Acidosis Treatment and Management

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What is the approximate annual increase in incidence of ESRD over the past 5 years?

5%

12%

10%

8% (correct)

What is the leading cause of ESRD?

Hypertension

Diabetes mellitus (correct)

Pyelonephritis

Chronic glomerulonephritis

What percentage of ESRD cases in the United States and Europe is caused by autosomal dominant polycystic kidney disease?

15% to 18%

5% to 7%

12% to 15%

8% to 10% (correct)

What is the eventual outcome for patients with ESRD?

Dialysis or kidney transplantation (B) Signup and view all the answers

What is the term for the accumulation of waste products in the blood due to declining renal function?

Uremia (C) Signup and view all the answers

How many stages of chronic renal disease are recognized?

3 (D) Signup and view all the answers

What factors influence the rate of decline in renal function and progression of chronic renal failure?

Underlying disorder, urinary excretion of protein, and presence of hypertension (B) Signup and view all the answers

Why do patients who excrete significant amounts of protein or have elevated blood pressure tend to progress more rapidly to ESRD?

Because their kidneys are more susceptible to damage (B) Signup and view all the answers

What is the primary reason for monitoring arterial blood gases or serum bicarbonate levels in patients with severe acidosis?

To determine the need for sodium bicarbonate therapy or dialysis (B) Signup and view all the answers

What is the purpose of phosphate-binding agents in the management of ARF?

To prevent a continuing rise in serum phosphate levels (D) Signup and view all the answers

What is the expected daily weight loss in a patient with ARF who has a negative nitrogen balance?

0.2-0.5 kg (0.5-1 lb) (C) Signup and view all the answers

Why are dietary proteins limited during the oliguric phase of ARF?

To minimize protein breakdown and prevent accumulation of toxic end products (C) Signup and view all the answers

What is the primary reason for restricting foods and fluids containing potassium in patients with ARF?

To prevent hyperkalemia (B) Signup and view all the answers

What is the purpose of high-carbohydrate meals in the nutritional management of ARF?

To have a protein-sparing effect (A) Signup and view all the answers

What is the typical duration of the oliguric phase of ARF?

10-20 days (C) Signup and view all the answers

What is the typical daily restriction for sodium intake in patients with ARF?

2 g/day (C) Signup and view all the answers

What is a potential complication of chronic renal failure due to decreased excretion and excessive intake?

Hyperkalemia (B) Signup and view all the answers

Which of the following is a complication of chronic renal failure due to retention of uremic waste products and inadequate dialysis?

Pericarditis (C) Signup and view all the answers

What is the goal of management in chronic renal failure?

To maintain kidney function and homeostasis for as long as possible (B) Signup and view all the answers

What is the primary means of achieving management in chronic renal failure?

Medications and diet therapy (A) Signup and view all the answers

What is the purpose of administering erythropoietin in chronic renal failure?

To treat anemia (C) Signup and view all the answers

What is the concern about the long-term use of aluminum-based antacids?

Toxicity (A) Signup and view all the answers

What is the purpose of administering phosphate-binding agents in chronic renal failure?

To bind dietary phosphorus in the GI tract (C) Signup and view all the answers

What is the alternative medication to high doses of aluminum-based antacids?

Calcium carbonate (D) Signup and view all the answers

What type of proteins are considered to have high biologic value?

Dairy, eggs, and meats (B) Signup and view all the answers

What is the typical fluid allowance for a patient based on the previous day's urine output?

500 to 600 mL more (A) Signup and view all the answers

What is the primary purpose of carbohydrates and fat in the diet described above?

To prevent muscle wasting (D) Signup and view all the answers

Why is vitamin supplementation necessary for patients on a protein-restricted diet?

To compensate for water-soluble vitamins lost during dialysis (C) Signup and view all the answers

What dietary recommendation is made to prevent hyperkalemia in patients undergoing dialysis?

Potassium-restricted diet (A) Signup and view all the answers

When is dialysis usually initiated in patients with chronic renal failure?

When conservative treatment fails to maintain a reasonable lifestyle (C) Signup and view all the answers

Which of the following is not a potential nursing diagnosis for a patient with chronic renal failure?

Hyperthyroidism (A) Signup and view all the answers

What role does nursing care play for patients with chronic renal failure?

Avoiding complications and managing anxieties (A) Signup and view all the answers

Which cardiovascular symptom is characterized by swelling in the feet, hands, and sacrum with an indentation present after applying pressure?

pitting edema (D) Signup and view all the answers

What is a common pulmonary manifestation that involves increased rate and depth of breathing due to severe metabolic acidosis?

Kussmaul-type respirations (C) Signup and view all the answers

Which gastrointestinal symptom is sometimes referred to as 'uremic fetor'?

ammonia odor to breath (A) Signup and view all the answers

Which term refers to the decrease in muscle mass and strength often seen in patients with kidney disease?

loss of muscle strength (D) Signup and view all the answers

What is considered the more sensitive indicator of renal function due to its constant production in the body?

serum creatinine (D) Signup and view all the answers

Which hematologic symptom commonly occurs in patients with renal disease and involves a low platelet count?

thrombocytopenia (C) Signup and view all the answers

Which reproductive symptom is characterized by the absence of menstruation in women?

amenorrhea (C) Signup and view all the answers

What physiological change in the kidneys leads to the inability to concentrate or dilute urine normally in End-Stage Renal Disease (ESRD)?

nonfunctioning glomeruli (C) Signup and view all the answers