ATI ch59

A nurse is assessing a client who has prerenal AKI. Which of the following findings should the nurse expect? (Select all that apply.) A. Reduced BUN B. Elevated cardiac enzymes C. Reduced urine output D. Elevated serum creatinine E. Elevated serum calcium

A. A manifestation of prerenal AKI is an elevated BUN caused by the retention of nitrogenous wastes in the blood. B. Elevated cardiac enzymes is a manifestation of cardiac tissue injury, not AKI. C. CORRECT: A manifestation of prerenal AKI is reduced urine output. D. CORRECT: A manifestation of prerenal AKI is elevated serum creatinine. E. CORRECT: A manifestation of prerenal AKI is reduced calcium level.

A nurse is planning care for a client who has Stage 4 chronic kidney disease. Which of the following actions should the nurse include in the plan of care? (Select all that apply.) A. Assess for jugular vein distention. B. Provide frequent mouth rinses. C. Auscultate for a pleural friction rub. D. Provide a high‐sodium diet. E. Monitor for dysrhythmias.

A. CORRECT: The nurse should assess for jugular vein distention, which can indicate fluid overload and heart failure. B. CORRECT: The nurse should provide frequent mouth rinses due to uremic halitosis caused by urea waste in the blood. C. CORRECT: The nurse should auscultate for a pleural friction rub related to respiratory failure and pulmonary edema caused by acid base imbalances and fluid retention. D. The nurse should monitor serum sodium and reduce the client's dietary sodium intake. E. CORRECT: The nurse should monitor for dysrhythmias related to increased serum potassium caused by Stage 4 chronic kidney disease.

A nurse is planning care for a client who has postrenal AKI due to metastatic cancer. The client has a serum creatinine of 5 mg/dL. Which of the following interventions should the nurse include in the plan? (Select all that apply.) A. Provide a high‐protein diet. B. Assess the urine for blood. C. Monitor for intermittent anuria. D. Weight the client once per week. E. Provide NSAIDs for pain.

A. CORRECT: The nurse should provide a high‐protein diet due to the high rate of protein breakdown that occurs with acute kidney injury. B. CORRECT: The nurse should assess urine for blood, stones, and particles indicating an obstruction of the urinary structures that leave the kidney. C. CORRECT: The nurse should assess for intermittent anuria due to obstruction or damage to kidneys or urinary structures. D. The nurse should weigh the client daily to monitor for fluid retention due to acute kidney injury. E. The nurse should not administer NSAIDs, which are toxic to the nephrons in the kidney.

A nurse is reviewing client laboratory data. The nurse should recognize that which of the following findings is expected for a client who has Stage 4 chronic kidney disease? A. Blood urea nitrogen (BUN) 15 mg/dL B. Glomerular ltration rate (GFR) 20 mL/min C. Serum creatinine 1.1 mg/dL D. Serum potassium 5.0 mEq/L

A. The nurse should expect the BUN to be above the expected reference range, about 10 to 20 times the BUN finding. B. CORRECT: The GFR is severely decreased to approximately 20 mL/min, which is indicative of stage 4 chronic kidney disease. C. In stage 4 chronic kidney disease, a creatinine level can be as high as 15 to 30 mg/dL. D. A client in stage 4 chronic kidney disease would have a potassium level greater than 5.0 mEq/L.

A nurse is planning care for a client who has prerenal acute kidney injury (AKI) following abdominal aortic aneurysm repair. Urinary output is 60 mL in the past 2 hr, and blood pressure is 92/58 mm Hg. The nurse should anticipate which of the following interventions? A. Prepare the client for a CT scan with contrast dye. B. Plan to administer nitroprusside. C. Prepare to administer a fluid challenge. D. Plan to position the client in Trendelenburg.

A. The nurse should not plan for a CT scan. Contrast dye is contraindicated for a client who has possible acute kidney injury. B. Nitroprusside is a rapid‐acting vasodilator used to rapidly reduce blood pressure for clients who have hypertensive crisis. It is contraindicated for clients who have hypotension. C. CORRECT: The nurse should plan to administer a fluid challenge for hypovolemia, which is indicated by the client's low urinary output and blood pressure. D. The nurse should position the client in reverse Trendelenburg, with the head down and feet up, to treat hypotension.