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Week 4 Sherpath
Week 4 NCO Collaboratiev Care of Acute Kidney Injury and chronic kidney disease
| Question | Answer |
|---|---|
| Which dietary interventions would the nurse institute to prevent hypertension and edema in a patient with acute kidney injury (AKI)? | Restrict foods that are high in sodium Restrict foods that are high in potassium |
| A patient with chronic kidney disease (CKD) asks the nurse why their diet is restricted in protein. Which explanation would the nurse provide to better help the patient understand their diet? | To limit catabolic production of nitrogenous waste |
| A patient with chronic kidney disease (CKD) asks the nurse to help him make choices for dinner. The nurse notes that the patient has been ordered a low-protein, low-sodium, low-potassium diet. Which items on the patient’s meal tray should the nurse remove | -Beef Steak - Salt substitutes - Plain baked Potato |
| Which interventions does the nurse know are available to manage hyperkalemia in a patient with acute kidney injury (AKI)? | - Dialysis - Calcium gluconate - Sodium polystyrene sulfonate - Insulin and sodium bicardonate |
| Which statement is the rationale for discontinuing metformin in a patient with chronic kidney disease (CKD) and diabetes who has worsening kidney function? | To prevent drug accumulation and possible toxicity |
| Which treatment would be avoided for a patient with decreased gastrointestinal motility who has CKD? | Sodium polystyrene sulfonate |
| A patient with AKI asks the nurse about different dialysis treatments. How would the nurse describe the reasons for choosing hemodialysis (HD) over peritoneal dialysis (PD)? | - "Less protein will be lost sing HD then PD." - " HD is more efficient at removing waste products than PD." |
| Which clinical manifestations or lab values would indicate to the nurse that dialysis (renal replacement therapy) may be required for a patient with acute kidney injury (AKI)? | - BUN >120 - Volume overload - Metabolic acidosis - Elevated serum potassium |
| Patients with end-stage renal disease (ESRD) receive maintenance dialysis. The nurse tells a patient with ESRD that dialysis may no longer be required due to which reason? | The patient will receive a kidney transplant. |
| Which menu items would the nurse remove from the meal tray of a patient with chronic kidney disease who is not currently receiving dialysis? | - Bananas - Hardboiled eggs |
| A patient with CKD, who receives hemodialysis three times weekly, has a urine output of 200 mL for the day. The nurse calculates the recommended daily fluid intake for this patient to be ____ mL of fluid. | 800 |
| Which nutritional food group limitations would the nurse recommend to a patient with CKD and renal osteodystrophy in order to help manage the diagnosis? | - Protein - Phosphorus |
| What is the recommendation regarding the use of diuretics for a patient with acute kidney injury (AKI) during the oliguric phase? | Not recommended, may be harmful |
| A patient with late stage chronic kidney disease (CKD) wants to know why active-form vitamin D has been prescribed. How would the nurse explain the use of this drug therapy to the patient? | “The kidney is no longer activating vitamin D, which will prevent calcium from being absorbed.” |
| The nurse instructs a patient with CKD and mineral bone disorder to take which medications with food in order to maximize function? | - Vitamin D - Calcimimetics - Phosphate binders |
| A patient who will soon begin dialysis requests more information about how dialysis will fit into their life. The patient would like to remain involved with work (full-time) and family activities, including day trips. Which statement by the nurse is most | “Continuous ambulatory peritoneal dialysis (CAPD) is the best option for you.” |
| Some patients may feel weak and have low blood pressure immediately following hemodialysis (HD). How would the nurse explain the mechanism that caused these symptoms to the patient? | Rapid fluid shifts can occur during HD as fluid is removed from the body. |
| A 93-year old patient with end-stage renal disease (ESRD) refuses dialysis. The patient’s family insists the patient cannot make that decision on their own. The nurse talks with the ... Which action should the nurse take to support the patient’s request? | Explain to the family that the patient is competent. Treatment would be burdensome to the patient and is not what the patient desires. |
| Which issues would the nurse take into consideration when discussing dialysis versus kidney transplantation as management strategies for a patient with end-stage renal disease? | - The physical ability to receive a kidney transplant. - The patient’s mental competency to make the decision. - The reasoning behind the patient’s decision regarding their treatment. |
| A patient undergoing hemodialysis will likely have an arteriovenous fistula or graft. Which specific safety precautions would the nurse take to care for these patients, in regards to their dialysis access? | - Interventions to prevent clotting of the vascular access - Meticulous aseptic technique to prevent infection of vasc - Peripheral venous access and venipuncture should be in the - Blood pressure measurements should be in the contralateral extremity |
Created by:
Brandi Sizemore
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