Diagnostic Tests
Urinary Disorders
Hemodialysis & Peritoneal Dialysis
Renal Disease
Miscellaneous
100
When preparing a patient for a radiologic procedure what allergy is important to assess for?
What is Contrast Dye, seafood, shellfish allergies
100
A patient develops urinary incontinence. What should the nurse further investigate.
Potential cause of incontinence UTI, trauma, menopause..........
100
what is the primary purpose of dialysis?
To remove waste products and excess fluid therefore restoring balance.
100
what is most accurate indicator of fluid loss or gain in a renal patient?
What is Weight
100
why is TUMS given to chronic renal failure patients?
binds with phosphorus to lower serum phosphate levels since kidneys are not functioning properly
200
removing transdermal patches and piercings is important to instruct in what procedure?
What is MRI
200
Renal neoplasms often have silent symptoms in early stages name some late s/s of renal neoplasms.
gross hematuria, flank pain, palpable mass.
200
A patient receiving hemodialysis had an AVF (arteriovenous Fistula) placed 3 weeks ago. You are assessing your patient in the morning name 2 important assessments and nursing care r/t a AVF.
Palpate fistula for a thrill no B/P or labs in affected arm monitor site for bleeding and s/s of infection make sure sign is posted on wall NO LABS OR B/P
200
Pyelonephritis is usually a result of what?
Recurrent Infections. Rationale: bacteria enters renal pelvis causing inflammatory response edema, fibrosis, scarring. Scarring causes permanent renal tissue damage.
200
Why is Epoetin (Epogen) given to a patient with ESRD?
To increase RBC production. Rationale: Kidneys that are damaged do not produce erythropoietin that stimulates RBC production hence they are often anemic.
300
When caring for a patient who is a post Arteriogram/Angiogram what is your priority assessment? a. monitor output b. restrict activity x 1 day c. monitor peripheral pulses d. monitor bleeding @ femoral artery
D. Monitor bleeding at femoral artery.
300
A patient is in your office states that they have had blood in their urine that does not cause pain. What would you infer based on this data?
The patient should be evaluated for a possible bladder neoplasm. Rationale: painless hematuria is a common s/s in patients with bladder neoplasms.
300
What intervention is done by the nurse in a patient receiving dialysis in order to determine if correct amount of fluid is removed from the patient?
Obtain a weight before and after dialysis. Rationale: Weight is way to determine the fluid status of the patient. Sometimes referred to as a "wet" or "dry" weight (before and after)
300
A patient with end stage renal disease will typically show what diagnostic findings? Select all that apply a. vomiting b. anemia c. hyperkalemia d. hypocalcemia
B. anemia r/t decreased erythropoietin production c. hyperkalemia: kidney function decreased cannot maintain electrolyte balance D. hypocalcemia - Calcium varies in renal patients but typically it is low. LeMone 812.
300
A nurse has been monitoring at patient's labs and sees that the GFR (glomerular filtration rate) has been consistently < 30 for the past 5 months. What conclusion does the nurse come to based on these lab values?
Patient is in chronic renal failure. Rationale: GFR <60 ml/min for 3 months or longer is indicative of renal failure.
400
What is a major complication of a Renal biopsy?
Bleeding at the site.
400
which of the following is considered an incomplete protein and is not recommended in patients with ESRD on hemodialysis. a. eggs b. fish c. milk d. nuts
Nuts
400
A patient c/o not feeling good after dialysis. This is caused by a condition that delays the removal of waste from the brain. What is this condition called?
What is Disequilibrium syndrome
400
what is the cause of glomerulonephritis?
Antigen-Antibody reaction with glomerular tissue.
400
Patients are often given Kayexalate (sodium polystyrene sulfonate) who are in ESRD. Why is this given and what is its action?
Kayexalate lowers potassium levels in ESRD patients by binding to potassium and excreting through the GI tract.
500
A 24 hour urine is collected for creatinine clearance. What would the nurse expect to see if the kidneys are not functioning properly?
Creatinine clearance level would be low in impaired kidney function. Rationale: creatinine is "cleared" totally by kidneys. If not working you will see low urine cr levels and high serum cr levels.
500
A patient in ESRD is experiencing fluid overload. Which of the following assessment findings would the nurse see that would be suspicious of fluid overload. (select all that apply) a. bilateral pedal edema b. b/p 110/60 c. crackles in lung fields d. urine output 200 ml in 24 hours
pedal edema crackles output 200 ml in 24 hours
500
While monitoring a patient at home perform peritoneal dialysis what assessment finding would alert you that the patient is developing an infection?
Cloudy dialysate fluid is returned.
500
Name 2 lab values that you will significantly see elevated when kidneys are unable to filter waste products adequately?
Elevation in BUN and serum creatinine Rationale: BUN measures urea which should be excreted in kidneys NOT seen elevated in serum. Creatinine: evaluates kidney function. Cr is by-product of the breakdown of muscle and is excreted by kidneys.
500
A patient in ESRD is receiving a Phosphate binding medication such as: TUMS, Renagel, Fosrenaol, sodium bicarbonate. What lab value is important to monitor with this classification of medication?
Calcium Levels Rationale: phosphate binders bind to phosphorus and normalize serum calcium levels (LeMone 812). Important to monitor calcium to make sure stays within normal range.