Show:
Glomerulonephritis A
Glomerulonephritis B
Renal Failure A
Renal Failure B
Meds and Misc
100
A client with glomerulonephritis is at risk of developing acute renal failure. The nurse monitors the client for which sign of this complication? a) bradycardia b) hypertension c) decreased cardiac output d) decreased central venous pressure
b) hypertension - Acute renal failure caused by glomerulonephritis is classified as intrinsic or intrarenal failure. This form of acute renal failure is commonly manifested by hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload. Acute renal failure from prerenal causes is characterized by decreased blood pressure or a recent history of the same, tachycardia, and decreased cardiac output and central venous pressure. Bradycardia is not part of the clinical picture for renal failure.
100
Clinical manifestations of acute glomerulonephritis include which of the following? A-Chills and flank pain B-Oliguria and generalized edema C-Hematuria and proteinuria D-Dysuria and hypotension
C-Hematuria and proteinuria Hematuria and proteinuria indicate acute glomerulonephritis. These finding result from increased permeability of the glomerular membrane due to the antigen-antibody reaction. Generalized edema is seen most often in nephrosis.
100
Which of the following is the most common initial manifestation of acute renal failure? A.) Dysuria B.) Anuria C.) Hematuria D.) Oliguria
D.) Oliguria Oliguria is the most common initial symptom of acute renal failure. Anuria is rarely the initial symptom. Dysuria and hematuria are not associated with acute renal failure.
100
A patient returns from surgery with an indwelling urinary catheter in place and empty. Six hours later, the volume is 120ml. The drainage system has no obstructions. Which intervention has priority? A-Give a 500 ml bolus of isotonic saline B-Evaluate the patient’s circulation and vital signs C-Flush the urinary catheter with sterile water or saline D-Place the patient in the shock position, and notify the surgeon
B-Evaluate the patient’s circulation and vital signs A total UO of 120ml is too low. Assess the patient’s circulation and hemodynamic stability for signs of hypovolemia. A fluid bolus may be required, but only after further nursing assessment and a doctor’s order.
100
The client's serum potassium level is elevated in acute renal failure, and the nurse administers sodium polystyrene sulfonate (Kayexalate). This drug acts to: A.) Increase potassium excretion from the colon B.) Release hydrogen ions for sodium ions C.) Increase calcium absorption in the colon D.) Exchange sodium for potassium ions in the colon
D.) Exchange sodium for potassium ions in the colon. Polystyrene sulfonate, a cation-exchange resin, causes the body to excrete potassium through the gastrointestinal tract. In the intestines, particularly the colon, the sodium of the resin is partially replaced by potassium. The potassium is then eliminated when the resin is eliminated with feces. Although the result is to increase potassium excretion, the specific method of action is the exchange of sodium ions for potassium ions. Polystyrene sulfonate does not release hydrogen ions or increase calcium absorption.
200
A client has been admitted to the hospital with a diagnosis of acute glomerulonephritis. During history-taking the nurse first asks the client about a recent history of: A) bleeding ulcer B) deep vein thrombosis C) myocardial infarction D) streptococcal infection
D) streptococcal infection
200
A nurse is presenting information to a client who has a new diagnosis of chronic glomerulonephritis. Which of the following nursing statements is appropriate? A. "A high sodium diet is recommended." B. "The destruction of the glomeruli occurs rapidly." C. "The cause of the disease is not known." D. "To compensate, the number of functioning nephrons is increased."
C. "The cause of the disease is not known."
200
The client's blood urea nitrogen (BUN) concentration is elevated in acute renal failure. What is the likely cause of this finding? A.) Fluid retention B.) Hemolysis of red blood cells C.) Below-normal metabolic rate D.) Reduced renal blood flow
D.) Reduced renal blood flow Urea an end product of protein metabolism, is excreted by the kidneys. Impairment in renal function caused by reduced renal blood flow results in an increase in the plasma urea level. Fluid retention, hemolysis or red blood cells, and lowered metabolic rate do not cause an elevated BUN value.
200
Your patient with chronic renal failure reports pruritus. Which instruction should you include in this patient’s teaching plan? A-Rub the skin vigorously with a towel B-Take frequent baths C-Apply alcohol-based emollients to the skin D-Keep fingernails short and clean
D-Keep fingernails short and clean Calcium-phosphate deposits in the skin may cause pruritus. Scratching leads to excoriation and breaks in the skin that increase the patient’s risk of infection. Keeping fingernails short and clean helps reduce the risk of infection.
200
A client with renal failure is receiving epoetin alfa (Epogen) to support erythropoiesis. The nurse questions the client about compliance with taking which of the following medications that supports red blood cell (RBC) production? A) iron supplement B) zinc supplement C) calcium supplement D) magnesium supplement
A) iron supplement
300
A nurse is caring for a client who has just returned to the nursing unit after an intravenous pyelogram (IVP). The nurse determines that which of the following is important in the postprocedure care of this client? a) encouraging increased intake of oral fluids b) ambulating the client in the hallway c) encouraging the client to try to avoid frequently d) maintaining the client on bedrest
A.) encouraging increased intake of oral fluids
300
A client with glomerulonephritis is at risk of developing acute renal failure. The nurse monitors the client for which sign of this complication? a) bradycardia b) hypertension c) decreased cardiac output d) decreased central venous pressure
B) Hypertension. Acute renal failure caused by glomerulonephritis is classified as intrinsic or intrarenal failure. This form of acute renal failure is commonly manifested by hypertension, tachycardia, oliguria, lethargy, edema, and other signs of fluid overload. Acute renal failure from prerenal causes is characterized by decreased blood pressure or a recent history of the same, tachycardia, and decreased cardiac output and central venous pressure. Bradycardia is not part of the clinical picture for renal failure.
300
A patient on hemodialysis develops a thrombus of a subcutaneous arteriovenous graft, requiring its removal. While waiting for a replacement graft or fistula, the patient is most likely to have what done for treatment? A.) Peritoneal dialysis B.) Peripheral vascular access using radial artery C.) Silastic catheter tunneled subcutaneously to the jugular vein D.) Peripherally inserted central catheter line inserted into subclavian vein
C.) A more permanent, soft, flexible Silastic double-lumen catheter is used for long-term access when other forms of vascular access have failed. These catheters are tunneled subcutaneously and have Dacron cuffs that prevent infection from tracking along the catheter.
300
Which sign indicated the second phase of acute renal failure? A-Daily doubling of urine output (4 to 5 L/day) B-Urine output less than 400 ml/day C-Urine output less than 100 ml/day D-Stabilization of renal function
A-Daily doubling of urine output (4 to 5 L/day) Daily doubling of the urine output indicates that the nephrons are healing. This means the patient is passing into the second phase (dieresis) of acute renal failure.
300
The client with chronic renal failure who is scheduled for hemodialysis this morning is due to receive a daily dose of enalapril (Vasotec). The nurse should plan to administer this medication: a) during dialysis b) just before dialysis c) the day after dialysis d) on return from dialysis
d) on return from dialysis
400
A client with pyelonephritis is being discharged from the hospital, and the nurse provides instructions to the client to prevent recurrence. The nurse determines that the cleint understands the information that was given if the client states an intention to: a) increase fluids for 2 days if signs and symptoms of a urinary tract infection develop b) take the prescribed antibiotics until all symptoms subside c) return to the physician's office for scheduled follow-up urine cultures d) decrease fluid intake if frequent urination occurs
c) return to the physician's office for scheduled follow-up urine cultures
400
Glomerulonephritis is characterized by glomerular damage caused by: A.) growth of microorganisms in the glomeruli B.) release of bacterial substances toxic to the glomeruli C.) accumulation of immune complexes in the glomeruli D.) hemolysis of RBCs circulating
C. Glomerulonephritis is not an infection but rather an antibody-induced injury to the glomerulus, where either autoantibodies against the glomerular basement membrane directly damage the tissue or antibodies reacting with nonglomerular antigens are randomly deposited as immune complexes along the GBM. Prior infection by bacteria or viruses may stimulate the antibody production but is not present or active at the time of glomerular damage.
400
The patient with chronic kidney disease is considering whether to use peritoneal dialysis or hemodialysis. What are advantages of PD when compared to HD? (Select all that apply lol) A.) Less protein loss B.) Rapid fluid removal C.) Less cardiovascular stress D.) Decreased hyperlipidemia E.) Requires fewer dietary restrictions
C, E Peritoneal dialysis is less stressful for the cardiovascular system and requires fewer dietary restrictions. Peritoneal dialysis actually contributes to more protein loss and increased hyperlipidemia. The fluid and creatinine removal are slower with peritoneal dialysis than hemodialysis. Wow
400
In order to slow the progression of end stage renal disease in the client who has been diagnosed with glomerular disease the nurse would plan to administer: (Select all that apply) A) antihypertensives. B) nonsteriodal anti-inflammatory drugs. C) packed red blood cells. D) antiplatelet drugs.
A and B Antihypertensives are administered to control systemic and renal hypertension. Non steroidal anti-inflammatory drugs reduce proteinuria. Hypertension inflammation and proteinuria lead to end stage renal disease.
400
What is the normal BUN and Creatinine levels? (And their units of measurement... mwahaha)
BUN: 7-18 mg/dL Creatinine: 0.6-1.2 mg/dL
500
A client with renal insufficiency is admitted with a diagnosis of pneumonia. He is being treated with IV antibiotics, which can be nephrotoxic. Which laboratory value(s) should be monitored closely? A. Blood Urea Nitrogen (BUN) and creatinine levels. B. Arterial Blood Gas (ABG) levels C. Platelet count D. Potassium level
A. Blood Urea Nitrogen (BUN) and creatinine levels.
500
Which disease causes connective tissue changes that cause glomerulonephritis? A.) Gout B.) Amyloidosis C.) Diabetes Mellitus D.) Systemic lupus erythematosus
D. Systemic lupus erythematosus causes connective tissue damage that affects the glomerulus. Gout deposits uric acid crystals in the kidney. Amyloidosis deposits hyaline bodies in the kidney. Diabetes mellitus causes microvascular damage affecting the kidney.
500
A client who has experienced a burn injury over 40 percent of his body is at risk for acute tubular necrosis. In order to prevent renal failure in this client the nurse should: (Mark all that apply) A) maintain blood pressure. B) prevent infection. C) maintain adequate fluid balance. D) increase fluids to prevent crystal formation.
A) maintain blood pressure. B) prevent infection. C) maintain adequate fluid balance. Acute tubular necrosis results from burns and hypovolemia sepsis. The nurse should prevent ischemia by maintaining blood flow to the kidney and prevent hypotension and infection.
500
The nurse monitoring a client receiving peritoneal dialysis notes that the client's outflow is less than the inflow. Which nursing actions should the nurse take? Select all that apply. A) Contact the physician. B) Check the level of the drainage bag. C) Re position the client to his or her side. D) Place the client in good body alignment. E) Check the peritoneal dialysis system for kinks. F) Increase the flow rate of peritoneal dialysis solution.
B,C,D,E: B) Check the level of the drainage bag. C) Re position the client to his or her side. D) Place the client in good body alignment. E) Check the peritoneal dialysis system for kinks.
500
In order to slow the progression of end stage renal disease in the client who has been diagnosed with glomerular disease the nurse would plan to administer: (Select all that apply) A) antihypertensives. B) nonsteriodal anti-inflammatory drugs. C) packed red blood cells. D) antiplatelet drugs.
A) Antihypertensives B) Nonsteroidal anti-inflammatory drugs Rationale: Antihypertensives are administered to control systemic and renal hypertension. Non steroidal anti-inflammatory drugs reduce proteinuria. Hypertension inflammation and proteinuria lead to end stage renal disease.