Med-Surg Sp17 Renal Failure
Increased serum creatinine level Explanation: In renal failure, laboratory blood tests reveal elevations in BUN, creatinine, potassium, magnesium, and phosphorus. Calcium levels are low. The RBC count, hematocrit, and hemoglobin are decreased.
Which of the following would the nurse expect to find when reviewing the laboratory test results of a client with renal failure? Decreased serum potassium level Increased red blood cell count Increased serum creatinine level Increased serum calcium level
The most accurate indicator of fluid loss or gain in an acutely ill patient is blood pressure. weight. pulse rate. edema.
weight. Explanation: The most accurate indicator of fluid loss or gain in an acutely ill patient is weight. An accurate daily weight must be obtained and recorded. Blood pressure, pulse rate, and edema are not the most accurate indicator of fluid loss or gain.
Anemia Explanation: Anemia develops as a result of inadequate erythropoietin production, the shortened lifespan of RBCs, nutritional deficiencies, and the patient's tendency to bleed, particularly from the GI tract. Erythropoietin, a substance normally produced by the kidneys, stimulates bone marrow to produce RBCs (Murphy, Bennett, & Jenkins, 2010). In ESKD, erythropoietin production decreases and profound anemia results, producing fatigue, angina, and shortness of breath.
A patient with chronic kidney failure experiences decreased levels of erythropoietin. What serious complication related to those levels should the nurse assess for when caring for this patient? Anemia Acidosis Hyperkalemia Pericarditis
Observing the client's urinary output. Explanation: Nephrotoxic drugs are not administered to a client with renal disease unless the client's life is in danger and no other therapeutic agent is of value. Since the client is given nephrotoxic drugs in normal doses, observing the client's urinary output can help the nurse determine a change in the renal status. Observing the client's fluid intake and noting the color of skin and nail beds do not help a nurse determine a change in the renal status. Checking for a thrill or a bruit daily is performed for a client with a vascular access device.
A client, aged 75, is diagnosed with a renal disease and administered nephrotoxic drugs in normal doses. The nurse is aware that it is important to observe the client closely for any changes in renal status. Which of the following measures may help a nurse determine a change in renal status? Observing the client's urinary output. Observing the client's fluid intake. Observing the skin color and nail beds. Checking for a thrill or a bruit daily.