#5

The nurse is caring for a client who is in renal failure. When reviewing the client's laboratory values, what would the nurse expect to find? (Select all that apply) Decreased GFR Increased creatinine Decreased hemoglobin Increased potassium

Decreased GFR Increased creatinine Decreased hemoglobin Increased potassium

A nurse is performing an admission assessment of a client with a diagnosis of cirrhosis. What technique should the nurse use to palpate the client's liver? Place hand under the right lower abdominal quadrant and press down lightly with the other hand. Hold hand 90 degrees to right side of the abdomen and push down firmly. Place hand under right lower rib cage and press down lightly with the other hand. Place the left hand over the abdomen and behind the left side at the 11th rib.

Place hand under right lower rib cage and press down lightly with the other hand.

The respiratory therapist explains respiratory acidosis to the new-grad nurse. The therapist knows the new-grad nurse understands the topic when she verbalizes which concept? "The manifestations of respiratory acidosis often are intermixed with those of oxygen deficit." "Acute respiratory failure is characterized by a sustained increase in arterial CO2, resulting in renal adaptation with a more marked increase in plasma HCO3-." "Respiratory acidosis occurs in conditions that impair alveolar ventilation and cause a decrease in plasma PCO2." "Respiratory acidosis is associated with a pH above 7.35 and a PCO2 below 45 mm Hg."

"The manifestations of respiratory acidosis often are intermixed with those of oxygen deficit."

The nurse is caring for a diverse group of clients. In which client should the nurse assess for an alteration in drug metabolism? 35-year-old female with cervical cancer 50-year-old male with cirrhosis of the liver 32-year-old female with urosepsis 41-year-old male with kidney stones

50-year-old male with cirrhosis of the liver

The nurse is caring for an older adult client who is prescribed vancomycin for an infected wound. When planning the client's assessment, the nurse should be aware of what possible adverse effect? Fluid overload Epistaxis Acute kidney injury Intercostal retractions

Acute kidney injury

A client presents to the ED after being in a boating accident about 3 hours ago. Now the client reports headache, fatigue, and the feeling that he "just can't breathe enough." The nurse notes that the client is restless and tachycardic with an elevated blood pressure. This client may be in the early stages of what respiratory problem? Pneumonia Acute respiratory failure Pleural effusion Pneumoconiosis

Acute respiratory failure

The nurse is caring for a client with renal failure whose hemoglobin level is 7.9 g/dL. What is the nurse's best action? Monitor the client's intake and output closely. Collaborate with the provider to arrange dialysis. Administer erythropoietin as prescribed. Encourage the client's fluid intake.

Administer erythropoietin as prescribed.

The charge nurse notifies the staff RN that she is getting an admission from the ED, and the patient has cirrhosis. The staff RN can expect the patient to present with which of the following symptoms? Select all that apply. Ascites Loss of hearing Jaundice Blurred vision

Ascites Jaundice

A nurse is caring for a client who has been admitted for the treatment of advanced cirrhosis. What assessment should the nurse prioritize in this client's plan of care? Assessment for signs and symptoms of jaundice Monitoring of results of liver function testing Measurement of abdominal girth and body weight Assessment for variceal bleeding

Assessment for variceal bleeding

A staff nurse on a renal unit knows that most patients require treatment for hypertensive disease. What would the nurse expect to assess prior to the beginning of antihypertensive treatment? A temporary increase in renal function A sustained decrease in renal function Baseline renal function A sustained increase in renal dysfunction

Baseline renal function

A 82 year old patient is admitted from the ED with pneumonia. He has a history of falls, a total hip replacement, and COPD. The nurse understands that to prevent the patient from progressing into respiratory failure, treatment may include: (Select all that apply) Bronchodilator Antibiotic Oxygen therapy Pulmonary function tests

Bronchodilator Antibiotic Oxygen therapy

You are the night shift RN caring for a patient in a semi-private room. Your patient complains that he hasn't been able to get any sleep because his neighbor has been snoring loudly all night for the past 3 nights. When you're in the room you can hear the O2 Sat monitor alarming regularly. At the nurse's station you speak with your coworker to share your concern about his patient being at risk for acute respiratory failure. Your coworker should: Ensure his patient's CPAP machine is on properly Give your patient ear plugs/headphones Call a rapid response Call the provider

Ensure his patient's CPAP machine is on properly

A nurse has entered the room of a client with cirrhosis and found the client on the floor. The client states that she fell when transferring to the commode. The client's vital signs are within reference ranges and the nurse observes no apparent injuries. What is the nurse's most appropriate action? Remove the client's commode and supply a bedpan. Perform a focused abdominal assessment in order to rule out injury. Have the client assessed by the primary provider due to the risk of internal bleeding. Complete an incident report and submit it to the unit supervisor.

Have the client assessed by the primary provider due to the risk of internal bleeding.

Renal failure can have prerenal, renal, or postrenal causes. A patient with acute kidney injury is being assessed to determine where, physiologically, the cause is. If the cause is found to be prerenal, which condition most likely caused it? Aminoglycoside toxicity Heart failure Ureterolithiasis Glomerulonephritis

Heart failure

The nurse is assisting a provider with a liver biopsy. The nurse should instruct the patient to... Hold her breath at the end of a deep expiration. Lay on her left side. Drink lots of fluid with the oral contrast. Be prepared for intubation.

Hold her breath at the end of a deep expiration.

When caring for a client with acute respiratory failure, the nurse should expect to focus on resolving which set of problems? Hyperoxemia, hypocapnia, and hyperventilation Hypotension, hyperoxemia, and hypercapnia Hyperventilation, hypertension, and hypocapnia Hypercapnia, hypoventilation, and hypoxemia

Hypercapnia, hypoventilation, and hypoxemia

An end-stage renal failure patient on hemodialysis demonstrates understanding when she states... (Select all that apply) I need to weigh myself every day. I will need three treatments per week for the rest of my life. The nurse will give me more fluids to keep me hydrated. My blood will be filtered through a machine and returned to me.

I need to weigh myself every day. I will need three treatments per week for the rest of my life. My blood will be filtered through a machine and returned to me.

Alexander, a 4 month old, is brought to the clinic by his mother. He has a cold and has been coughing a great deal for 2 days. Today he has had difficulty taking his bottle and is breathing very quickly. You note the following on exam: child appears pale, respiratory rate 68, retractions, nasal flaring, wheezing, and diminished breath sounds. Based on these assessment findings, which nursing diagnoses are priorities for Alexander? (Select all that apply). Ineffective breathing pattern Impaired gas exchange Ineffective airway clearance Activity intolerance

Ineffective breathing pattern Impaired gas exchange Ineffective airway clearance

The client has just been diagnosed with acute renal failure. The client asks the nurse what functional units of the kidneys are involved. What would the nurse reply? Nephrons Renal capsules Glomeruli Renal pelves

Nephrons

A client with a history of cirrhosis is admitted to the ICU with a diagnosis of bleeding esophageal varices; an attempt to stop the bleeding has been only partially successful. What would the critical care nurse expect the care team to prescribe for this client? (Select all that apply) Vitamin K Packed red blood cells (PRBCs) Heparin infusion Oral anticoagulants

Packed red blood cells (PRBCs) Heparin infusion

The kidney's inability to _____ causes anemia in chronic renal failure. Produce erythropoietin Inactivate vitamin D Produce rennin Produce angiotensin

Produce erythropoietin

A medical-surgical nurse is teaching a patient about the health implications of her recently diagnosed type 2 diabetes. The nurse should teach the patient to be proactive with her glycemic control in order to reduce her risk of what health problem? GI bleed Renal failure Asthma CHF

Renal failure

A nurse is caring for a client with cirrhosis secondary to heavy alcohol use. The nurse's most recent assessment reveals subtle changes in the client's cognition and behavior. What is the nurse's most appropriate response? Report this finding to the primary provider due to the possibility of hepatic encephalopathy. Ensure that the client's sodium intake does not exceed recommended levels. Inform the primary provider that the client should be assessed for alcoholic hepatitis. Implement interventions aimed at ensuring a calm and therapeutic care environment.

Report this finding to the primary provider due to the possibility of hepatic encephalopathy.

A client who was involved in a workplace accident suffered a penetrating wound of the chest that led to acute respiratory failure. What goal of treatment should the care team prioritize when planning this client's care? Restoration of adequate gas exchange Attainment of effective coping Self-management of oxygen therapy Facilitation of long-term intubation

Restoration of adequate gas exchange

A patient has completed 4 weeks of treatment with epoetin alfa. Which of the following assessment findings would most strongly indicate that treatment has been effective? The patient's hemoglobin level is 12 g/dL The patient maintains an oxygen saturation of 92% on room air Capillary refill in the patient's nail beds is less than or equal to 3 seconds The patient white blood cell level is within reference ranges

The patient's hemoglobin level is 12 g/dL

A client has developed hepatic encephalopathy secondary to cirrhosis and is receiving care on the medical unit. The client's current medication regimen includes lactulose four times daily. What desired outcome should the nurse relate to this pharmacologic intervention? Absence of nausea and vomiting Absence of blood or mucus in stool Two to three soft bowel movements daily Significant increase in appetite and food intake

Two to three soft bowel movements daily

A client is brought to the ED by ambulance after a motor vehicle accident in which the client received blunt trauma to the chest. The client is in acute respiratory failure, is intubated, and is transferred to the ICU. What assessment parameters should the nurse monitor most closely? Select all that apply. Vital signs Oral intake Coping Arterial blood gases Level of consciousness

Vital signs Arterial blood gases Level of consciousness

An ammonia lab results as critically high in the patient with cirrhosis. The RN understands that... (Select all that apply) administer Vitamin K as ordered to assess the patient's LOC ammonia is a byproduct of the liver's conversion of amino acids to glucose ammonia is typically excreted in the urine

to assess the patient's LOC ammonia is a byproduct of the liver's conversion of amino acids to glucose ammonia is typically excreted in the urine

A client has been diagnosed with renal failure and is surprised to learn of the large volume of blood that is filtered by the kidneys. The client asks, "If that much blood gets filtered, why don't people produce more urine than they do?" In response, the nurse should describe what phenomenon? Most of the substances that are removed from urine are recycled. very large majority of filtrate is returned to circulation. Most urine is processed internally rather than excreted. Electrolytes draw the water from urine back into circulation.

very large majority of filtrate is returned to circulation.