CH19 Kidney Disorders and Therapeutic Management

30. An alert and oriented patient presents with a pulmonary artery wedge pressure of 4 mm Hg and a cardiac index of 0.8. The BUN is 44 mg/dL, creatinine is 3.2 mg/dL, and BP is 88/36 mm Hg. Urine output is 15 mL/hr. Lungs are clear to auscultation with no peripheral edema noted. Which of the following treatments would the physician most likely order? · Lasix 40 mg intravenous push · 0.9% normal saline at 125 mL/hr · Dopamine 15 μg/kg/min · Transfuse 1 U of packed red blood cells

· 0.9% normal saline at 125 mL/hr

14. What is the recommended nutritional intake of protein to control azotemia in the patient with acute kidney injury? · 0.5 to 1.0 g/kg/day · 1.2 to 1.5 g/kg/day · 1.7 to 2.5 g/kg/day · 2.5 to 3.5 g/kg/day

· 1.2 to 1.5 g/kg/day -𝘈𝘻𝘰𝘵𝘦𝘮𝘪𝘢 = 𝘪𝘯𝘤𝘳𝘦𝘢𝘴𝘦𝘥 𝘉𝘜𝘕 𝘭𝘦𝘷𝘦𝘭 -𝘛𝘩𝘦 𝘳𝘦𝘤𝘰𝘮𝘮𝘦𝘯𝘥𝘦𝘥 𝘦𝘯𝘦𝘳𝘨𝘺 𝘪𝘯𝘵𝘢𝘬𝘦 𝘪𝘴 𝘣𝘦𝘵𝘸𝘦𝘦𝘯 20 𝘢𝘯𝘥 30 𝘬𝘤𝘢𝘭/𝘬𝘨 𝘱𝘦𝘳 𝘥𝘢𝘺, 𝘸𝘪𝘵𝘩 1.2 𝘵𝘰 1.5 𝘨/𝘬𝘨 𝘰𝘧 𝘱𝘳𝘰𝘵𝘦𝘪𝘯 𝘱𝘦𝘳 𝘥𝘢𝘺 𝘵𝘰 𝘤𝘰𝘯𝘵𝘳𝘰𝘭 𝘢𝘻𝘰𝘵𝘦𝘮𝘪𝘢 (352).

27. A patient has sepsis and is placed on broad-spectrum antibiotics. Her temperature is 37.8°C. Her BUN level is elevated. She continues on vasopressor therapy. What other steps should be taken to protect the patient from inadequate organ perfusion? · Increase net ultrafiltrate of fluid. · Discontinue vasopressor support. · Assess the patient for blood loss and hypotension. · Notify the physician of access pressures.

· Assess the patient for blood loss and hypotension.

13. A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodiafiltration (CVVHDF). The nurse understands the patient should be closely monitored for what circuit-related complications of the therapy? · Hypervolemia, hypothermia, and hyperkalemia · Access dislodgment, decreased outflow pressures, and bleeding · Filter clotting, access failure, and air embolism · Increased overflow pressure, dehydration, and calcium loss

· Filter clotting, access failure, and air embolism 𝘊𝘰𝘮𝘱𝘭𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴 𝘰𝘧 𝘊𝘰𝘯𝘵𝘪𝘯𝘶𝘰𝘶𝘴 𝘙𝘦𝘯𝘢𝘭 𝘙𝘦𝘱𝘭𝘢𝘤𝘦𝘮𝘦𝘯𝘵 𝘛𝘩𝘦𝘳𝘢𝘱𝘺, 𝘉𝘰𝘹 19.8 (359).

17. The nursing management plan for the patient with a urinary drainage catheter would include which interventions to prevent catheter-associated UTI (CAUTI)? (Select all that apply.) · Insert urinary catheters using aseptic techniques. · Change the urinary catheter daily. · Review the need for the urinary catheter daily and remove promptly. · Flush the urinary catheter q8 hours to maintain patency. · Avoid unnecessary use of indwelling urinary catheters.

· Insert urinary catheters using aseptic techniques. · Review the need for the urinary catheter daily and remove promptly. · Avoid unnecessary use of indwelling urinary catheters. The key components of CAUTI prevention are to avoid unnecessary use of urinary catheters, insert urinary catheters using aseptic technique, adopt evidence-based standards for maintenance of urinary catheters, review the need for the urinary catheter daily, and remove the catheter promptly.

4. A patient was admitted with liver failure and acute kidney injury (AKI). Which intravenous solution should the nurse question if it was ordered for this patient? · D5W · 0.9% NaCl · Lactated Ringer solution · 0.45% NaCl

· Lactated Ringer solution 𝘓𝘢𝘤𝘵𝘢𝘵𝘦𝘥 𝘙𝘪𝘯𝘨𝘦𝘳 𝘴𝘰𝘭𝘶𝘵𝘪𝘰𝘯 𝘶𝘴𝘶𝘢𝘭𝘭𝘺 𝘪𝘴 𝘢𝘷𝘰𝘪𝘥𝘦𝘥 𝘪𝘯 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘸𝘪𝘵𝘩 𝘬𝘪𝘥𝘯𝘦𝘺 𝘧𝘢𝘪𝘭𝘶𝘳𝘦 𝘣𝘦𝘤𝘢𝘶𝘴𝘦 𝘪𝘵 𝘤𝘰𝘯𝘵𝘢𝘪𝘯𝘴 𝘱𝘰𝘵𝘢𝘴𝘴𝘪𝘶𝘮 (348)

9. A patient is admitted with sepsis and acute kidney injury (AKI). The patient is started on continuous renal replacement therapy (CRRT). The nurse knows that fluid removed each hour is charted as what on the CRRT flow sheet? · Convection · Diffusion · Replacement fluid · Ultrafiltrate

· Ultrafiltrate 𝘛𝘩𝘦 𝘧𝘭𝘶𝘪𝘥 𝘵𝘩𝘢𝘵 𝘪𝘴 𝘳𝘦𝘮𝘰𝘷𝘦𝘥 𝘦𝘢𝘤𝘩 𝘩𝘰𝘶𝘳 𝘪𝘴 𝘯𝘰𝘵 𝘤𝘢𝘭𝘭𝘦𝘥 𝘶𝘳𝘪𝘯𝘦; 𝘪𝘵 𝘪𝘴 𝘬𝘯𝘰𝘸𝘯 𝘢𝘴 𝘶𝘭𝘵𝘳𝘢𝘧𝘪𝘭𝘵𝘳𝘢𝘵𝘦 (357).

29. What is the dose for low-dose dopamine? · 1 to 2 mcg/kg/min · 1 to 2 mg/kg/min · 2 to 3 mcg/kg/min · 2 to 3 mg/kg/min

· 2 to 3 mcg/kg/min -𝘓𝘰𝘸-𝘥𝘰𝘴𝘦 𝘥𝘰𝘱𝘢𝘮𝘪𝘯𝘦 (2 𝘵𝘰 3 𝘮𝘤𝘨/𝘬𝘨 𝘱𝘦𝘳 𝘮𝘪𝘯𝘶𝘵𝘦), 𝘱𝘳𝘦𝘷𝘪𝘰𝘶𝘴𝘭𝘺 𝘬𝘯𝘰𝘸𝘯 𝘢𝘴 𝘳𝘦𝘯𝘢𝘭-𝘥𝘰𝘴𝘦 𝘥𝘰𝘱𝘢𝘮𝘪𝘯𝘦, 𝘪𝘴 𝘧𝘳𝘦𝘲𝘶𝘦𝘯𝘵𝘭𝘺 𝘪𝘯𝘧𝘶𝘴𝘦𝘥 𝘵𝘰 𝘴𝘵𝘪𝘮𝘶𝘭𝘢𝘵𝘦 𝘣𝘭𝘰𝘰𝘥 𝘧𝘭𝘰𝘸 𝘵𝘰 𝘵𝘩𝘦 𝘬𝘪𝘥𝘯𝘦𝘺 (351) -𝘥𝘰𝘱𝘢𝘮𝘪𝘯𝘦 ↑ 𝘶𝘳𝘪𝘯𝘦 𝘰𝘶𝘵𝘱𝘶𝘵 𝘪𝘯 𝘵𝘩𝘦 𝘴𝘩𝘰𝘳𝘵 𝘵𝘦𝘳𝘮

33.Which of the following conditions is associated between kidney failure and respiratory failure? (Select all that apply.) · ARDS · Lower GFR · Increased urine output · Decreased urine output · Decreased blood flow to the kidneys

· ARDS · Lower GFR · Decreased urine output · Decreased blood flow to the kidneys -𝘔𝘦𝘤𝘩𝘢𝘯𝘪𝘤𝘢𝘭 𝘷𝘦𝘯𝘵𝘪𝘭𝘢𝘵𝘪𝘰𝘯 𝘤𝘢𝘯 𝘢𝘭𝘵𝘦𝘳 𝘬𝘪𝘥𝘯𝘦𝘺 𝘧𝘶𝘯𝘤𝘵𝘪𝘰𝘯. 𝘗𝘰𝘴𝘪𝘵𝘪𝘷𝘦-𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 𝘷𝘦𝘯𝘵𝘪𝘭𝘢𝘵𝘪𝘰𝘯 𝘳𝘦𝘥𝘶𝘤𝘦𝘴 𝘣𝘭𝘰𝘰𝘥 𝘧𝘭𝘰𝘸 𝘵𝘰 𝘵𝘩𝘦 𝘬𝘪𝘥𝘯𝘦𝘺, 𝘭𝘰𝘸𝘦𝘳𝘴 𝘵𝘩𝘦 𝘎𝘍𝘙, 𝘢𝘯𝘥 𝘥𝘦𝘤𝘳𝘦𝘢𝘴𝘦𝘴 𝘶𝘳𝘪𝘯𝘦 𝘰𝘶𝘵𝘱𝘶𝘵 (345) -𝘈𝘒𝘐 𝘪𝘯𝘤𝘳𝘦𝘢𝘴𝘦𝘴 𝘪𝘯𝘧𝘭𝘢𝘮𝘮𝘢𝘵𝘪𝘰𝘯, 𝘤𝘢𝘶𝘴𝘦𝘴 𝘵𝘩𝘦 𝘭𝘶𝘯𝘨 𝘷𝘢𝘴𝘤𝘶𝘭𝘢𝘵𝘶𝘳𝘦 𝘵𝘰 𝘣𝘦𝘤𝘰𝘮𝘦 𝘮𝘰𝘳𝘦 𝘱𝘦𝘳𝘮𝘦𝘢𝘣𝘭𝘦, 𝘢𝘯𝘥 𝘤𝘰𝘯𝘵𝘳𝘪𝘣𝘶𝘵𝘦𝘴 𝘵𝘰 𝘵𝘩𝘦 𝘥𝘦𝘷𝘦𝘭𝘰𝘱𝘮𝘦𝘯𝘵 𝘰𝘧 𝘢𝘤𝘶𝘵𝘦 𝘳𝘦𝘴𝘱𝘪𝘳𝘢𝘵𝘰𝘳𝘺 𝘥𝘪𝘴𝘵𝘳𝘦𝘴𝘴 𝘴𝘺𝘯𝘥𝘳𝘰𝘮𝘦

22. A patient has acute kidney injury (previously known as acute tubular necrosis). The following blood work was noted: complete blood count shows a white blood cell count of 11,000 mm3, a hemoglobin of 8 g/dL, and a hematocrit of 30%. His chemistry panel shows serum potassium, 4.5 mg/dL; serum sodium, 135 mg/dL; serum calcium, 8.5 mg/dL; BUN, 20 mg/dL; and creatinine, 1.5 mg/dL. What laboratory value(s) need(s) to be treated most immediately and why? · Administration of 5% dextrose in water and insulin because the patient is hyperkalemic and needs this level reduced · Administration of Epogen to treat anemia · Administration of a broad-spectrum antibiotic to treat the elevated blood cell count · Administration of a calcium supplement for low calcium

· Administration of Epogen to treat anemia -𝘈𝘯𝘦𝘮𝘪𝘢 𝘪𝘴 𝘦𝘹𝘱𝘦𝘤𝘵𝘦𝘥 𝘸𝘪𝘵𝘩 𝘬𝘪𝘥𝘯𝘦𝘺 𝘧𝘢𝘪𝘭𝘶𝘳𝘦, 𝘵𝘳𝘦𝘢𝘵 𝘸𝘪𝘵𝘩 𝘦𝘱𝘰𝘦𝘵𝘪𝘯 𝘢𝘭𝘧𝘢 (𝘌𝘱𝘰𝘨𝘦𝘯) (352) -𝘢𝘭𝘭 𝘰𝘵𝘩𝘦𝘳 𝘭𝘢𝘣𝘴 𝘢𝘳𝘦 𝘸𝘪𝘵𝘩𝘪𝘯 𝘯𝘰𝘳𝘮𝘢𝘭 𝘭𝘪𝘮𝘪𝘵𝘴

24. The patient is a gravida 6, para 1. She is admitted after a cesarean section after an amniotic embolus. Her heart rate (HR) is more than 150 beats/min with a systolic BP less than 80 mm Hg. Her temperature is 38°C, and her condition has caused her to develop prerenal azotemia. The patient was fluid resuscitated through a double-lumen catheter, which was placed into her right femoral access, and started on vasopressors with a fair response (BP, 80/50 mm Hg; HR, 122 beats/min). Because of her diagnosis and a concern regarding fulminating sepsis, the patient was begun on CVVH. Identify three complications of CVVH therapy. · Fat emboli, increased ultrafiltration, and hypertension · Hyperthermia, overhydration, and power surge · Air embolism, decreased inflow pressure, and electrolyte imbalance · Blood loss, decreased outflow resistance, and acid-base imbalance

· Air embolism, decreased inflow pressure, and electrolyte imbalance -𝘊𝘰𝘮𝘱𝘭𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴 𝘰𝘧 𝘊𝘰𝘯𝘵𝘪𝘯𝘶𝘰𝘶𝘴 𝘙𝘦𝘯𝘢𝘭 𝘙𝘦𝘱𝘭𝘢𝘤𝘦𝘮𝘦𝘯𝘵 𝘛𝘩𝘦𝘳𝘢𝘱𝘺, 𝘉𝘰𝘹 19.8 (358)

23. The patient is a gravida 6, para 1. She is admitted after a cesarean section after an amniotic embolus. Her heart rate (HR) is more than 150 beats/min with a systolic BP less than 80 mm Hg. Her temperature is 38°C, and her condition has caused her to develop prerenal azotemia. The patient was fluid resuscitated through a double-lumen catheter, which was placed into her right femoral access, and started on vasopressors with a fair response (BP, 80/50 mm Hg; HR, 122 beats/min). Because of her diagnosis and a concern regarding fulminating sepsis, the patient was begun on CVVH. Which of the statements best describes CVVH? · Complete renal replacement therapy requiring large volumes of ultrafiltrate and filter replacement · Complete renal replacement therapy that allows removal of solutes and modification of the volume and composition of extracellular fluid to occur evenly over time · Involves the introduction of sterile dialyzing fluid through an implanted catheter into the abdominal cavity, which relies on osmosis, diffusion, and active transport to help remove waste from the body · Complete renal replacement therapy that allows an exchange of fluid, solutes, and solvents across a semipermeable membrane at 100 to 300 mL/hr

· Complete renal replacement therapy that allows removal of solutes and modification of the volume and composition of extracellular fluid to occur evenly over time -𝘊𝘰𝘯𝘵𝘪𝘯𝘶𝘰𝘶𝘴 𝘷𝘦𝘯𝘰𝘷𝘦𝘯𝘰𝘶𝘴 𝘩𝘦𝘮𝘰𝘧𝘪𝘭𝘵𝘳𝘢𝘵𝘪𝘰𝘯 (𝘊𝘝𝘝𝘏) 𝘪𝘴 𝘢 𝘵𝘺𝘱𝘦 𝘰𝘧 𝘊𝘙𝘙𝘛 𝘧𝘰𝘳 𝘱𝘵𝘴 𝘵𝘩𝘢𝘵 𝘯𝘦𝘦𝘥 𝘳𝘦𝘮𝘰𝘷𝘢𝘭 𝘰𝘧 𝘴𝘪𝘨𝘯𝘪𝘧𝘪𝘤𝘢𝘯𝘵 𝘷𝘰𝘭𝘶𝘮𝘦𝘴 𝘰𝘧 𝘧𝘭𝘶𝘪𝘥 𝘢𝘯𝘥 𝘴𝘰𝘭𝘶𝘵𝘦𝘴 (358)

16. A patient is admitted with respiratory failure and is being mechanically ventilated. The nurse understands there is a significant association between acute kidney injury and respiratory failure. How does mechanical ventilation alter kidney function? (Select all that apply.) · Decreases blood flow to the kidney. · Decreases glomerular filtration rate (GFR). · Damages the kidney tubular endothelium. · Decreases urine output. · Hinders flow of urine from the kidneys.

· Decreases blood flow to the kidney. · Decreases glomerular filtration rate (GFR). · Decreases urine output. 𝘗𝘰𝘴𝘪𝘵𝘪𝘷𝘦-𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 𝘷𝘦𝘯𝘵𝘪𝘭𝘢𝘵𝘪𝘰𝘯 𝘳𝘦𝘥𝘶𝘤𝘦𝘴 𝘣𝘭𝘰𝘰𝘥 𝘧𝘭𝘰𝘸 𝘵𝘰 𝘵𝘩𝘦 𝘬𝘪𝘥𝘯𝘦𝘺, 𝘭𝘰𝘸𝘦𝘳𝘴 𝘵𝘩𝘦 𝘎𝘍𝘙, 𝘢𝘯𝘥 𝘥𝘦𝘤𝘳𝘦𝘢𝘴𝘦𝘴 𝘶𝘳𝘪𝘯𝘦 𝘰𝘶𝘵𝘱𝘶𝘵. 𝘛𝘩𝘦𝘴𝘦 𝘦𝘧𝘧𝘦𝘤𝘵𝘴 𝘢𝘳𝘦 𝘪𝘯𝘵𝘦𝘯𝘴𝘪𝘧𝘪𝘦𝘥 𝘸𝘪𝘵𝘩 𝘵𝘩𝘦 𝘢𝘥𝘥𝘪𝘵𝘪𝘰𝘯 𝘰𝘧 𝘗𝘌𝘌𝘗 (345).

26. What is a continuous venovenous hemodialysis filter permeable to? · Electrolytes · Red blood cells · Protein · Lipids

· Electrolytes

12. A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse understands that this type of continuous renal replacement therapy (CRRT) is indicated for the patient who needs what type of treatment? · Fluid removal only · Fluid removal and moderate solute removal · Fluid removal and maximum solute removal · Maximum fluid and solute removal

· Fluid removal and maximum solute removal 𝘊𝘝𝘝𝘏𝘋 𝘪𝘴 𝘪𝘯𝘥𝘪𝘤𝘢𝘵𝘦𝘥 𝘧𝘰𝘳 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘸𝘩𝘰 𝘳𝘦𝘲𝘶𝘪𝘳𝘦 𝘭𝘢𝘳𝘨𝘦-𝘷𝘰𝘭𝘶𝘮𝘦 𝘳𝘦𝘮𝘰𝘷𝘢𝘭 𝘧𝘰𝘳 𝘴𝘦𝘷𝘦𝘳𝘦 𝘶𝘳𝘦𝘮𝘪𝘢 𝘰𝘳 𝘤𝘳𝘪𝘵𝘪𝘤𝘢𝘭 𝘢𝘤𝘪𝘥-𝘣𝘢𝘴𝘦 𝘪𝘮𝘣𝘢𝘭𝘢𝘯𝘤𝘦𝘴 𝘰𝘳 𝘧𝘰𝘳 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘸𝘩𝘰 𝘢𝘳𝘦 𝘳𝘦𝘴𝘪𝘴𝘵𝘢𝘯𝘵 𝘵𝘰 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤𝘴 (358).

3. One therapeutic measure for treating hyperkalemia is the administration of dextrose and regular insulin. Which description regarding how this treatment works is accurate? · Forces potassium out of the serum into the lymphatic space. · Promotes higher excretion of potassium in the urine. · Binds with potassium lowering available amounts. · Forces potassium out of the serum into the cells.

· Forces potassium out of the serum into the cells. 𝘈𝘤𝘶𝘵𝘦 𝘩𝘺𝘱𝘦𝘳𝘬𝘢𝘭𝘦𝘮𝘪𝘢 𝘤𝘢𝘯 𝘣𝘦 𝘵𝘳𝘦𝘢𝘵𝘦𝘥 𝘵𝘦𝘮𝘱𝘰𝘳𝘢𝘳𝘪𝘭𝘺 𝘣𝘺 𝘐𝘝 𝘢𝘥𝘮𝘪𝘯𝘪𝘴𝘵𝘳𝘢𝘵𝘪𝘰𝘯 𝘰𝘧 𝘪𝘯𝘴𝘶𝘭𝘪𝘯 𝘢𝘯𝘥 𝘨𝘭𝘶𝘤𝘰𝘴𝘦. 𝘈𝘯 𝘪𝘯𝘧𝘶𝘴𝘪𝘰𝘯 𝘰𝘧 50 𝘮𝘓 𝘰𝘧 50% 𝘥𝘦𝘹𝘵𝘳𝘰𝘴𝘦 𝘢𝘤𝘤𝘰𝘮𝘱𝘢𝘯𝘪𝘦𝘥 𝘣𝘺 10 𝘶𝘯𝘪𝘵𝘴 𝘰𝘧 𝘳𝘦𝘨𝘶𝘭𝘢𝘳 𝘪𝘯𝘴𝘶𝘭𝘪𝘯 𝘧𝘰𝘳𝘤𝘦𝘴 𝘱𝘰𝘵𝘢𝘴𝘴𝘪𝘶𝘮 𝘰𝘶𝘵 𝘰𝘧 𝘵𝘩𝘦 𝘴𝘦𝘳𝘶𝘮 𝘢𝘯𝘥 𝘪𝘯𝘵𝘰 𝘵𝘩𝘦 𝘤𝘦𝘭𝘭𝘴(346).

32. Which of the following medications is considered a loop diuretic? · Acetazolamide (Diamox) · Furosemide (Lasix) · Mannitol · Metolazone (Zaroxolyn)

· Furosemide (Lasix) -𝘓𝘰𝘰𝘱 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤𝘴 𝘸𝘰𝘳𝘬 𝘰𝘯 𝘵𝘩𝘦 𝘓𝘰𝘰𝘱 𝘰𝘧 𝘏𝘦𝘯𝘭𝘦: 𝘧𝘶𝘳𝘰𝘴𝘦𝘮𝘪𝘥𝘦, 𝘣𝘶𝘮𝘦𝘵𝘢𝘯𝘪𝘥𝘦, 𝘵𝘰𝘳𝘴𝘦𝘮𝘪𝘥𝘦 (350) 𝘹 𝘈𝘤𝘦𝘵𝘢𝘻𝘰𝘭𝘢𝘮𝘪𝘥𝘦 = 𝘊𝘢𝘳𝘣𝘰𝘯𝘪𝘤 𝘢𝘯𝘩𝘺𝘥𝘳𝘢𝘴𝘦 𝘪𝘯𝘩𝘪𝘣𝘪𝘵𝘰𝘳 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤𝘴 𝘹 𝘔𝘢𝘯𝘯𝘪𝘵𝘰𝘭 = 𝘖𝘴𝘮𝘰𝘵𝘪𝘤 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤 𝘹 𝘔𝘦𝘵𝘰𝘭𝘢𝘻𝘰𝘯𝘦 (𝘡𝘢𝘳𝘰𝘹𝘰𝘭𝘺𝘯) = 𝘛𝘩𝘪𝘢𝘻𝘪𝘥𝘦 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤

20. A patient has been hospitalized for a subtotal gastrectomy. After the procedure, an infection developed that eventually had to be treated with gentamicin, an aminoglycoside antibiotic. After 3 days of administration, oliguria occurred, and subsequent laboratory values indicated elevated BUN and creatinine levels. The patient is transferred to the critical care unit with acute kidney injury (previously known as acute tubular necrosis). The patient's vital signs are stable. Which dialysis method would be most appropriate for the patient's condition? · Peritoneal dialysis · Hemodialysis · Continuous renal replacement therapy · Continuous venovenous hemodialysis (CVVH)

· Hemodialysis -𝘐𝘯𝘥𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴 𝘢𝘯𝘥 𝘊𝘰𝘯𝘵𝘳𝘢𝘪𝘯𝘥𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴 𝘧𝘰𝘳 𝘏𝘦𝘮𝘰𝘥𝘪𝘢𝘭𝘺𝘴𝘪𝘴𝘛𝘢𝘣𝘭𝘦, 19.6 (353)

11. A patient with acute kidney injury (AKI) has been started on continuous venovenous hemodialysis (CVVHD). The nurse understands the patient should be closely monitored for what 𝐩𝐚𝐭𝐢𝐞𝐧𝐭-𝐫𝐞𝐥𝐚𝐭𝐞𝐝 complications of the therapy? · Air embolism, access failure, and blood leaks · Decreased inflow pressure, air bubbles, and power surge · Infection, hypotension, and electrolyte imbalances · Catheter dislodgement, decreased outflow pressure, and acid-base imbalances

· Infection, hypotension, and electrolyte imbalances 𝘖𝘵𝘩𝘦𝘳 𝘱𝘢𝘵𝘪𝘦𝘯𝘵-𝘳𝘦𝘭𝘢𝘵𝘦𝘥 𝘤𝘰𝘮𝘱𝘭𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴 𝘪𝘯𝘤𝘭𝘶𝘥𝘦 𝘧𝘭𝘶𝘪𝘥 𝘢𝘯𝘥 𝘦𝘭𝘦𝘤𝘵𝘳𝘰𝘭𝘺𝘵𝘦 𝘢𝘭𝘵𝘦𝘳𝘢𝘵𝘪𝘰𝘯𝘴, 𝘣𝘭𝘦𝘦𝘥𝘪𝘯𝘨 𝘣𝘦𝘤𝘢𝘶𝘴𝘦 𝘰𝘧 𝘢𝘯𝘵𝘪𝘤𝘰𝘢𝘨𝘶𝘭𝘢𝘵𝘪𝘰𝘯, 𝘰𝘳 𝘱𝘳𝘰𝘣𝘭𝘦𝘮𝘴 𝘸𝘪𝘵𝘩 𝘵𝘩𝘦 𝘢𝘤𝘤𝘦𝘴𝘴 𝘴𝘪𝘵𝘦 𝘴𝘶𝘤𝘩 𝘢𝘴 𝘥𝘪𝘴𝘭𝘰𝘥𝘨𝘮𝘦𝘯𝘵 𝘰𝘳 𝘪𝘯𝘧𝘦𝘤𝘵𝘪𝘰𝘯 (358).

8. A patient was admitted with an infection that had to be treated with gentamicin, an aminoglycoside antibiotic. After 3 days of administration, the patient developed oliguria, and an elevated blood urea nitrogen and creatinine levels. The nurse suspects the patient has developed what type of kidney injury? · Prerenal · Intrarenal · Anuric · Postrenal

· Intrarenal -𝘈𝘯𝘺 𝘤𝘰𝘯𝘥𝘪𝘵𝘪𝘰𝘯 𝘵𝘩𝘢𝘵 𝘱𝘳𝘰𝘥𝘶𝘤𝘦𝘴 𝘢𝘯 𝘪𝘴𝘤𝘩𝘦𝘮𝘪𝘤 𝘰𝘳 𝘵𝘰𝘹𝘪𝘤 𝘪𝘯𝘴𝘶𝘭𝘵 𝘥𝘪𝘳𝘦𝘤𝘵𝘭𝘺 𝘢𝘵 𝘱𝘢𝘳𝘦𝘯𝘤𝘩𝘺𝘮𝘢𝘭 𝘯𝘦𝘱𝘩𝘳𝘰𝘯 𝘵𝘪𝘴𝘴𝘶𝘦 𝘱𝘭𝘢𝘤𝘦𝘴 𝘵𝘩𝘦 𝘱𝘢𝘵𝘪𝘦𝘯𝘵 𝘢𝘵 𝘳𝘪𝘴𝘬 𝘧𝘰𝘳 𝘥𝘦𝘷𝘦𝘭𝘰𝘱𝘮𝘦𝘯𝘵 𝘰𝘧 𝘪𝘯𝘵𝘳𝘢𝘳𝘦𝘯𝘢𝘭 𝘈𝘒𝘐 (340). -𝘌𝘹𝘰𝘨𝘦𝘯𝘰𝘶𝘴 𝘵𝘰𝘹𝘪𝘯𝘴 (𝘳𝘢𝘥𝘪𝘰𝘤𝘰𝘯𝘵𝘳𝘢𝘴𝘵 𝘥𝘺𝘦, 𝘯𝘦𝘱𝘩𝘳𝘰𝘵𝘰𝘹𝘪𝘤 𝘮𝘦𝘥𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴), 𝘛𝘺𝘱𝘦𝘴 𝘰𝘧 𝘈𝘒𝘐, 𝘉𝘰𝘹 19.2 (339).

25. The patient is a gravida 6, para 1. She is admitted after a cesarean section after an amniotic embolus. Her heart rate (HR) is more than 150 beats/min with a systolic BP less than 80 mm Hg. Her temperature is 38°C, and her condition has caused her to develop prerenal azotemia. The patient was fluid resuscitated through a double-lumen catheter, which was placed into her right femoral access, and started on vasopressors with a fair response (BP, 80/50 mm Hg; HR, 122 beats/min). Because of her diagnosis and a concern regarding fulminating sepsis, the patient was begun on CVVH. Why would this therapy be chosen for this patient? · Hyperdynamic patients can better tolerate abrupt fluid and solute changes. · It is the treatment of choice for patients with diminished renal perfusion who are unresponsive to diuretics. · It is indicated for patients who require large-volume removal for severe uremia or critical acid-base imbalances. · It is indicated for hemodynamically unstable patients, who are often intolerant of the abrupt fluid and solute changes that can occur with hemodialysis.

· It is indicated for hemodynamically unstable patients, who are often intolerant of the abrupt fluid and solute changes that can occur with hemodialysis. -𝘛𝘩𝘪𝘴 𝘵𝘩𝘦𝘳𝘢𝘱𝘺 𝘪𝘴 𝘪𝘥𝘦𝘢𝘭 𝘧𝘰𝘳 𝘩𝘦𝘮𝘰𝘥𝘺𝘯𝘢𝘮𝘪𝘤𝘢𝘭𝘭𝘺 𝘶𝘯𝘴𝘵𝘢𝘣𝘭𝘦 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘪𝘯 𝘵𝘩𝘦 𝘤𝘳𝘪𝘵𝘪𝘤𝘢𝘭 𝘤𝘢𝘳𝘦 𝘴𝘦𝘵𝘵𝘪𝘯𝘨 𝘣𝘦𝘤𝘢𝘶𝘴𝘦 𝘵𝘩𝘦𝘺 𝘥𝘰 𝘯𝘰𝘵 𝘦𝘹𝘱𝘦𝘳𝘪𝘦𝘯𝘤𝘦 𝘵𝘩𝘦 𝘢𝘣𝘳𝘶𝘱𝘵 𝘧𝘭𝘶𝘪𝘥 𝘢𝘯𝘥 𝘴𝘰𝘭𝘶𝘵𝘦 𝘤𝘩𝘢𝘯𝘨𝘦𝘴 𝘵𝘩𝘢𝘵 𝘤𝘢𝘯 𝘢𝘤𝘤𝘰𝘮𝘱𝘢𝘯𝘺 𝘴𝘵𝘢𝘯𝘥𝘢𝘳𝘥 𝘩𝘦𝘮𝘰𝘥𝘪𝘢𝘭𝘺𝘴𝘪𝘴 𝘵𝘳𝘦𝘢𝘵𝘮𝘦𝘯𝘵𝘴 (358)

31. A patient with chronic renal failure receives hemodialysis treatments 3 days a week. Every 2 weeks, the patient requires a transfusion of 1 or 2 U of packed red blood cells. What is the probable reason for this patient's frequent transfusion needs? · Too much blood phlebotomized for tests · Increased destruction of red blood cells because of the increased toxin levels · Lack of production of erythropoietin to stimulate red blood cell formation · Fluid retention causing hemodilution

· Lack of production of erythropoietin to stimulate red blood cell formation -𝘒𝘪𝘥𝘯𝘦𝘺𝘴 𝘢𝘳𝘦 𝘳𝘦𝘴𝘱𝘰𝘯𝘴𝘪𝘣𝘭𝘦 𝘧𝘰𝘳 𝘱𝘳𝘰𝘥𝘶𝘤𝘪𝘯𝘨 𝘦𝘳𝘺𝘵𝘩𝘳𝘰𝘱𝘰𝘦𝘵𝘪𝘯; 𝘤𝘢𝘯 𝘯𝘰 𝘭𝘰𝘯𝘨𝘦𝘳 𝘱𝘳𝘰𝘥𝘶𝘤𝘦 𝘪𝘵 𝘪𝘯 𝘬𝘪𝘥𝘯𝘦𝘺 𝘧𝘢𝘪𝘭𝘶𝘳𝘦, 𝘙𝘉𝘊𝘴 𝘸𝘪𝘭𝘭 𝘥𝘪𝘦 𝘧𝘢𝘴𝘵𝘦𝘳 𝘰𝘯 𝘥𝘪𝘢𝘭𝘺𝘴𝘪𝘴 𝘢𝘯𝘥 𝘸𝘰𝘯'𝘵 𝘣𝘦 𝘳𝘦𝘱𝘭𝘢𝘤𝘦𝘥 (352)

28. Which of the following diuretics maybe combined to work on different parts of the nephron? · Loop and thiazide diuretics · Loop and osmotic diuretics · Osmotic and carbonic anhydrase inhibitor diuretics · Thiazide and osmotic diuretics

· Loop and thiazide diuretics -𝘈 𝘵𝘩𝘪𝘢𝘻𝘪𝘥𝘦 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤 𝘴𝘶𝘤𝘩 𝘢𝘴 𝘤𝘩𝘭𝘰𝘳𝘰𝘵𝘩𝘪𝘢𝘻𝘪𝘥𝘦 𝘮𝘢𝘺 𝘣𝘦 𝘢𝘥𝘮𝘪𝘯𝘪𝘴𝘵𝘦𝘳𝘦𝘥 𝘢𝘯𝘥 𝘧𝘰𝘭𝘭𝘰𝘸𝘦𝘥 𝘣𝘺 𝘢 𝘭𝘰𝘰𝘱 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤 𝘵𝘰 𝘵𝘢𝘬𝘦 𝘢𝘥𝘷𝘢𝘯𝘵𝘢𝘨𝘦 𝘰𝘧 𝘵𝘩𝘦 𝘧𝘢𝘤𝘵 𝘵𝘩𝘢𝘵 𝘵𝘩𝘦𝘴𝘦 𝘮𝘦𝘥𝘪𝘤𝘢𝘵𝘪𝘰𝘯𝘴 𝘸𝘰𝘳𝘬 𝘰𝘯 𝘥𝘪𝘧𝘧𝘦𝘳𝘦𝘯𝘵 𝘱𝘢𝘳𝘵𝘴 𝘰𝘧 𝘵𝘩𝘦 𝘯𝘦𝘱𝘩𝘳𝘰𝘯, 𝘍𝘪𝘨𝘶𝘳𝘦 19.3 (350) -𝘚𝘰𝘮𝘦𝘵𝘪𝘮𝘦𝘴 𝘢 𝘵𝘩𝘪𝘢𝘻𝘪𝘥𝘦 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤 𝘪𝘴 𝘢𝘥𝘥𝘦𝘥 𝘵𝘰 𝘢 𝘭𝘰𝘰𝘱 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤 𝘵𝘰 𝘤𝘰𝘮𝘱𝘦𝘯𝘴𝘢𝘵𝘦 𝘧𝘰𝘳 𝘵𝘩𝘦 𝘥𝘦𝘷𝘦𝘭𝘰𝘱𝘮𝘦𝘯𝘵 𝘰𝘧 𝘭𝘰𝘰𝘱 𝘥𝘪𝘶𝘳𝘦𝘵𝘪𝘤 𝘳𝘦𝘴𝘪𝘴𝘵𝘢𝘯𝘤𝘦

18. Which of the following IV solutions is recommended for treatment of prerenal failure? · Dextrose in water · Normal saline · Albumin · Lactated Ringer solution

· Normal saline 𝘗𝘳𝘦𝘳𝘦𝘯𝘢𝘭 𝘧𝘢𝘪𝘭𝘶𝘳𝘦 𝘪𝘴 𝘤𝘢𝘶𝘴𝘦𝘥 𝘣𝘺 𝘥𝘦𝘤𝘳𝘦𝘢𝘴𝘦𝘥 𝘱𝘦𝘳𝘧𝘶𝘴𝘪𝘰𝘯 𝘢𝘯𝘥 𝘧𝘭𝘰𝘸 𝘵𝘰 𝘵𝘩𝘦 𝘬𝘪𝘥𝘯𝘦𝘺. 𝘐𝘵 𝘪𝘴 𝘰𝘧𝘵𝘦𝘯 𝘢𝘴𝘴𝘰𝘤𝘪𝘢𝘵𝘦𝘥 𝘸𝘪𝘵𝘩 𝘵𝘳𝘢𝘶𝘮𝘢, 𝘩𝘦𝘮𝘰𝘳𝘳𝘩𝘢𝘨𝘦, 𝘩𝘺𝘱𝘰𝘵𝘦𝘯𝘴𝘪𝘰𝘯, 𝘢𝘯𝘥 𝘮𝘢𝘫𝘰𝘳 𝘧𝘭𝘶𝘪𝘥 𝘭𝘰𝘴𝘴𝘦𝘴. 𝘐𝘧 𝘤𝘰𝘯𝘵𝘳𝘢𝘴𝘵 𝘥𝘺𝘦 𝘪𝘴 𝘶𝘴𝘦𝘥, 𝘢𝘨𝘨𝘳𝘦𝘴𝘴𝘪𝘷𝘦 𝘧𝘭𝘶𝘪𝘥 𝘳𝘦𝘴𝘶𝘴𝘤𝘪𝘵𝘢𝘵𝘪𝘰𝘯 𝘸𝘪𝘵𝘩 𝙣𝙤𝙧𝙢𝙖𝙡 𝙨𝙖𝙡𝙞𝙣𝙚 (𝙉𝙖𝘾𝙡) 𝘪𝘴 𝘳𝘦𝘤𝘰𝘮𝘮𝘦𝘯𝘥𝘦𝘥 (348).

5. To assess whether or not an arteriovenous fistula is functioning, what must the nurse do and why? · Palpate the quality of the pulse distal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. · Palpate the quality of the pulse proximal to the site to determine whether a thrill is present; auscultate with a stethoscope to appreciate a bruit to assess the quality of the blood flow. · Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow. · Palpate over the site of the fistula to determine whether a thrill is present; check whether the extremity is pink and warm.

· Palpate gently over the site of the fistula to determine whether a thrill is present; listen with a stethoscope over this site to appreciate a bruit to assess the quality of the blood flow. 𝘛𝘩𝘦 𝘤𝘳𝘪𝘵𝘪𝘤𝘢𝘭 𝘤𝘢𝘳𝘦 𝘯𝘶𝘳𝘴𝘦 𝘧𝘳𝘦𝘲𝘶𝘦𝘯𝘵𝘭𝘺 𝘢𝘴𝘴𝘦𝘴𝘴𝘦𝘴 𝘵𝘩𝘦 𝘲𝘶𝘢𝘭𝘪𝘵𝘺 𝘰𝘧 𝘣𝘭𝘰𝘰𝘥 𝘧𝘭𝘰𝘸 𝘵𝘩𝘳𝘰𝘶𝘨𝘩 𝘵𝘩𝘦 𝘧𝘪𝘴𝘵𝘶𝘭𝘢. 𝘈 𝘱𝘢𝘵𝘦𝘯𝘵 𝘧𝘪𝘴𝘵𝘶𝘭𝘢 𝘩𝘢𝘴 𝘢 𝘵𝘩𝘳𝘪𝘭𝘭 𝘸𝘩𝘦𝘯 𝘱𝘢𝘭𝘱𝘢𝘵𝘦𝘥 𝘨𝘦𝘯𝘵𝘭𝘺 𝘸𝘪𝘵𝘩 𝘵𝘩𝘦 𝘧𝘪𝘯𝘨𝘦𝘳𝘴 𝘢𝘯𝘥 𝘩𝘢𝘴 𝘢 𝘣𝘳𝘶𝘪𝘵 𝘪𝘧 𝘢𝘶𝘴𝘤𝘶𝘭𝘵𝘢𝘵𝘦𝘥 𝘸𝘪𝘵𝘩 𝘢 𝘴𝘵𝘦𝘵𝘩𝘰𝘴𝘤𝘰𝘱𝘦 (354).

19. Which electrolytes pose the most potential hazard if not within normal limits for a person with renal failure? · Phosphorous and calcium · Potassium and calcium · Magnesium and sodium · Phosphorous and magnesium

· Potassium and calcium -𝘈𝘣𝘯𝘰𝘳𝘮𝘢𝘭 𝘷𝘢𝘭𝘶𝘦𝘴 𝘰𝘧 𝘒 𝘢𝘯𝘥 𝘊𝘢 𝘤𝘢𝘯 𝘳𝘦𝘴𝘶𝘭𝘵 𝘪𝘯 𝘌𝘊𝘎 𝘤𝘩𝘢𝘯𝘨𝘦𝘴 -𝘚𝘦𝘳𝘶𝘮 𝘌𝘭𝘦𝘤𝘵𝘳𝘰𝘭𝘺𝘵𝘦𝘴 𝘪𝘯 𝘈𝘤𝘶𝘵𝘦 𝘒𝘪𝘥𝘯𝘦𝘺 𝘍𝘢𝘪𝘭𝘶𝘳𝘦, 𝘛𝘢𝘣𝘭𝘦 19.4 (341)

1. An elderly patient is in a motor vehicle accident and sustains a significant internal hemorrhage. The nurse knows the patient is at risk for developing what type of acute kidney injury (AKI)? · Intrinsic · Postrenal · Prerenal · Intrarenal

· Prerenal 𝘈𝘯𝘺 𝘤𝘰𝘯𝘥𝘪𝘵𝘪𝘰𝘯 𝘵𝘩𝘢𝘵 𝘥𝘦𝘤𝘳𝘦𝘢𝘴𝘦𝘴 𝘣𝘭𝘰𝘰𝘥 𝘧𝘭𝘰𝘸, 𝘣𝘭𝘰𝘰𝘥 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦, 𝘰𝘳 𝘬𝘪𝘥𝘯𝘦𝘺 𝘱𝘦𝘳𝘧𝘶𝘴𝘪𝘰𝘯 𝘣𝘦𝘧𝘰𝘳𝘦 𝘢𝘳𝘵𝘦𝘳𝘪𝘢𝘭 𝘣𝘭𝘰𝘰𝘥 𝘳𝘦𝘢𝘤𝘩𝘦𝘴 𝘵𝘩𝘦 𝘳𝘦𝘯𝘢𝘭 𝘢𝘳𝘵𝘦𝘳𝘺 𝘵𝘩𝘢𝘵 𝘴𝘶𝘱𝘱𝘭𝘪𝘦𝘴 𝘵𝘩𝘦 𝘬𝘪𝘥𝘯𝘦𝘺 𝘮𝘢𝘺 𝘣𝘦 𝘢𝘯𝘢𝘵𝘰𝘮𝘪𝘤𝘢𝘭𝘭𝘺 𝘥𝘦𝘴𝘤𝘳𝘪𝘣𝘦𝘥 𝘢𝘴 𝘱𝘳𝘦𝘳𝘦𝘯𝘢𝘭 𝘈𝘒𝘐 (339).

15. A patient is admitted with acute kidney injury (AKI). Which event from the patient's history was the most probable cause of the patient's AKI? · Recent computed tomography of the brain with and without contrast · A recent bout of acute heart failure after an acute myocardial infarction · Twice-daily prescription of Lasix 40 mg by mouth · A recent bout of benign prostatic hypertrophy and transurethral resection of the prostate

· Recent computed tomography of the brain with and without contrast 𝘛𝘩𝘦 𝘤𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘥𝘦𝘧𝘪𝘯𝘪𝘵𝘪𝘰𝘯 𝘰𝘧 𝘊𝘐𝘕 𝘪𝘴 𝘢𝘯 𝘪𝘯𝘤𝘳𝘦𝘢𝘴𝘦 𝘪𝘯 𝘴𝘦𝘳𝘶𝘮 𝘤𝘳𝘦𝘢𝘵𝘪𝘯𝘪𝘯𝘦 𝘤𝘰𝘯𝘤𝘦𝘯𝘵𝘳𝘢𝘵𝘪𝘰𝘯 𝘰𝘧 0.5 𝘮𝘨/𝘥𝘓 𝘰𝘳 𝘮𝘰𝘳𝘦, 𝘰𝘳 𝘢 25% 𝘪𝘯𝘤𝘳𝘦𝘢𝘴𝘦 𝘧𝘳𝘰𝘮 𝘵𝘩𝘦 𝘱𝘢𝘵𝘪𝘦𝘯𝘵'𝘴 𝘣𝘢𝘴𝘦𝘭𝘪𝘯𝘦 𝘸𝘪𝘵𝘩𝘪𝘯 3 𝘥𝘢𝘺𝘴 𝘰𝘧 𝘤𝘰𝘯𝘵𝘳𝘢𝘴𝘵 𝘮𝘦𝘥𝘪𝘶𝘮 𝘦𝘹𝘱𝘰𝘴𝘶𝘳𝘦, 𝘸𝘪𝘵𝘩𝘰𝘶𝘵 𝘢𝘯 𝘢𝘭𝘵𝘦𝘳𝘯𝘢𝘵𝘪𝘷𝘦 𝘤𝘭𝘪𝘯𝘪𝘤𝘢𝘭 𝘦𝘹𝘱𝘭𝘢𝘯𝘢𝘵𝘪𝘰𝘯 𝘧𝘰𝘳 𝘥𝘦𝘷𝘦𝘭𝘰𝘱𝘮𝘦𝘯𝘵 𝘰𝘧 𝘈𝘒𝘐 (345).

2. A patient has developed acute kidney injury (AKI) secondary to cardiogenic shock. Which laboratory value would the nurse find helpful in evaluating patient's renal status? · Serum sodium · Serum creatinine · Serum potassium · Urine potassium

· Serum creatinine ...𝘤𝘰𝘦𝘹𝘪𝘴𝘵𝘪𝘯𝘨 𝘩𝘦𝘮𝘰𝘥𝘺𝘯𝘢𝘮𝘪𝘤, 𝘤𝘢𝘳𝘥𝘪𝘢𝘤, 𝘱𝘶𝘭𝘮𝘰𝘯𝘢𝘳𝘺, 𝘰𝘳 𝘯𝘦𝘶𝘳𝘰𝘭𝘰𝘨𝘪𝘤 𝘤𝘰𝘮𝘱𝘳𝘰𝘮𝘪𝘴𝘦. 𝘔𝘢𝘯𝘺 𝘱𝘢𝘵𝘪𝘦𝘯𝘵𝘴 𝘤𝘰𝘮𝘦 𝘪𝘯𝘵𝘰 𝘵𝘩𝘦 𝘩𝘰𝘴𝘱𝘪𝘵𝘢𝘭 𝘸𝘪𝘵𝘩 𝘶𝘯𝘥𝘦𝘳𝘭𝘺𝘪𝘯𝘨 𝘤𝘩𝘢𝘯𝘨𝘦𝘴 𝘪𝘯 𝘬𝘪𝘥𝘯𝘦𝘺 𝘧𝘶𝘯𝘤𝘵𝘪𝘰𝘯, 𝘴𝘶𝘤𝘩 𝘢𝘴 𝘢𝘯 𝘦𝘭𝘦𝘷𝘢𝘵𝘦𝘥 𝘴𝘦𝘳𝘶𝘮 𝘤𝘳𝘦𝘢𝘵𝘪𝘯𝘪𝘯𝘦 𝘭𝘦𝘷𝘦𝘭, 𝘢𝘭𝘵𝘩𝘰𝘶𝘨𝘩 𝘵𝘩𝘦𝘺 𝘩𝘢𝘷𝘦 𝘯𝘰 𝘴𝘺𝘮𝘱𝘵𝘰𝘮𝘴 𝘢𝘯𝘥 𝘢𝘳𝘦 𝘰𝘧𝘵𝘦𝘯 𝘶𝘯𝘢𝘸𝘢𝘳𝘦 𝘰𝘧 𝘵𝘩𝘦𝘪𝘳 𝘤𝘰𝘮𝘱𝘳𝘰𝘮𝘪𝘴𝘦𝘥 𝘬𝘪𝘥𝘯𝘦𝘺 𝘧𝘶𝘯𝘤𝘵𝘪𝘰𝘯 (339).

10. What is the most common site for short-term vascular access for immediate hemodialysis? · Subclavian artery · Subclavian vein · Femoral artery · Radial vein

· Subclavian vein 𝘚𝘶𝘣𝘤𝘭𝘢𝘷𝘪𝘢𝘯 𝘢𝘯𝘥 𝘧𝘦𝘮𝘰𝘳𝘢𝘭 𝘷𝘦𝘪𝘯𝘴 𝘢𝘳𝘦 𝘤𝘢𝘵𝘩𝘦𝘵𝘦𝘳𝘪𝘻𝘦𝘥 𝘸𝘩𝘦𝘯 𝘴𝘩𝘰𝘳𝘵-𝘵𝘦𝘳𝘮 𝘢𝘤𝘤𝘦𝘴𝘴 𝘪𝘴 𝘳𝘦𝘲𝘶𝘪𝘳𝘦𝘥 𝘰𝘳 𝘸𝘩𝘦𝘯 𝘢 𝘨𝘳𝘢𝘧𝘵 𝘰𝘳 𝘧𝘪𝘴𝘵𝘶𝘭𝘢 𝘷𝘢𝘴𝘤𝘶𝘭𝘢𝘳 𝘢𝘤𝘤𝘦𝘴𝘴 𝘪𝘴 𝘯𝘰𝘯𝘧𝘶𝘯𝘤𝘵𝘪𝘰𝘯𝘢𝘭 𝘪𝘯 𝘢 𝘱𝘢𝘵𝘪𝘦𝘯𝘵 𝘳𝘦𝘲𝘶𝘪𝘳𝘪𝘯𝘨 𝘪𝘮𝘮𝘦𝘥𝘪𝘢𝘵𝘦 𝘩𝘦𝘮𝘰𝘥𝘪𝘢𝘭𝘺𝘴𝘪𝘴 (353).

6. To remove fluid during hemodialysis, a positive hydrostatic pressure is applied to the blood and a negative hydrostatic pressure is applied to the dialysate bath. What is this process called? · Ultrafiltration · Hemodialysis · Reverse osmosis · Colloid extraction

· Ultrafiltration 𝘛𝘰 𝘳𝘦𝘮𝘰𝘷𝘦 𝘧𝘭𝘶𝘪𝘥, 𝘢 𝘱𝘰𝘴𝘪𝘵𝘪𝘷𝘦 𝘩𝘺𝘥𝘳𝘰𝘴𝘵𝘢𝘵𝘪𝘤 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 𝘪𝘴 𝘢𝘱𝘱𝘭𝘪𝘦𝘥 𝘵𝘰 𝘵𝘩𝘦 𝘣𝘭𝘰𝘰𝘥, 𝘢𝘯𝘥 𝘢 𝘯𝘦𝘨𝘢𝘵𝘪𝘷𝘦 𝘩𝘺𝘥𝘳𝘰𝘴𝘵𝘢𝘵𝘪𝘤 𝘱𝘳𝘦𝘴𝘴𝘶𝘳𝘦 𝘪𝘴 𝘢𝘱𝘱𝘭𝘪𝘦𝘥 𝘵𝘰 𝘵𝘩𝘦 𝘥𝘪𝘢𝘭𝘺𝘴𝘢𝘵𝘦 𝘣𝘢𝘵𝘩 (353).

21. A patient has been hospitalized for a subtotal gastrectomy. After the procedure, an infection developed that eventually had to be treated with gentamicin, an aminoglycoside antibiotic. After 3 days of administration, oliguria occurred, and subsequent laboratory values indicated elevated BUN and creatinine levels. The patient is transferred to the critical care unit with acute kidney injury (previously known as acute tubular necrosis). The fluid that is removed each hour is not called urine; it is known as · convection. · diffusion. · replacement fluid. · ultrafiltrate.

· ultrafiltrate.