renal part 2
A client with chronic renal failure comes to the clinic for a visit. During the visit, he complains of pruritus. Which suggestion by the nurse would be most appropriate? "Liberally apply alcohol to the areas of your skin where you itch the most." "When you shower, use really warm water and an antibacterial soap." "Try washing clothes with a strong detergent to ensure that all impurities are gone." "Keep your showers brief, patting your skin dry after showering."
"Keep your showers brief, patting your skin dry after showering." Explanation: The client with pruritus needs to keep the skin clean and dry. The client should take brief showers with tepid water, pat the skin dry, use moisturizing lotions or creams, and avoid scratching. In addition, the client should use a mild laundry detergent to wash clothes and an extra rinse cycle to remove all detergent or add 1 tsp vinegar per quart of water to the rinse cycle to remove any detergent residue.
A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. What outcome will the decrease in erythropoietin have? Anemia from the decrease in maturation of red blood cells Increase in blood sugar levels due to alteration in insulin levels Decrease in blood sugar levels due to alteration in insulin levels Development of male sex characteristics
Anemia from the decrease in maturation of red blood cells Explanation: The kidneys secrete erythropoietin, which is a substance that promotes the maturation of red blood cells.
The nurse is caring for a client with acute glomerular inflammation. When assessing for the characteristic signs and symptoms of this health problem, the nurse should include which assessments? Select all that apply. Assess for the presence of peripheral edema. Auscultate the client's apical heart rate for dysrhythmias. Assess the client's BP. Percuss for pain in the right lower abdominal quadrant. Assess the client's orientation and judgment.
Assess for the presence of peripheral edema. Assess the client's BP. Explanation: Most clients with acute glomerular inflammation have some degree of edema and hypertension. Dysrhythmias, RLQ pain, and changes in mental status are not among the most common manifestations of acute glomerular inflammation.
During hemodialysis, toxins and wastes in the blood are removed by which of the following? Filtration Diffusion Ultrafiltration Osmosis
Diffusion Explanation: The toxins and wastes in the blood are removed by diffusion, in which particles move from an area of higher concentration in the blood to an area of lower concentration into the dialysate.
A client is being treated for AKI and the client daily weights have been ordered. The nurse notes a weight gain of 3 pounds (1.4 kg) over the past 48 hours. What nursing diagnosis is suggested by this assessment finding? Sedentary Lifestyle Excess Fluid Volume Imbalanced Nutrition: More than body requirements Adult Failure to Thrive
Excess Fluid Volume Explanation: If the client with AKI gains or does not lose weight, fluid retention should be suspected. Short-term weight gain is not associated with excessive caloric intake or a sedentary lifestyle. Failure to thrive is not associated with weight gain.
A client admitted with nephrotic syndrome is being cared for on the medical unit. When writing this client's care plan, based on the major clinical manifestation of nephrotic syndrome, what nursing diagnosis should the nurse include? Risk for injury related to altered thought processes Hyperthermia related to the inflammatory process Constipation related to immobility Excess fluid volume related to generalized edema
Excess fluid volume related to generalized edema Explanation: The major clinical manifestation of nephrotic syndrome is edema, so the appropriate nursing diagnosis is "Excess fluid volume related to generalized edema." Edema is usually soft, pitting, and commonly occurs around the eyes, in dependent areas, and in the abdomen.
Based on her knowledge of the primary cause of end-stage renal disease, the nurse knows to assess the most important indicator. What is that indicator? pH and HCO3 Blood pressure Serum glucose Urine protein
Serum glucose Explanation: The nurse would evaluate serum and urine levels of glucose because diabetes is the primary cause of renal failure.
A child is brought into the clinic with symptoms of edema and dark brown rusty urine. Which nursing assessment finding would best assist in determining the cause of this problem? Elevation of blood pressure Sore throat 2 weeks ago Red blood cells in the urine Protein elevation in the urine
Sore throat 2 weeks ago Explanation: Acute glomerulonephritis usually occurs as a result of bacterial infection such as seen with a beta-hemolytic streptococcal infection or impetigo. Red blood cells and protein found in the urine and elevated blood pressure are symptoms associated with glomerulonephritis.
Which of the following is the most accurate indicator of fluid loss or gain? Weight Body temperature Urine output Caloric intake
Weight Explanation: The most accurate indicator of fluid loss or gain in an acutely ill patient is weight, as accurate intake and output and assessment of insensible losses may be difficult. Urine output, caloric intake, and body temperature would not be the most reliable indicator of fluid loss or gain.
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: metabolic alkalosis secondary to retention of hydrogen ions. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. a decreased serum phosphate level secondary to kidney failure. an increased serum calcium level secondary to kidney failure.
water and sodium retention secondary to a severe decrease in the glomerular filtration rate. Explanation: The client with CRF is at risk for fluid imbalance — dehydration if the kidneys fail to concentrate urine, or fluid retention if the kidneys fail to produce urine. Electrolyte imbalances associated with this disorder result from the kidneys' inability to excrete phosphorus; such imbalances may lead to hyperphosphatemia with reciprocal hypocalcemia. CRF may cause metabolic acidosis, not metabolic alkalosis, secondary to inability of the kidneys to excrete hydrogen ions.
