chapter 58 prep u
What is used to decrease potassium level seen in acute renal failure
sodium polystyrene sulfonate
Thumbs of the kidney are almost always cancer in adults. The cause fo kidney tumors is unknown; however, certain risk factors are known. What are the known risk factors? Select all that apply.
tobacco use, obesity, age
A patient admitted with electrolyte imbalance has carpopedeal spasm, ECG changes and a positive chvostek sign. What deficit does the nurse suspect the patient has?
calcium
The nurse recognizes which condition as an integumentary manifestation of chronic renal failure?
gray-bronze skin color
The nurse is caring for a client who has returned to the post surgical suite after postanestthetic recovery from a nephrectomy. The nurses most recent hourly assessment reveals a significant drop in LOC and BP as well as scant urine output over the past hour. What is the nurses best response?
assess the client for signs of bleeding and inform the primary provider
Which of the following is a term used to describe excessive nitrogenous waste in the blood, as seen in acute glomerulonephritis?
azotemia
The nurse is caring for a client who has just returned to the post surgical unit following renal surgery. When assessing the clients output form surgical drains, the use should assess what parameters? Select all that apply
color of the output, visible characteristics of the output, quantity of output
A patient who has been treated for uric acid stones is being discharged form the hospital. What type of diet does the nurse discuss with the patient?
low-purine diet
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
What is a hallmark of the diagnosis of nephrotic syndrome?
protienuria
A client has pyelonephritis and is undergoing parenteral antibiotic treatment. What will be the effect of the infection on the clients kidneys?
real scarring
The nurse is Planning client teaching for a client with end-stage kidney disease who is scheduled for the creation of a fistula. The nurse should teach the client what information about the fistula?
"a vein and and artery in your arm will be attached surgically."
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 diseases progresses, you will most likely require renal replacement therapy."
The nurse notes that 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
Th ensues 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 patient has stage 3 chronic kidney failure. What would the nurse expect the patient glomerular filtration rate (GFR) to be?
A GFR of 30-59 ml/min 1.73m
Hyperkalemia is a serious side effect of acute renal failure. Identify the ECG tracing that is diagnostic for hyperkalemia.
Tall, peaked T waves
A patient with a UTI is having burning and pain when urinating. What urinary analgesic is prescribed for relief of these symptoms?
Pyridium
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the clients risk of:
water and sodium retention secondary to a severe decrease in he glomerular filtration rate.
The nurse is caring for a patient in the oliguric phase of acute kidney injury (AKI). What does the nurse know would the daily urine output?
less than 400 mL
The nurse has identified the nursing diagnosis of "risk for infection" in a client who undergoes peritoneal dialysis. What nursing action best addresses this risk?
maintain aseptic technique when administering dialysate
A client brought th renal unit form the PACU status post resection of a renal tumor. Which of the following nursing actions should the nurse prioritize in the care of this client?
managing postoperative pain
A client was hospitalized for treatment of large renal calculi that were causing obstruction to urine flow, and was taken tot surgery for a nephrology tube placement. What should the nurse teach the client about he ongoing management of the nephrology tube?
never clamp the nephrostomy tubing
A client has a family history of polycystic kidney disease as the nurse gathers information and completes an assessment related to polycystic dandy diagnosis, which findings would be expected? Select all that apply.
pain form retroperitoneal bleeding, hypertension
A client with chronic renal failure (CRF) has developed faulty red blood cell (RBC) production. The nurse should monitor this client for:
fatigue and weakness
Which of the following causes should the nurse suspect in a client is diagnosed with infrarenal failure?
glomerulonephritis
A football player is thought to have sustained an injury to the kidneys form being tacked from behind. The ER caring for the client review the initial orders and notes an order to collect all voided urine and send it to the lab for analysis. The nurse understands that the nursing intervention is important for what reason?
hematuria is the most common manifestation fo rant trauma and blood losses may be microscopic, so laboratory analysis is essential
The nurse is caring for a client in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate?
hyperkalemia
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 diagnosed with acute kidney injury (AKI) has developed congestive heart failure. The client has received 40 mg of IVP Lasix and 2 hours later, the nurse notes that there are 50 ml of urine in the foley catheter bag. The clients VS are stabel. Which health care order should the nurse anticipate?
Lasix 80 mg IVP
The nurse is caring for a client after kidney surgery. When assessing for bleeding, what assessment parameter should the nurse evaluate?
level of consciousness
A patient has had surgery to creat an ill conduit for urinary diversion. What is a priority intervention by the nurse in the post operative phase of care
monitor urine output hourly and report output less than 30 mL/hr
Glomerulonephritis is an inflammatory response in the glomerular capillary membrane, and causes disruption of the renal filtration system. Although diagnostic urinalysis can reveal glomerulonephriits, many client with glomerulonephritis exhibit:
no symptoms
Which o nth following is the most accurate indicator of fluid loss or gain?
weight
The nurse is caring for a client with a history of systemic lupus erythematous who has been recently diagnosed with end-staged kidney (ESKD). The client has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. The nurse should teach the client to take the prescribed medication at what time?
with each meal
The critical care nurse is monitoring the clients urine output and drains following renal surgery. What should the nurse promptly report to the primary provider?
absence of drain output
The nurse is reviewing the potassium level of a patient with kidney disease. The results of the test are 6.5 and the nurse observes peak T waves on ECG. What priority intervention does the nurse anticipate the physician will order to reduce potassium level?
admin of sodium polystyrene sulfonate [Kayexalate]
A patient with chronic kidney failure experiences decreased levels of erythroproietin. What serious complication related to those levels should the nurse assess for when caring for this client?
anemia
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 injection for 2 to 4 hours after heparin administration
A female patient undergoes dialysis as part of treatment for kidney failure. The patient is administer 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 hors after heparin administration
A client with chronic renal failure (CRF) is admitted to the urology unit. Which diagnostic test results are consistent with CRF?
blood urea nitrogen (BUN) 100 mg/dL and serum creatine 6.5 mg/dl
Which factor contributes to UTI in older adults?
immunocompromised
What is a characteristic of the intrarenal category of acute kidney injury (AKI)?
increased BUN
A client with end stage renal disease receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurses most appropriate action?
inform the health care provider and assess the client for signs of infection
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 form children and pets
A client with chronic kidney disease is completing an exchange during peritoneal dialysis. The nurse observes that the peritoneal fluid is draining slowly and that the clients abdomen is increasing in girth. What is the nurses most appropriate actions?
reposition the client to facilitate drainage
One of the roles of the nurse in caring for client with chronic renal failure is to help them learn to minimize and mange potential complications. This would include:
restricting sources of potassium usually found in fresh fruits and vegetables
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 patient informs the nurse that every time she sneezes or coughs, she urrinates in her pants. What type of incontinence does the nurse recognize the patient is experiencing?
stress incontinence
The nurse is caring fo acutely ill client. What assessment finding should prompt the nurse to inform the physician that the client may be exhibiting signs of acute kidney injury (AKI)?
the clients average urine output has been 10 mL/hr for several hours
