Questions and Answers
A nurse is caring for a client who has nephrotic syndrome and has been taking prednisone for 3 days. Which of the following adverse effects should the nurse monitor for and report to the provider?
A nurse is providing education regarding cyclosporine for a client who had a kidney transplant 2 days ago. What should the nurse tell the client?
You will need to continue taking this medication to protect your new kidneys.
A nurse is assessing a client who has chronic kidney disease and has completed her third peritoneal dialysis (PD) treatment. What finding should the nurse report to the provider?
Cloudy dialysate effluent
A nurse is reviewing the medical history of a client who has end-stage kidney disease. What factor in the client's history is a contraindication for receiving hemodialysis?
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A nurse is caring for a client who has chronic kidney failure and the following laboratory results: BUN 196 mg/dL, sodium 152 mEq/L, and potassium 7.3 mEq/L. What intervention should the nurse implement?
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A nurse is obtaining a urine specimen for culture and sensitivity from a client who has manifestations of a urinary tract infection. What should the nurse do?
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A nurse is providing instructions for reducing the dietary intake of potassium for a client who has chronic kidney disease. What food selection indicates an understanding of the teaching?
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A nurse is providing discharge teaching to a client who has chronic kidney disease (CKD). What statement by the client indicates an understanding of the teaching?
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A nurse is teaching a client who has urge urinary incontinence about bladder retraining. What instruction should the nurse include?
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A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. What instruction should the nurse include in the teaching?
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A nurse in an emergency department is caring for a client who reports costovertebral angle tenderness, nausea, and vomiting. What laboratory value should the nurse report to the provider?
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A nurse is caring for a client who is receiving continuous bladder irrigation following a transurethral resection of the prostate. What should the nurse do upon detecting an output obstruction?
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A nurse is reviewing the laboratory report of a client who has acute kidney injury (AKI). Which of the following findings should the nurse expect?
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A nurse is caring for a client who is scheduled for an intravenous urography. What is the nurse's priority?
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A nurse is planning care for a group of clients. Which client should the nurse plan to monitor for signs of nephrotoxicity?
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A nurse is planning care for a client who is postoperative following a nephrectomy. What assessment is the nurse's priority?
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A nurse is reviewing the medical records of four clients. Which disorder is a risk factor for chronic pyelonephritis?
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A nurse is performing an admission assessment of a client who has acute glomerulonephritis. What finding should the nurse expect?
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A nurse is performing an admission assessment for a client who has severe chronic kidney disease (CKD). What finding should the nurse expect?
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A nurse is caring for a client immediately following a kidney transplant. What finding indicates a possible delay in functioning of the transplanted kidney?
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A nurse is planning care for a client who is scheduled for extracorporeal shock wave lithotripsy (ESWL) to treat urolithiasis. What action should the nurse plan to take?
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A nurse is preparing to assess a client who received hemodialysis 1 hr ago. What assessment should the nurse perform first?
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A nurse is providing teaching to a male client who has a continent internal ileal reservoir following surgery to treat bladder cancer. What client statement indicates an understanding of the teaching?
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A nurse is caring for a client who has acute kidney injury (AKI). What serum laboratory finding should the nurse report to the provider?
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A nurse is planning for a client who has acute glomerulonephritis. What intervention should the nurse plan to provide?
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A nurse in a women's health clinic is caring for a client who reports urinary urgency and dysuria. What additional finding should the nurse identify as an indication of a urinary tract infection (UTI)?
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A nurse is providing teaching to a client who has chronic kidney disease (CKD). What client statement indicates an understanding of the teaching?
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A nurse is caring for a client following extracorporeal shock wave lithotripsy (ESWL) for the treatment of calcium phosphate kidney stones. What action should the nurse take?
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A nurse is monitoring a client following hemodialysis. What factor places the client at risk for seizures?
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A nurse is caring for a postoperative client following arteriovenous (AV) fistula creation in the left arm. What action should the nurse take?
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Study Notes
Nephrotic Syndrome and Prednisone Use
- Monitor for sore throat as a potential adverse effect of prednisone.
Cyclosporine Post-Kidney Transplant
- Patient must continue cyclosporine to protect kidney function after transplant.
Chronic Kidney Disease and Peritoneal Dialysis
- Cloudy dialysate effluent indicates a potential problem requiring provider notification.
Contraindications for Hemodialysis
- History of hemophilia is a contraindication for hemodialysis treatment.
Chronic Kidney Failure Lab Values
- Elevated BUN (196 mg/dL), high sodium (152 mEq/L), and potassium (7.3 mEq/L) necessitate infusion of regular insulin and dextrose.
Urine Specimen Collection
- Initiate urine flow before collecting specimen to ensure accuracy for culture and sensitivity.
Dietary Management in Chronic Kidney Disease
- Decreasing potassium intake suggested; one large raw apple is a low-potassium choice.
Discharge Teaching in Chronic Kidney Disease
- Emphasis on reducing phosphorus-rich foods for better health outcomes.
Bladder Retraining Techniques
- Advise clients to extend urination intervals by 15 minutes per day to regain bladder control.
Managing Acute Pyelonephritis
- Recommend avoiding NSAIDs for pain management due to potential exacerbation of renal issues.
Emergency Signs in Kidney Disorders
- Report elevated WBC count (15,000/mm3) in clients with costovertebral angle tenderness.
Continuous Bladder Irrigation Post-Procedure
- First check irrigation tubing for kinks when output obstruction is detected.
Expected Findings in Acute Kidney Injury
- Anticipate elevated BUN (30 mg/dL), low urine output (40 mL in 3 hours), and reduced hematocrit (30%).
Pre-Procedure Education for Intravenous Urography
- Confirm any allergies to iodine or shellfish before administering contrast.
Nephrotoxicity Risk Factors
- Monitor clients receiving gentamicin as it poses a risk for nephrotoxicity.
Postoperative Care Following Nephrectomy
- Prioritize monitoring blood pressure in the postoperative care of nephrectomy patients.
Risk Factor for Chronic Pyelonephritis
- Diabetes mellitus is identified as a significant risk factor for chronic kidney infection recurrence.
Assessment Findings in Acute Glomerulonephritis
- Expect to find dark-colored urine upon assessment of acute glomerulonephritis clients.
Expected Symptoms in Severe Chronic Kidney Disease
- Tachypnea noted during assessments for clients with advanced chronic kidney disease.
Post-Kidney Transplant Monitoring
- Urine output of 30 mL over 2 hours may indicate delayed functioning of the transplanted kidney.
Pre-ESWL Care Planning
- Apply electrodes for cardiac monitoring during extracorporeal shock wave lithotripsy for urolithiasis.
Post-Hemodialysis Assessment
- Assess vital signs first after hemodialysis to determine overall patient stability.
Catheterization in Continent Internal Ileal Reservoir
- Patients must catheterize through the stoma to manage urine drainage effectively.
Reporting Laboratory Findings in Acute Kidney Injury
- Report a creatinine level of 4.0 mg/dL for urgent clinical intervention.
Daily Monitoring in Acute Glomerulonephritis
- Implement daily weight monitoring to assess fluid retention and kidney function in clients.
Indicators of Urinary Tract Infection
- Pyuria is a key indicator to confirm urinary tract infections in symptomatic clients.
Daily Weight Management in Chronic Kidney Disease
- Clients should weigh themselves each morning to monitor potential fluid retention.
Post-ESWL Care
- Direct client care to strain all urine to monitor for stone passage after lithotripsy.
Seizure Risk Post-Hemodialysis
- Rapid fluid decrease poses a risk for seizures in clients following hemodialysis procedures.
Monitoring Care for AV Fistula Post-Creation
- Auscultate for bruits every 4 hours in clients with a created AV fistula to ensure patency.
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Description
This quiz covers various aspects of chronic kidney disease, including medication use, lab values, and dietary management. It also covers contraindications for hemodialysis and urine specimen collection.
