Structure and Function of the Kidney

A client has just been admitted to the emergency department after sustaining severe injuries and massive blood loss following a motor vehicle accident. The nurse predicts that the client's glomerular filtration rate will:

Decrease

The nurse is preparing the client with suspected bladder cancer for a biopsy via cystoscopy. What does the nurse teach the client about cystoscopy?

A flexible, lighted tube will be inserted into the bladder and a tissue sample will be taken.

The anemia that occurs with end-stage kidney disease is often caused by the kidneys themselves. What loss of function in the kidney results in anemia of end-stage kidney disease?

Produce erythropoietin

A client is diagnosed with gouty arthritis. To prevent the buildup of uric acid and recurrence of gout attacks, the nurse teaches the client to avoid eating foods containing which compound?

Purine

Which medication may be responsible for a client developing increased uric acid levels by decreasing ECF volume?

Thiazide diuretics

Clients with CKD are at risk for demineralization of their bones since they are no longer able to:

transform vitamin D to its active form

In contrast to the descending limb, the ascending limb of the loop of Henle is impermeable to which substance that results in dilute tubular filtrate?

water

The nurse would be most concerned when the glomerular filtrate contains:

Protein

A nurse is teaching a client scheduled for a cystoscopy about the procedure. Which statement made by the client verifies that the teaching has been successful?

"The doctor will insert a lighted tube through my urethra into my bladder in order to inspect the inside of the bladder."

A client is scheduled for a creatinine clearance test to measure the glomerular filtration rate (GFR). The client asks the nurse what this test is used for. What is the nurse's best response?

"This test provides a gauge of renal function."

The nurse is educating a client about renal disease. Which percentage of cardiac output perfuses the kidneys?

22% to 25%

A client asks the nurse what may have caused elevation in urinary protein levels (proteinuria) on a urine test. The best response by the nurse would be:

Abnormal glomerular filtration

When caring for a client with dehydration, the nurse anticipates the client will have an alteration in which substance in the blood?

Blood urea nitrogen

The nurse is assigned multiple clients with anemia. Which client may be experiencing a failure of the body to produce erythropoietin and thus may require supplemental injections of this hormone?

Client with history of chronic kidney failure

Which diagnostic study would be effective in determining direct visualization of the bladder and ureters?

Cystoscope

When the urologist wants to directly visualize the bladder, urethra, and ureteral orifices, what diagnostic test would he use?

Cystoscopy

Which occurrence is most likely to cause increased urination?

Decrease in antidiuretic hormone

What contributes to impairment in renal function in aging?

Decrease in functioning nephrons

When teaching the client with gout about the cause of the disease, which cause should the nurse relate?

Increased levels of uric acid in the blood cause gout.

The filtration of blood undergoes several steps between the entry of blood into the kidney and the accumulation of urine. Which anatomical location begins the process of delivering blood for the filtration of blood and the flow of filtrate?

Interlobular artery

To treat enuresis in a young girl, her pediatrician prescribes desmopressin, an antidiuretic hormone (ADH) nasal spray, before bedtime. Which rationale for this treatment is the most likely?

It removes water from the filtrate and returns it to the vascular compartment.

A client who has been diagnosed with Addison disease will likely experience which abnormal lab result related to the absence of aldosterone?

Serum potassium levels elevated

When the glomerular transport maximum for blood glucose is exceeded and its renal threshold has been reached, what happens to the excess glucose?

Spills into the urine

Which factor is likely to result in decreased renal blood flow?

Stimulation of the sympathetic nervous system

The nurse is caring for a client with kidney disease who has an estimated glomerular filtration rate of 75 mL/minute. The nurse interprets this data in which way?

The client has reduced glomerular filtration, reflecting damage to the kidney.

A client has been prescribed a drug that is not removed quickly by renal filtration. The drug likely has this quality because it is:

bound to plasma proteins.

The nurse is reviewing the results of a renal client's laboratory results. This client's urine specific gravity allows the nurse to assess the kidneys' ability to:

concentrate urine

In the emergency department, a client arrives following a car accident. His pulse is 122; BP 88/60; respiration is 18 bpm. Urine output is 4 mL over the first hour on arrival. When in shock, this lower urine output is primarily due to:

innervation of the sympathetic nervous system, causing constriction of the afferent arteriole.

A nursing student studying pharmacology is learning how angiotensin converting enzyme inhibitors (ACE) work. The student is correct when stating that the mechanism of action of ACE inhibitors is to:

prevent conversion of angiotensin I to II.

In the intensive care unit (ICU), the nurse is caring for a trauma client who has abdominal injuries, is beginning to have a decrease in BP and increased pulse rate, and is pale with diaphoretic skin. The nurse is assessing the client for hemorrhagic shock. If the client is in shock, the nurse would expect to find:

significant decrease in urine output due to decrease in renal blood flow.

A client with end-stage kidney disease has developed anemia. The nurse teach this client that the reason anemia has developed is:

the damaged kidney is unable to produce erythropoietin.