Renal Disorders Overview

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Questions and Answers

Which symptom would indicate that a client has developed a complication after undergoing cystoscopy?

Dizziness (correct)

Bladder spasms

Pink-tinged urine

Chills

Where is prompt management of renal calculi most critical due to a high propensity for obstruction?

In the ureteral segment near the sacroiliac junction

In the ureterovesical junction

In the urethra

In the ureteropelvic junction (correct)

In which situation is renal replacement therapy indicated for a patient with declining renal function?

When the patient's creatinine level drops below 1.2 mg/dL

When approximately 40% of nephrons are not functioning

When about 80% of the nephrons are no longer functioning (correct)

When the patient's blood urea nitrogen (BUN) is above 15 mg/dL

What would be considered a priority outcome for a client experiencing severe flank pain due to renal calculi?

Alleviation of pain Signup and view all the answers

What preparation is necessary for a client scheduled to have a KUB radiograph?

No special preparation is required for the examination Signup and view all the answers

Which measure is most important for the nurse to include in pretest preparation for an intravenous pyelogram (IVP)?

Checking the client's history for allergy to iodine Signup and view all the answers

What might be a misleading assumption about the location of renal calculi regarding urgency of management?

Obstructions in the sacroiliac junction are least concerning Signup and view all the answers

What is a common misconception regarding renal function decline and the need for dialysis?

Dialysis can be postponed regardless of nephron function percentage Signup and view all the answers

Which statement reflects an inadequate understanding of the diuretic phase of kidney injury?

The diuretic phase develops about 14 days after the initial insult and lasts about 10 days. Signup and view all the answers

If a client with chronic kidney disease states which medication is needed to enhance red blood cell production, further teaching is required?

Calcium carbonate (Tums) Signup and view all the answers

What type of samples should the nurse collect for a creatinine clearance measurement?

A 24-hour urine specimen and a serum creatinine level midway through the urine collection process. Signup and view all the answers

Which manifestation should a nurse assess for in a client diagnosed with acute pyelonephritis?

Low-grade fever Signup and view all the answers

What should the nurse investigate regarding a client presenting with low abdominal pain and hematuria?

Trauma to the bladder or abdomen Signup and view all the answers

When administering Epoetin alfa (Epogen), which adverse effect should the nurse monitor for?

Hypertension Signup and view all the answers

What clinical manifestations should a nurse assess in a hemodialysis client with a left arm fistula at risk for steal syndrome?

Pallor, diminished pulse, and pain in the left hand Signup and view all the answers

Which of the following is an indication for further assessment when a client presents with unexplained hematuria?

History of kidney stones Signup and view all the answers

Study Notes

Cystoscopy Complications

Pink-tinged urine, dizziness, chills, and bladder spasms can all be post-cystoscopy complications

Renal Replacement Therapy

Renal replacement therapy (dialysis) is indicated when roughly 80% of nephrons are no longer functioning

Renal Calculi Location

Prompt management of renal calculi is most important when they are located in the ureteropelvic junction

Acute Kidney Injury (AKI)

The diuretic phase of AKI is characterized by increased urine output, indicating some return of renal function
BUN and serum creatinine levels will typically rise in the initial days of diuresis

Hemodialysis: Steal Syndrome

Steal syndrome, which can occur in hemodialysis patients with a left arm fistula, is characterized by pallor, diminished pulse, and pain in the left hand
This occurs due to the fistula stealing blood from the hand

Hemodialysis: Fistula Care

A hemodialysis client with a left arm fistula may experience steal syndrome – this presents as pallor, diminished pulse, and pain in the left hand

Chronic Kidney Disease (CKD)

CKD is treated with medications to enhance red blood cell production, such as Epogen (Procrit)
Epoetin alfa (Epogen), a medication used for CKD, can cause hypertension as an adverse effect
Iron intoxication is not a common adverse effect of Epogen

Pyelonephritis

Chills and nausea are manifestations of acute pyelonephritis.

Hematuria and Abdominal Pain

Hematuria and low abdominal pain, without fever, can indicate trauma to the bladder or abdomen.

Intravenous Pyelogram (IVP)

A client scheduled for an IVP should have their iodine allergy checked.

Kidney, Ureter, and Bladder (KUB) Radiograph

No special preparation is required for a KUB radiograph.

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Description

This quiz covers various aspects of renal disorders including complications of cystoscopy, renal replacement therapy, renal calculi management, acute kidney injury phases, and hemodialysis issues. Test your knowledge on the identification and management of common renal conditions.