AKI/CKD/ESRD

The nurse is caring for a client whose acute kidney injury (AKI) resulted from a prerenal cause. Which condition most likely caused this client's health problem?

Burns

Diet modifications are part of nutritional therapy for the management of ARF. Select the high-potassium food that should be restricted.

Citrus fruits

A client is admitted to the ICU after a motor vehicle accident. On the second day of the hospital admission, the client develops acute kidney injury. The client is hemodynamically unstable, and renal replacement therapy is needed to manage the client's hypervolemia and hyperkalemia. Which of the following therapies will the client's hemodynamic status best tolerate?

Continuous venovenous hemodialysis (CVVHD)

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

Dehydration

A client is undergoing peritoneal dialysis as medical treatment for acute renal failure. Before the next instillation, the nurse observes that the client has marked abdominal distention accompanied by pain. Which of the following nursing actions is likely to offer an immediate solution to this problem?

Delay the next dialysis cycle.

The client with chronic kidney disease is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?

Diminished erythropoietin production

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?

Oliguria

Nursing assessment for the patient receiving peritoneal dialysis would include which of the following to detect the most serious complication of this procedure?

Palpate the abdominal wall for rebound tenderness.

A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. The nurse explains that the decrease in erythropoietin will have what effect?

Anemia from the decrease in maturation of red blood cells

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?

Assess the AV fistula for a bruit and thrill.

The nurse is caring for an acutely ill client. What assessment finding should prompt the nurse to inform the health care provider that the client may be exhibiting signs of acute kidney injury (AKI)?

Average urine output has been 10 mL/hr for several hours.

The nurse is caring for a patient with a medical history of untreated CKD that has progressed to ESKD. Which of the following serum values and associated signs and symptoms will the nurse expect the patient to exhibit? Select all that apply.

-Calcium 7.5 mg/dL; hypotension and irritability -Potassium 6.4 mEq/L; dysrhythmias and abdominal distention -Phosphate 5.0 mg/dL; tachycardia and nausea and emesis

Based on the pathophysiologic changes that occur as renal failure progresses, the nurse identifies the following indicators associated with the disease. Select all that apply.

-Hyperkalemia -Anemia -Hypocalcemia

A client's renal failure has become chronic. Which signs and symptoms are associated with chronic renal failure? Select all that apply.

-lethargy -muscle cramps -bleeding of the oral mucous membranes

A client who suffered hypovolemic shock during a cardiac incident has developed acute kidney injury. Which is the best nursing rationale for this complication?

Decrease in the blood flow through the kidneys

During hemodialysis, toxins and wastes in the blood are removed by which of the following?

Diffusion

A client is being treated for AKI and the client daily weights have been ordered. The nurse notes a weight gain of 3 pounds (1.4 kg) over the past 48 hours. What nursing diagnosis is suggested by this assessment finding?

Excess fluid volume

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

Increased BUN

A client with decreased renal function is to receive a low-protein diet. The client asks the nurse why he needs this type of diet. The nurse would incorporate which reason into the response?

Lessen workload on the kidneys

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)?

Urine output of 250 ml/24 hours

A client is scheduled for a CT scan of the abdomen with contrast. The client has a baseline creatinine level of 2.3 mg/dL (203 µmol/L). In preparing this client for the procedure, the nurse anticipates what orders?

Provide adequate hydration before the procedure.

Which of the following is the most sensitive indicator of renal function?

Serum creatinine

The nurse notes that a patient who is retaining fluid had a 1-kg weight gain. The nurse knows that this is equivalent to about how many mL?

1,000 mL

Compliance to a renal diet is a difficult lifestyle change for a patient on hemodialysis. The nurse should reinforce nutritional information. Which of the following teaching points should be included?

limit protein and limit dairy products due to high phosphorus.

Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure?

Increased serum creatinine level

The nurse cares for a client with a right-arm arteriovenous fistula (AVF) for hemodialysis treatments. Which nursing action is contraindicated?

Obtaining a blood pressure reading from the right arm

Based on her knowledge of the primary cause of end-stage renal disease, the nurse knows to assess the most important indicator. What is that indicator?

Serum glucose

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 most accurate indicator of fluid loss or gain in an acutely ill client is:

weight.

A nurse receives her client care assignment. Following the report, she should give priority assessment to the client:

who, following a kidney transplant, has returned from hemodialysis with a sodium level of 110 mEq/L and a potassium level of 2.0 mEq/L.