulonephritis has generalized edema. Which response by the nurse best describes why anasarca occurs w/ this disorder?

Fluid shifts occurs due to loss of serum protein Anasarca; is caused by the shift of fluid from the intravascular space to interstitial and intracellular locations

Patient is suspected to have urinary problem and is asked to collect 24H specimen?

Refrigerate specimen on ice until taken to lab

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

Wear a mask

Nurse should physically examine a patient who has difficulty in voiding, which of following methods should nurse use to assess kidneys for tenderness or pain

Lightly strike fist at costovertebral angle