PrepU Adult 2 Assignment 13

The client with polycystic kidney disease asks the nurse, "Will my kidneys ever function normally again?" The best response by the nurse is:

"As the disease progresses, you will most likely require renal replacement therapy."

One of the roles of the nurse in caring for clients with chronic renal failure is to help them learn to minimize and manage potential complications. This would include:

restricting sources of potassium usually found in fresh fruits and vegetables.

Which term is used to describe the concentration of urea and other nitrogenous wastes in the blood?

Azotemia

The nurse is helping a client to correctly perform peritoneal dialysis at home. Which suggestions should the nurse provide while educating the client? Select all that apply.

Keep the dialysis supplies in a clean area, away from children and pets. Wash hands before handling the catheter. Wear a mask while handling any dialysate solutions if you have a respiratory infection.

When assessing the impact of medications on the etiology of acute renal failure, the nurse recognizes which of the following as the drug that is not nephrotoxic?

Penicillin

A 44-year-old client is in the hospital unit where you practice nursing. From the results of a series of diagnostic tests, she has been diagnosed with acute glomerulonephritis. What would you expect to find as a result of this condition?

Proteinuria

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

Uremia

The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:

Hyperkalemia

For a client in the oliguric phase of acute renal failure (ARF), which nursing intervention is the most important?

Limiting fluid intake

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?

Renal calculi

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?

Donors are selected from compatible living donors.

Which period of acute renal failure is accompanied by an increase in the serum concentration of substances usually excreted by the kidneys?

Oliguria

A nurse who provides care in a high-acuity medical setting is aware of the high incidence and morbidity of acute renal failure (ARF). To reduce patients' risks of developing ARF during their stay in hospital, it is imperative that:

Patients' medication regimens be monitored closely

Hyperkalemia is a serious side effect of acute renal failure. Identify the electrocardiogram (ECG) tracing that is diagnostic for hyperkalemia.

Tall, peaked T waves

When caring for the patient with acute glomerulonephritis, which of the following assessment findings should the nurse anticipate?

Tea-colored urine

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 client?

Anemia

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

Dehydration

A client has been diagnosed with acute glomerulonephritis. This condition causes:

proteinuria.

Nicholas Pendergast, a 57-year-old professional athlete, has a lengthy history with chronic pyelonephritis. He is attending his annual physical and has become rather concerned with his potential for renal failure. How many clients with a history of chronic pyelonephritis require dialysis?

10% - 15%

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

"Increase your carbohydrate intake."

The nurse is caring for a client with chronic kidney disease. The patient has gained 4 kg in the past 3 days. In milliliters, how much fluid retention does this equal? __________________

4000

A client who has a history of chronic renal failure is in stage 4 for CRF. What is the approximate level of nephron function loss?

75% to 90%

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

Increased BUN

The nurse is caring for a patient after kidney surgery. What major danger should the nurse closely monitor for?

Hypovolemic shock caused by hemorrhage

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

It is accompanied by reduced blood flow to the nephrons.

A client diagnosed with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse anticipates administering:

sodium polystyrene sulfonate (Kayexalate)

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 nurse is educating a client who is required to restrict potassium intake. What foods would the nurse suggest the client eliminate that are rich in potassium?

Citrus fruits

What is a hallmark of the diagnosis of nephrotic syndrome?

Proteinuria

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

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

The nurse helps a client to correctly perform peritoneal dialysis at home. The nurse must educate the client about the procedure. Which educational information should the nurse provide to the client?

Keep the dialysis supplies in a clean area, away from children and pets

What is true about extracorporeal shock wave lithotripsy (ESWL)? Select all that apply.

-Stones are shattered into smaller particles that are passed from the urinary tract. -ESWL is administered with the client in a water bath or surrounded by a soft cushion while under light anesthesia or sedation.

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

A client undergoes dialysis as a part of treatment for kidney failure, and is administered heparin during dialysis to achieve therapeutic levels. Which step should the nurse take to allow heparin to be metabolized and excreted in the client?

Avoid administering injections for 2 to 4 hours after heparin administration.

A female client undergoes dialysis as a part of treatment for kidney failure. The client is administered heparin during dialysis, to achieve therapeutic levels. Which of the following steps should the nurse take to allow heparin to be metabolized and excreted in the client?

Avoid administering injections for two to four hours after heparin administration

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?

Hemodialysis

A client with renal failure is undergoing continuous ambulatory peritoneal dialysis. Which nursing diagnosis is the most appropriate for this client?

Risk for infection

A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report to the physician immediately?

Urine output of 20 ml/hour

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

The nurse is administering calcium acetate (PhosLo) to a patient with end-stage renal disease. When is the best time for the nurse to administer this medication?

With food

The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 mEq/L, and the nurse observes peaked T waves on the ECG. What priority intervention does the nurse anticipate the physician will order to reduce the potassium level?

Administration of sodium polystyrene sulfonate [Kayexalate])

A female patient undergoes dialysis as a part of treatment for kidney failure. The patient is administered heparin during dialysis to achieve therapeutic levels. Which of the following steps should the nurse take to allow heparin to be metabolized and excreted in the patient?

Avoid administering injections for 2 to 4 hours after heparin administration.

A client has pyelonephritis and is undergoing parenteral antibiotic treatment. What will be the effect of the infection on the client's kidneys?

renal scarring

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

Use an aseptic technique during the procedure.

A patient has stage 3 chronic kidney failure. What would the nurse expect the patient's glomerular filtration rate (GFR) to be?

A GFR of 30-59 mL/min/1.73 m2

Which of the following causes should the nurse suspect in a client is diagnosed with intrarenal failure?

Glomerulonephritis

The nurse recognizes which condition as an integumentary manifestation of chronic renal failure?

Gray-bronze skin color

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?

Less than 400 mL

The nurse performs acute intermittent peritoneal dialysis (PD) on a client who is experiencing uremic signs and symptoms. The peritoneal fluid is not draining as expected. What is the best response by the nurse?

Turn the client from side to side.