Chronic Kidney Disease and Treatment
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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?

  • Sore throat (correct)
  • Fatigue
  • Nausea
  • Headache
  • 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?

    <p>History of hemophilia</p> Signup and view all the answers

    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?

    <p>Infuse regular insulin dextrose 10% in water</p> Signup and view all the answers

    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?

    <p>Instruct the client to initiate the flow of urine before collecting the specimen</p> Signup and view all the answers

    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?

    <p>One large raw apple</p> Signup and view all the answers

    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?

    <p>I will decrease my intake of foods high in phosphorus.</p> Signup and view all the answers

    A nurse is teaching a client who has urge urinary incontinence about bladder retraining. What instruction should the nurse include?

    <p>Increase the intervals between urination by 15 minutes per day when able to remain continent.</p> Signup and view all the answers

    A nurse is teaching a client who has a new diagnosis of acute pyelonephritis. What instruction should the nurse include in the teaching?

    <p>Avoid the use of NSAIDS for pain</p> Signup and view all the answers

    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?

    <p>WBC count 15,000/mm3</p> Signup and view all the answers

    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?

    <p>Check the irrigation tubing for kinks.</p> Signup and view all the answers

    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?

    <p>All of the above</p> Signup and view all the answers

    A nurse is caring for a client who is scheduled for an intravenous urography. What is the nurse's priority?

    <p>Determine if the client has an allergy to iodine or shellfish</p> Signup and view all the answers

    A nurse is planning care for a group of clients. Which client should the nurse plan to monitor for signs of nephrotoxicity?

    <p>A client who is receiving gentamicin for treatment of a wound infection</p> Signup and view all the answers

    A nurse is planning care for a client who is postoperative following a nephrectomy. What assessment is the nurse's priority?

    <p>Blood Pressure</p> Signup and view all the answers

    A nurse is reviewing the medical records of four clients. Which disorder is a risk factor for chronic pyelonephritis?

    <p>Diabetes mellitus</p> Signup and view all the answers

    A nurse is performing an admission assessment of a client who has acute glomerulonephritis. What finding should the nurse expect?

    <p>Dark colored urine</p> Signup and view all the answers

    A nurse is performing an admission assessment for a client who has severe chronic kidney disease (CKD). What finding should the nurse expect?

    <p>Tachypnea</p> Signup and view all the answers

    A nurse is caring for a client immediately following a kidney transplant. What finding indicates a possible delay in functioning of the transplanted kidney?

    <p>Urine output 30ml/2hr</p> Signup and view all the answers

    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?

    <p>Apply electrodes for cardiac monitoring</p> Signup and view all the answers

    A nurse is preparing to assess a client who received hemodialysis 1 hr ago. What assessment should the nurse perform first?

    <p>Vital signs</p> Signup and view all the answers

    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?

    <p>I must insert a catheter through my stoma to drain the urine.</p> Signup and view all the answers

    A nurse is caring for a client who has acute kidney injury (AKI). What serum laboratory finding should the nurse report to the provider?

    <p>Creatinine 4.0 mg/dL</p> Signup and view all the answers

    A nurse is planning for a client who has acute glomerulonephritis. What intervention should the nurse plan to provide?

    <p>Weigh the client daily.</p> Signup and view all the answers

    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)?

    <p>Pyuria</p> Signup and view all the answers

    A nurse is providing teaching to a client who has chronic kidney disease (CKD). What client statement indicates an understanding of the teaching?

    <p>I will weigh myself every morning.</p> Signup and view all the answers

    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?

    <p>Strain all of the client's urine.</p> Signup and view all the answers

    A nurse is monitoring a client following hemodialysis. What factor places the client at risk for seizures?

    <p>A rapid decrease in fluid</p> Signup and view all the answers

    A nurse is caring for a postoperative client following arteriovenous (AV) fistula creation in the left arm. What action should the nurse take?

    <p>Auscultate for bruits in the client's fistula every 4 hr.</p> Signup and view all the answers

    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.

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