Patho Exam 2 Ch 26

Vitamin D metabolism is deranged in clients with chronic kidney disease (CKD). The nurse recognizes that which of the following statements regarding vitamin D is correct?

Kidneys convert inactive vitamin D to its active form, calcitriol.

A client has undergone a kidney transplant and voices concerns about organ rejection to the nurse. The most appropriate response by the nurse would be:

"You will be given medication to decrease your immune systems from attacking your new kidney."

The nurse is instructing a patient with advanced kidney disease (AKD) about a dietary regimen. Which of the following restrictions should the nurse be sure to include in the treatment plan to decrease the progress of renal impairment in people with AKD?

Dietary protein.

A nurse is assessing a client for early manifestations of chronic kidney disease (CKD). Which would the nurse expect the client to display?

Hypertension.

The nurse is caring for a group of patients in the acute care unit. Which of the following patients are at risk for developing intrarenal failure? Select all that apply.

One who is taking gentamicin for the treatment of a kidney infection, One with lead poisoning, and One with acute glomerulonephritis.

T/F? Bruising of the skin is a manifestation of bleeding disorders in patients with CKD.

True.

The nurse knows that uremia or "urine in the blood" is often used to describe the clinical manifestations of chronic kidney disease (CKD). Which of the following are early signs and symptoms of uremia? Select all that apply.

Weakness, fatigue, apathy, and nausea.

A client is diagnosed with chronic kidney disease (CKD). The nurse will monitor this client for which gastrointestinal signs and symptoms? Select all that apply.

Early morning nausea, Gastrointestinal ulceration, Metallic taste, and Anorexia.

A client diagnosed with CKD has begun to experience periods of epistaxis and developed bruising of skin and subcutaneous tissues. The nurse recognizes these manifestations as:

Impaired platelet function.

A patient in renal failure has marked decrease in renal blood flow caused by hypovolemia, caused by gastrointestinal bleeding. The nurse is aware that this form of renal failure can be reversed if the bleeding is under control. Which of the following forms of acute renal injury does this patient have?

Prerenal failure.

Hypertension frequently accompanies chronic kidney disease (CKD). The nurse knows that which of the following mechanisms can contribute to this hypertension? Select all that apply.

Renin-angiotension aldosterone (RAAS) activation, Sodium rentention, Increased vasoconstriction, and increased blood volume.

The GFR is considered to be the best measure of renal function. What is used to estimate the GFR?

Serum creatinine.

A 35-year-old client is diagnosed with acute kidney injury (AKI) and is started on hemodialysis. The client is concerned with the diagnosis and wants to know what to expect in the progression of this disorder. Which statement best addresses the client's concern?

"Acute kidney injury is abrupt in onset and often reversible if recognized early and treated appropriately."

A 42 year-old male has been diagnosed with renal failure secondary to diabetes mellitus and is scheduled to begin dialysis soon. Which of the following statements by the client reflects an accurate understanding of the process of hemodialysis?

"I won't be able to go about my normal routine during treatment."

A client with a diagnosis of end-stage renal disease received a kidney transplant 2 years ago that was deemed a success. During the most recent follow-up appointment, the nurse should prioritize the client for referral based on which statement?

"I'm feeling a bit under the weather these days and I'm a bit feverish."

A nurse educator is performing client education with a 51 year-old man who has been recently diagnosed with chronic kidney disease. Which of the following statements by the client would the nurse most likely want to correct or clarify?

"My kidney problems increase my chance of developing high blood pressure or diabetes."

A family physician is providing care for a 61 year-old obese male who has a history of diabetes and hypertension. Blood work has indicated that the man has a GFR of 51 mL/min with elevated serum creatinine levels. Which of the following statements will the physician most likely provide to the client in light of these results?

"Your chronic kidney disease has likely been caused by your diabetes and high blood pressure."

A patient has developed chronic kidney disease (CKD). The nurse will advise the patient to be alert for the development of which hematologic signs and symptoms of this disorder? Select all that apply.

Bruising, Gastrointestional bleeding, and Fatigue.

A geriatric nurse is caring for several clients. Which alterations in clients' health should the nurse attribute to age-related physiologic changes?

A 78-year-old woman's GFR has been steadily declining over several years.

The nurse knows that a patient with which glomerular filtration rate (GFR) would be classified as "decreased GFR"?

70 mL/min.

The nurse is caring for a patient who has had acute blood loss from ruptured esophageal varices. Which of the following does the nurse recognize is an early sign of prerenal failure?

Baseline urine output of 50 mL/hr that is now 10 mL/hr.

The nurse is caring for a patient with chronic renal failure who is on hemodialysis three times a week. In order to treat hyperphosphatemia and hypocalcemia, which of the following medications will the nurse administer to decrease absorption of phosphate from the gastrointestinal tract?

Calcium carbonate.

A new client presents with elevated BUN, systemic edema, a BP of 145/93 mm Hg, recurrent infections, and a GFR of 51 mL/min/1.73 m2. What treatment should the nurse anticipate?

Dialysis.

A 1-year-old baby boy with renal dysplasia risks end-stage renal disease unless intervention occurs. Which of the following treatment options is his care team most likely to reject?

Dietary restriction plus erythropoietin.

A client with chronic kidney disease (CKD) has developed asterixis. The nurse knows that asterixis is which of the following?

Dorsiflexion of hands and feet.

In a client in the uremic state of chronic kidney failure (CKD), the nurse will monitor for which of the following signs and symptoms? Select all that apply.

Encephalopathy, Nausea, Anemia, and Apathy.

The health care provider is reviewing lab results of a client. Select the test that is the best measurement of overall kidney function?

Glomerular filtration rate (GFR).

Which of the following data would a clinician consider as most indicative of acute renal failure?

Increased nitrogenous waste levels; decreased glomerular filtration rate (GFR).

A patient sustained acute tubular injury approximately 2 hours ago. Which of the following phases of this disorder does the nurse recognize that the patient is in at this time?

Initiating phase.

A 35-year-old female ultramarathon runner is admitted to hospital following a day-long, 80-km race because her urinary volume is drastically decreased and her urine is dark red. Tests indicate that she is in the initiating phase of acute tubular necrosis. Why is her urine red?

Myoglobinuria.

Chronic kidney disease (CKD) can provoke many cardiovascular changes. The nurse will monitor for which of the following in a client with CKD? Select all that apply.

Pericarditis, Impaired platelet function, Hypertension, and Congestive heart failure.

Neuromuscular disorders can be triggered by CKD. For those clients on dialysis, approximately two thirds suffer from what peripheral neuropathy?

Restless legs syndrome.

A client diagnosed with chronic kidney disease (CKD) is experiencing nausea and vomiting. Which would be the best instruction for the nurse to provide?

Restrict intake of dietary protein.

The nurse is reviewing the diagnosis of four male clients. Select the diagnosis that places the clients at risk for developing postrenal kidney failure.

Prostatic hyperplasia.

The nurse recognizes that acute renal injury is characterized by which of the following?

Rapid decline in renal function.

The nurse will monitor clients with which of the following disorders for development of chronic kidney disease (CKD)? Select all that apply.

Systemic lupus erythematous, Polycystic kidney disease, glomerulonephritis, and diabetes.