Renal (CKD/AKD) Review Questions

What action by the nurse is most important when caring for a patient with chronic kidney disease who has an order for furosemide? a. assess urine output and renal laboratory values for signs of nephrotoxicity b. check the specific gravity of the urine daily c. eliminate potassium-rich foods from the diet d. encourage the patient to void every 4 hours

a. check urine output and renal laboratory values for signs of nephrotoxicity Rationale: Because the kidneys excrete most drugs, patients with CKD may need a lower dose of furosemide to prevent further damage.

The nurse is providing teaching to a patient who has been prescribed furosemide. Which of the following should the nurse teach the patient? a. avoid consuming large amounts of kale, cauliflower, or cabbage b. rise slowly from a lying or sitting position c. count the pulse for one full minute before taking medication d. restrict fluid intake to no more than 1 L per 24 hour period

b. rise slowly from a lying or sitting position Rationale: Loop diuretics may dramatically reduce a patient's blood volume and BP. Watch for orthostatic hypotension

Which of the following clinical manifestations may indicate that the patient taking hydrochlorothiazide is experiencing hypokalemia? a. hypertension b. polydipsia c. cardiac dysrhythmias d. skin rash

c. cardiac dysrhythmias Rationale: Thiazide diuretics causes potassium loss. Symptoms of hypokalemia include cardiac dysrhythmias, hypotension, dizziness, and syncope

The patient admitted for heart failure has been receiving hydrochlorothiazide. Which lab levels should the nurse carefully monitor? (SATA) a. platelet count b. WBC c. Potassium d. sodium e. uric acid

c. potassium d. sodium e. uric acid Rationale: Thiazide diuretics cause loss of sodium and potassium and may cause hyperuricemia

While planning for a patient's discharge from the hospital, which teaching points would be included for a patient going home with a prescription for hydrochlorothiazide? a. increase fluid and salt intake to make up for the losses caused by the drug b. increase intake of vitamin C rich foods, such as grapefruit juice and oranges c. report muscle cramping or weakness to the HCP d. take the drug at night because it may cause drowsiness

c. report muscle cramping or weakness to the HCP Rationale: muscle cramping or weakness may indicate hypokalemia

A patient with a history of heart failure will be started on spironolactone. Which drug group should NOT be used, or used with extreme caution in patients taking potassium-sparing diuretics? a. NSAIDs b. Corticosteroids c. loop diuretics d. ACE inhibitors and ARBs

d. ACE inhibitors and ARBs Rationale: ACE inhibitors and ARBs taken concurrently with potassium-sparing diuretics increase the risk of hyperkalemia