Chapter 33: Disorders of Renal Function

Which statement about the use of angiotensin-converting enzyme (ACE) inhibitors and autosomal recessive polycystic kidney disease (ARPKD) is accurate?

ACE inhibitors may interrupt the renin-angiotensin-aldosterone system to reduce renal vasoconstriction.

A child is recovering from a bout with group A beta-hemolytic Streptococcus infection. The child returns to the clinic a week later complaining of decrease in urine output with puffiness and edema noted in the face and hands. The health care provider suspects the child has developed:

Acute postinfectious glomerulonephritis

Which of the following clients is at greatest risk for developing a urinary tract infection (UTI)?

Older adult female client admitted with an indwelling Foley catheter that has been in place for 1 month

The nurse is performing a history and physical on a client with diabetic nephropathy. Findings include BP 124/80; smokes two packs of cigarettes/day; diet high in saturated fats and sodium. Which intervention can help prevent the progression of the diabetic nephropathy?

Smoking cessation program

A nurse's neighbor is experiencing some odd symptoms, and asks the nurse about them. The neighbor states having blood in the urine intermittently and thinks there is a lump in the back (where kidney is located). What advice is most appropriate for the nurse to relay to this neighbor?

"Make an appointment with your health care provider immediately."

The nurse is caring for a client who delivers a stillborn child due to bilateral total agenesis of the kidneys. Which physical features will the newborn exhibit that correlate with this diagnosis? Select all that apply.

- Eyes widely separated with epicanthic folds - Low-set ears - Broad and flat nose

Which client clinical manifestation most clearly suggests a need for diagnostic testing to rule out renal cell carcinoma?

Hematuria

The form of polycystic kidney disease (PKD) that first manifests in the early infant period is most commonly characterized as:

Autosomal recessive

The nurse suspects that a newborn infant who presents with bilateral flank masses, impaired lung development, and oliguria may be suffering from which disorder?

Autosomal recessive polycystic kidney disease (ARPKD)

The most important information for a nurse to give a client who has been diagnosed and treated for a calcium oxalate stone would include which facts related to their diet?

Avoid spinach and peanuts

Acute pyelonephritis is a result of:

Bacterial Infection

A client who has had an intestinal bypass has developed a kidney stone. Which type of kidney stone does the nurse recognize that this client will most likely be treated for?

Calcium

Hospitalized neonates are at greatest risk of developing septicemia related to which procedure?

Catheter-associated bacteriuria

Which client would the nurse consider having the highest risk for developing a urinary tract infection?

Client with obstructed urinary outflow from a kidney stone

The family asks the nurse what the usual treatment of focal segmental glomerulosclerosis entails. What is the nurse's best response?

Corticosteroids

The nurse encourages a female client with recurrent urinary tract infections (UTIs) to drink which liquid on a daily basis?

Cranberry juice

While taking a history from an adult client newly diagnosed with renal cell cancer, the nurse can associate which high-risk factor with the development of this cancer?

Heavy Smoking

The nurse is planning care for a client with a urinary tract obstruction. The nurse includes assessment for which possible complication?

Increased blood pressure

What is the usual cause of acute pyelonephritis?

Infection

Wilms tumor is a tumor of childhood. It is usually an encapsulated mass occurring in any part of the kidney. What are the common presenting signs of a Wilms tumor?

Large asymptomatic abdominal mass and hypertension

If a client is in the early phases of nephrotic syndrome, which area of the body will likely have the initial presence of edema?

Lower extremities

Which condition/disorder would the nurse see as being likely to cause the most serious long-term problems?

Polycystic Kidney Disease

Which substance would not be found in glomerular filtrate?

Protein

Drug-related nephropathies involve functional and/or structural changes to the kidney after exposure to a drug. What does the tolerance to drugs depend on?

State of hydration

A female teenager has experienced three uncomplicated urinary tract infections in the past 3 months. Which action should the nurse include in education for this teenager?

Taking antimicrobials to treat Escherichia coli while forcing fluids

A nurse observes that a client's urine is cola colored and considers which factor as a possible reason?

The client's urine contains material from the degradation of red blood cells.

A client is being treated with colchicine for pain in the big right toe. The client begins to complain of severe right flank pain and is diagnosed with kidney stones. Which type of kidney stone does the nurse recognize this client is most likely affected by?

Uric acid

The nurse caring for an older adult notes a marked decrease in mental acuity over a 24-hour period. What assessment indicates the most likely cause of this change?

Urine cloudy with strong odor

The nurse recognizes the most common cause of acute postinfectious glomerulonephritis as:

a streptococcal infection 7 to 12 days prior to onset.

The nurse is evaluating the urinalysis results of a client presenting with polyuria and lower abdominal pain due to a suspected urinary tract infection (UTI). Which finding should the nurse report as evidence of a UTI?

increased nitrites

What is the most common cancer of the kidney?

renal cell carcinoma

The initiating event in the development of nephrotic syndrome is a derangement in the glomerular membrane that causes increased permeability to which substance?

Plasma proteins