PU Renal 54 (1-)

Urine output of 250 ml/24 hours

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)?

sodium polystyrene sulfonate (Kayexalate)

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

"It is appropriate to warm the dialysate in a microwave."

After teaching a group of students about how to perform peritoneal dialysis, which statement would indicate to the instructor that the students need additional teaching?

"This type of dialysis will provide more independence."

An investment banker with chronic renal failure informs the nurse of the choice for continuous cyclic peritoneal dialysis. Which is the best response by the nurse?

chronic glomerulonephritis.

Anemia, hyperkalemia, metabolic acidosis, and hyperphosphatemia occur during

Dehydration

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

Tall, peaked T waves

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

SpO2 at 90% with fine crackles in the lung bases

Following a nephrectomy, which assessment finding is most important in determining nursing care for the client?

Intrarenal causes of renal failure include

Intrarenal causes of renal failure include prolonged renal ischemia, nephrotoxic agents, and infectious processes such as acute glomerulonephritis.

postrenal disorders

Obstruction of urine flow from the kidneys through blood clot formation and structural damage can result in

restricting sources of potassium.

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:

Check daily for thrill and bruit. Avoid compression of the site. No IV or blood pressure taken on extremity with dialysis access. No tight clothing.

Patient education regarding a fistulae or graft includes which of the following? Select all that apply.

Administration of sodium polystyrene sulfonate [Kayexalate])

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?

1000 ml

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?

6

Sevelamer hydrochloride (Renagel) has been prescribed for a client with chronic renal failure. The physician has prescribed Renagel 800 mg orally three times per day with meals to treat the client's hyperphosphatemia. The medication is available in 400 mg tablets. How many tablets per day will the nurse administer to the client?

Gray-bronze skin color

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

Brief, hot daily showers

The client with chronic renal failure complains of intense itching. Which assessment finding would indicate the need for further nursing education?

increased urine output, hypotension, and dehydration.

The diuretic phase of acute renal failure is characterized by

Anemia

The nurse cares for a client diagnosed with chronic glomerulonephritis. The nurse will observe the client for the development of

Obtaining a blood pressure reading from the right arm

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

Oliguria

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?

pH 7.20, PaCO2 36, HCO3 14-

The nurse cares for a client with end-stage kidney disease (ESKD). Which acid-base imbalance is associated with this disorder?

dehydration

The nurse expects which of the following assessment findings in the client in the diuretic phase of acute renal failure?

An excess of urea in the blood

The nurse is able to identify which condition as uremia?

Hypovolemic shock caused by hemorrhage

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

citrus fruits

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?

"I should drink as much as possible to keep my kidneys working."

The nurse is providing discharge instructions to the client with acute post-streptococcal glomerulonephritis. Which statement by the client indicates a need for further teaching?

Proteinuria

What is a hallmark of the diagnosis of nephrotic syndrome?

Cola-colored urine

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

fever

Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes?

Glomerulonephritis

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

Azotemia

Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?

Peripheral neuropathy

Which of the following occurs late in chronic glomerulonephritis?

primary presenting features of acute glomerulonephritis

are hematuria, edema, azotemia (excessive nitrogenous wastes in the blood), and proteinuria (>3 to 5 g/day). Bacteremia is excessive bacteria in the blood.

Acute renal failure can be caused

by poor perfusion and/or decrease in circulating volume results from hypovolemic shock.

Characteristic ECG signs of hyperkalemia

tall, tented, or peaked T waves, absent P waves, and a widened QRS complex.

proteinuria.

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

Start IV fluids with a normal saline solution bolus followed by a maintenance dose.

A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mm Hg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. The physician will most likely write an order for which treatment?

Decrease in the blood flow through the kidneys

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

fatigue and weakness.

A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:

Hyperphosphatemia

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

lethargy muscle cramps bleeding of the oral mucous membranes

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

Acute glomerulonephritis

A history of infection specifically caused by group A beta-hemolytic streptococci is associated with which disorder?

Wear a mask when performing exchanges.

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

Encourage use of incentive spirometer every 2 hours.

A nurse identifies a nursing diagnosis of risk for ineffective breathing pattern related to incisional pain and restricted positioning for a client who has had a nephrectomy. Which of the following would be most appropriate for the nurse to include in the client's plan of care?

Recent history of streptococcal infection

A nurse is reviewing the history of a client who is suspected of having glomerulonephritis. Which of the following would the nurse consider significant?

0.5 kg/day

A patient has acute kidney injury (AKI) with a negative nitrogen balance. How much weight does the nurse expect the patient to lose?

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

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

The kidneys can improve over a period of months.

The nurse is providing supportive care to a client receiving hemodialysis in the management of acute renal failure. Which statement from the nurse best reflects the ability of the kidneys to recover from acute renal failure?

1500 ml

The nurse weighs a patient daily and measures urinary output every hour. The nurse notices a weight gain of 1.5 kg in a 74-kg patient over 48 hours. The nurse is aware that this weight gain is equivalent to the retention of: