RENAL
An elderly patient develops AKI after several days of vomiting and diarrhea.
Question: What type of AKI is most likely?
Pre-renal AKI due to decreased renal perfusion.
A patient reports chest pain that occurs when walking up stairs and resolves with rest.
Question: What type of angina is most likely occurring?
Stable Angina
A patient has an A1C of 6.0%.
Question: What condition does this indicate?
Prediabetes.
What do we prioritize with a patient with a Sinus Bradycardia rhythm?
Vital signs (blood pressure and heart rate)
Medications (atropine)
Possibly a pacemaker.
A nurse suspects DKA. Which findings support the diagnosis?
Select all that apply.
Fruity breath
Kussmaul respirations
Hypoglycemia
Metabolic acidosis
Polyuria
Bradycardia
Fruity breath
Kussmaul respirations
Metabolic acidosis
Polyuria
Which patient should the nurse assess first?
A. New crackles and edema in CKD patient
B. Blood glucose 180
C. Patient asking about discharge
D. Stable BP after antihypertensive
A. Signs of fluid overload.
A patient taking lisinopril develops a persistent dry cough.
Question: What is the most likely cause?
ACE inhibitor side effect.
A patient with diabetes becomes shaky, sweaty, and confused.
Question: What should the nurse assess first?
Blood glucose level
A patient takes lisinopril.
Today the patient reports:
Question:
What is the priority action?
Hold medication and seek emergency treatment immediately.
A nurse is preparing to administer insulin lispro to a pt with Type 1 DM. When will it begin to peak?
30 minutes.
A hospitalized patient receives IV contrast for a CT scan.
Question: What type of AKI risk is increased?
Intrarenal AKI from nephrotoxic injury.
A patient with chest pain receives nitroglycerin. Five minutes later the patient reports less pain, but BP drops from 132/80 to 86/54.
Question: Why did this happen, and what should the nurse do next?
Nitroglycerin causes vasodilation, reducing preload and BP. The nurse should stop further nitroglycerin doses, assess perfusion, monitor vitals, and notify the provider.
A patient with Type 1 diabetes develops:
Question: What complication is occurring?
DKA
Which lunch demonstrates understanding of the DASH diet?
A. Ham sandwich and chips
B. Fried chicken and fries
C. Turkey, vegetables, fruit, low-fat milk
D. Processed frozen dinner
DASH emphasizes fruits, vegetables, low-fat dairy, and reduced sodium.
What are some complications of DKA?
Diabetic neuropathy
Cardiovascular issues
A patient with renal insufficiency has:
Question: What condition is occurring and what medication is commonly used?
Fluid volume excess; administer furosemide if prescribed.
A patient with heart failure receives aggressive furosemide therapy.
Two days later:
Question: What type of AKI is most likely developing?
Pre-renal AKI due to excessive fluid loss and decreased renal perfusion.
A patient with Type 1 diabetes is sick with influenza.
They report:
Question: What teaching was not understood?
Never stop insulin during illness. Sick-day management requires continued insulin and frequent glucose monitoring.
Patient arrives in the ED:
The provider orders:
Question:
Which medication should the nurse ensure is given immediately if no contraindications exist?
Aspirin (325mg)
A patient taking hydrochlorothiazide complains of:
Question:
What electrolyte imbalance should the nurse suspect first?
Hypokalemia
A hospitalized patient developed AKI after receiving IV contrast.
Current assessment:
Provider orders:
Place the orders in priority from most urgent to least urgent and justify your reasoning.
Calcium Gluconate
IV dextrose
Furosemide
A nurse is caring for a patient in hypertensive crisis:
The provider orders oral lisinopril.
Question: What should the nurse question?
Hypertensive crisis requires rapid assessment and often IV antihypertensives. Oral medications may not be appropriate for immediate BP reduction.
A patient with DKA has:
The provider orders regular insulin.
Question: Why should the nurse closely monitor potassium after insulin administration?
Insulin drives potassium into cells, causing serum potassium to fall rapidly and potentially leading to dangerous hypokalemia.
A patient with DKA receives IV fluids before IV insulin.
Question: Why are fluids typically prioritized?
Severe dehydration is a major problem in DKA. Fluids improve circulation, tissue perfusion, and help reduce glucose levels before insulin begins correcting the metabolic problem.
A patient becomes confused, sweaty, and shaky.
The nurse checks a glucose of 48.
The patient is alert enough to swallow.
Question: What intervention is best and why?
Give 15 g rapid-acting carbohydrates first because the patient can safely swallow and requires immediate glucose replacement.