Renal Foundations
What is regulates fluid balance, electrolytes, acid-base balance, blood pressure, and waste removal?
This direction of perineal cleansing helps prevent bowel bacteria from entering the urethra.
What is wiping from front to back?
The nurse should have a client use this item after ESWL to collect fragments for analysis.
What is a urine strainer?
This laboratory value is generally more specific than BUN for evaluating renal function.
What is serum creatinine?
Before a kidney biopsy, the nurse verifies consent and reviews these studies because bleeding is the major complication.
What are coagulation studies such as PT/INR and PTT/aPTT?
A client with glomerulonephritis and edema should usually limit this dietary component to reduce fluid retention and hypertension.
What is sodium?
This hereditary disorder causes multiple fluid-filled renal cysts and often leads to hypertension and declining kidney function.
What is polycystic kidney disease (PKD)?
An older adult may show this atypical manifestation of a urinary tract infection rather than classic dysuria.
What is acute confusion or a change in mental status?
Unless contraindicated, this daily fluid goal is commonly taught to promote stone passage and reduce recurrence.
What is approximately 2-3 liters per day?
Positive leukocyte esterase suggests white blood cells, while positive nitrites commonly suggest this organism in a UTI.
What is Escherichia coli (E. coli)?
After a kidney biopsy, the client is commonly maintained in this position with bedrest to reduce bleeding.
What is supine?
A client with foul urine, dysuria, fever, and dehydration will likely need a urine specimen collected before this therapy begins.
What is antibiotic therapy?
A client with chronic glomerulonephritis has increasing edema, hypertension, and decreased urine output. Which pathophysiological change is primarily responsible for these findings?
what is damage to the glomeruli decreases renal filtration, causing sodium and water retention and accumulation of waste products.
For a client with dementia and functional incontinence, this scheduled intervention should be incorporated into the plan of care.
What is assisted toileting every 2 hours or prompted voiding?
A client with uric acid stones should limit these high-purine foods.
What are organ meats, sardines/oily fish, gravies, and similar high-purine foods?
Urine output below this hourly amount in an adult is a priority finding requiring evaluation.
What is less than 30 mL/hour?
A nephrostomy tube stops draining and the client reports flank pain. This is the nurse’s first action.
What is assess the tubing for kinks, obstruction, dependent loops, disconnection, or leakage?
A stable client needs routine intake and output recorded. This task can be delegated to this team member.
Who is the UAP?
Tea-colored urine, periorbital edema, hypertension, proteinuria, and hematuria after a streptococcal infection suggest this disorder.
What is acute post-streptococcal glomerulonephritis?
Fever, chills, flank pain, nausea, vomiting, and urinary symptoms indicate that infection has reached this location.
What is the kidney/upper urinary tract, causing pyelonephritis?
A client with calcium oxalate stones should reduce high-oxalate foods such as these.
What are spinach, rhubarb, nuts, and other high-oxalate foods?
A client with acute glomerulonephritis has a blood pressure of 172/96 mm Hg, periorbital edema, tea-colored urine, and a urine output of 25 mL/hr. Which assessment finding requires the nurse’s most immediate follow-up?
What is decreased urine output?
After ESWL, mild bruising and hematuria may be expected, but these findings require prompt reporting.
What are severe pain, fever, inability to void, heavy bleeding, large clots, or markedly decreased urine output?
A client has oliguria, rising creatinine, edema, and hypertension. State the priority nursing focus.
What is assess fluid status and perfusion, review trends, restrict fluids/sodium as ordered, avoid nephrotoxins, and promptly report worsening renal function?
For diabetic nephropathy, this long-term intervention is most important for slowing additional nephron damage.
What is maintaining blood glucose within target range, along with blood-pressure control?
A client says, “I will stop the antibiotic as soon as I feel better.” Give the corrective teach-back response.
What is: Take the entire prescribed antibiotic course, even when symptoms improve, and report worsening fever, flank pain, vomiting, or inability to hydrate?
After trauma, blood is seen at the urinary meatus. State the priority action and the action that must be avoided.
What is notify the provider and do not insert a urinary catheter until urethral injury is ruled out?
Name four findings that can indicate kidney-transplant rejection.
What are oliguria, rising creatinine/BUN, fever, hypertension, graft/flank tenderness, enlarged tender kidney, lethargy, or malaise? Any four
Create a three-part post-kidney-biopsy safety check.
What is monitor vital signs and urine for bleeding, assess the biopsy site/flank pain, maintain prescribed bedrest/positioning, and report hypotension, tachycardia, gross hematuria, or decreasing Hgb/Hct? Any three.
A client with pyelonephritis becomes hypotensive, tachycardic, febrile, and increasingly confused. Identify the complication and immediate response.
What is suspected sepsis: activate urgent evaluation/rapid response as indicated, obtain cultures/labs, begin ordered IV fluids and antibiotics, monitor perfusion and urine output, and communicate using SBAR?