Renal
The nurse is instructing a client with DM about peritoneal dialysis. The nurse tells the client that it is important to maintain the prescribed dwell time for the dialysis because of the rise of which complication?
1. Peritonitis
2. Hyperglycemia
3. Hyperphosphatemia
4. Disequilibrium
2. Hyperglycemia
Glucose from the dialysate can be absorbed into the bloodstream, raising blood sugar levels.
The kidneys help regulate blood pressure by adjusting the volume of urine, primarily through this hormone, which affects sodium and water reabsorption.
What is aldosterone
A client is diagnosed with renal failure. The nurse anticipates that data supporting decreased renal function includes which of the following?
1. Hypokalemia
2. Increased serum urea and creatinine
3. Anemia and decreased blood urea nitrogen
4. Increased serum albumin and hyperkalemia
2. Increased serum urea and creatinine
Which common complication of glomerulonephritis tends to recur frequently?
1. Fever and edema
2. UTI
3. Hypertension and edema
4. Upper respiratory infections
3. Hypertension and edema
Headaches and Oliguria are common complications and tend to recur
A nurse if planning care for a client diagnosed with acute renal failure and anticipates that the interventions of highest priority would be directly related toward:
1. Excess Fluid volume
2. Impaired gas exchange
3. Ineffective coping
4. Imbalanced nutrition: less than body requirements
1. Excess Fluid volume
Primary problem of acute renal failure and highest priority
This is the function of the distal convoluted tubule in the nephron.
What is the regulation of sodium, potassium, and pH balance
The nurse is monitoring an older client sspected of having a UTI. Which s/s is likely to present FIRST?
1. Fever
2. Urgency
3. Confusion
4. Frequency
3. Confusion
A 40 yo client is 2 days post kidney transplant. The most appropriate roommate for this client would be someone with which diagnosis?
1. Hepatitis C
2. Renal calculi
3. Osteomyelitis
4. Bronchial pneumonia
2. Renal calculi
A client is scheduled for peritoneal dialysis. What is the highest priority action that the nurse should perform before starting dialysis?
1. Weight the client
2. Administer pain medication
3. Position patient in high-fowlers
4. Position patient in trendelenburg
1. Weight the client
Weigh client before and after dialysis to determine amount of fluid removed.
A client who has CKD has an arteriovenous graft in the right forearm. Which assessment is the highest priority for a nurse to perform related to the AV graft?
1. Compare left radial pulse with the pulse on the AV graft site
2. Check the range of motion of the arm that has the AV graft site
3. Listen over the area of the AV graft with a stethoscope for a bruit.
4. Observe for clubbing of the fingers on the hand of the AV graft site.
3. Listen over the area of the AV graft with a stethoscope for a bruit.
Must assess site for patency; A bruit is a swishing sound caused by turbulent blood flow, which is a normal finding in an AV graft. The presence of a bruit confirms patency of the graft, which is crucial for ensuring it functions properly for dialysis. Monitoring the graft for adequate blood flow is the highest priority to avoid complications such as graft thrombosis or occlusion.
This is the term for the high concentration of solutes in the kidney medulla, which allows for water reabsorption in the loop of Henle and collecting ducts.
What is the concentration gradient
**A nurse is admitting a client with a diagnosis of chronic kidney disease. Which admission order should be questioned by the nurse?
1. 2-gram sodium diet
2. Oxygen via nasal cannula at 4 L/min
3. Furosemide 40 mg orally, twice a day
4. IV of 0.9% sodium chloride at 125 ml/hr
4. IV of 0.9% sodium chloride at 125 ml/hr
At risk for fluid overload
Client arrives in ER 2 weeks after a kidney transplant and states, "I'm having problems with my new kidney." Which symptoms reported by the client indicates acute rejection of the transplanted kidney?
1. Fever and anorexia
2. Edema and nausea
3. Weight gain and graft tenderness
4. Increased WBC count
3. Weight gain and graft tenderness
Indicates kidney is not functioning and may be rejected.
a nurse should instruct a client with nephrotic syndrome regarding which diet?
1. Low in fat
2. Low in protein
3. High protein
4. High carbhydrates
3. High protein
To replace protein lost through the kidneys and correct hypoalbuminemia.
Which assessment of a client who has CKD would indicate to the nurse that hemodialysis is having the desired effect?
1. Decrease hematocrit and diuresis
2. Decreased serum creatinine and weight loss
3. Elevated potassium and improved appetite
4. Decreased WBC count and diaphoresis
2. Decreased serum creatinine and weight loss
One of main purposes of hemodialysis is removal of creatinine, other waste products and water. You would weight patient before and after dialysis.
Nurse is reviewing lab values on a patient with a renal disorder. Which lab result would indicate a decrease in renal function? (select all that apply)
1. Elevated Serum Creatinine
2. Elevated thrombocyte cell count
3. Decreased RBC count
4. Decreased WBC count
5. Elevated Blood urea nitrogen (BUN)
1. Elevated Serum Creatinine
3. Decreased RBC count
5. Elevated Blood urea nitrogen (BUN)
A nurse is assessing the mental status of a client in Acute renal failure. If there is an abnormal finding, which condition is most likely to be the cause?
1. Anger related to denial of chronic illness
2. Delirium related to hypoxia of brain cells
3. Confusion related to increased urea levels
4. Aggression related to possible underlying comorbidities
3. Confusion related to increased urea levels
A nurse is assessing a client with renal calculi. Which of the following clinical manifestations would most likely be found in this client?
1. Abdominal pain and constipation
2. Polyuria and fever
3. Nausea/vomiting and flank pain
4. Hematuria and diarrhea
3. Nausea/vomiting and flank pain
A nurse is caring fr a client who has renal calculi primarily composed of calcium phosphate. Which foods, if selected by the cliet, indicate a lack of understanding regarding calcium dietary restrictions? (select all that apply)
1. yogurt
2. oranges
3. chicken
4. cranberry juice
5. spinach
6. eggs
1. yogurt
5. spinach
Renal calculi (kidney stones) can form when certain substances, such as calcium, phosphate, and oxalate, crystallize in the kidneys. In the case of calcium phosphate stones, the patient may need to limit foods that are high in calcium and phosphate.
Which of the following lab data would be the most significant indicator that a client is responding positively to peritoneal dialysis?
1. Creatinine of 2.7 mg/dL
2. Potassium 4.1 mEq/L
3. BUN elevated
4. Calcium level decreased below normal
2. Potassium 4.1 mEq/L
Serum potassium level will return to normal values.
This is a common complication of chronic kidney disease, where the kidneys can no longer effectively filter waste, leading to uremia.
What is end-stage renal disease (ESRD)
A nurse is preparing to discharge a client diagnosed in the ER with renal calculus. What is the most important instruction for the nurse to include in the client teaching?
1. Maintain bed rest
2. Continue a clear liquid diet
3. Strain all urine at home for stones
4. Perform relaxation exercises to decrease pain.
3. Strain all urine at home for stones
a nurse understands that acidic urine will decrease the possibility of UTI. With this information, which juice would the nurse recommend to a client to increase urine acidity?
1. Apple
2. Carrot
3. Prune
4. Cranberry
4. Cranberry
A nurse is monitoring a client in acute renal failure. Which lab test is the best indicator of renal function?
1. Potassium
2. Creatinine
3. BUN
4. ALT
2. Creatinine
Best indicator of renal function
Which procedure would a nurse anticipate as a therapeutic medical intervention for renal calculi?
1. Myelogram
2. Lithotripsy
3. Renal sonogram
4. IVP Intravenous pyelogram
2. Lithotripsy: is a shock wave used to break them into smaller pieces