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Med/Surg Chp 47 & 48
Assessment of Kidney/Urinary Function & Management of Urinary Disorders
| Question | Answer |
|---|---|
| The nurse is reviewing the laboratory values for a patient and observes an increase in blood osmolality. Which is the significance of this increase? ADH stimulation An increase in urine volume Diuresis Less reabsorption of water | ADH stimulation |
| A patient is being seen in the clinic for possible kidney disease. Which major sensitive indicator of kidney disease does the nurse prepare the patient for? Blood urea nitrogen (BUN) Creatinine clearance Serum potassium Uric acid | Creatinine clearance |
| A patient with end-stage kidney disease has fetid odor when breathing. Which major manifestation of uremia will be present? A decreased serum phosphorus level Hyperparathyroidism Hypocalcemia with bone changes Increased secretion of parathormone | Hypocalcemia with bone changes |
| A nurse assesses a patient upon admission to the hospital. Which significant nursing assessment data is relevant to renal function? Select all that apply: Any voiding disorders Occupation Presence of hypertension or diabetes Ability to manage ADLs | Any voiding disorders Occupation Presence of hypertension or diabetes |
| A nurse is caring for a patient in the oliguric phase of kidney failure. When does the nurse document that oliguria is present? Urine output less than 30ml/h Urine output about 100ml/h Urine output 300-500ml/h Urine output 500 -1000ml/h | Urine output is less than 30ml/h |
| A 24-hour urine collection is scheduled to begin at 8am. When should the nurse initiate the procedure? After discarding the 8am specimen At 8am, with or without specimen 6 hours after the urine is discarded With the first specimen voided after 8am | After discarding the 8am specimen |
| The nurse is providing education in preparation for an IV urography. Which will be included in the instructions? Liquid restriction for 8-10h prior to test May have liquids before the test Enemas until urine is clear NPO after midnight until the test | May have liquids before the test |
| A patient is post renal angiography. Which actions will be performed to detect complications? SATA Assess peripheral pulses Compare color/temperature between involved/uninvolved extremities Examine puncture site Apply warm compress Increase IV fluid | Assess peripheral pulses Compare color and temperature between involved and uninvolved extremities Examine puncture site for swelling/hematoma formation |
| A patient is having an MAG3 renogram to determine kidney function. The patient will be instructed to do which of the following during the procedure? Lie still on the table for approximately 35 minutes Drink contrast Turn from side to side | Lie still on the table for approximately 35 minutes |
| A patient is scheduled for a test with contrast to determine kidney function. Which statement should the nurse notify the health care provider about prior to test? "I don't like needles" "I'm allergic to shrimp" "I take medication to help me sleep" | "I'm allergic to shrimp" |
| A patient is retaining fluid and had a 1kg weight gain. How many milliliters is this equivalent to? 250mL 500mL 750mL 1000mL | 1000mL |
| A patient with electrolyte imbalance has carpopedal spasm, ECG changes, and a positive Chvostek sign. What should the patient be evaluated for? Hypercalcemia Hypomagnesemia Hypocalcemia Hyperkalemia | Hypocalcemia |
| Patient's lab results are reviewed, which findings are consistent with acute glomerulonephritis? SATA RBC in urine Polyuria Proteinuria White cell casts in urine Hemoglobin 12.8g/dL | RBC in urine Proteinuria White cell casts in urine |
| A patient with restricted potassium intake should be educated to eliminate food rich in potassium. What food(s) would be potassium rich? Butter Citrus fruits Cooked white rice Salad oils | Citrus fruits |
| A nurse is caring for a patient with stage 3 chronic kidney failure. What is an expected glomerular filtration rate (GFR)? 90mL/min 30-59 mL/min 120 mL/min 85 mL/min | 30-59 mL/min |
| A patient with chronic kidney failure experiences decreased levels of erythropoietin. Which complications can arise from this decreased level? Anemia Acidosis Hyperkalemia Pericarditis | Anemia |
| A patient post kidney surgery is at risk for this major danger and must be monitored closely? Abdominal distention owing to reflex cessation Hypovolemic shock caused by hemorrhage Paralytic ileus caused by manipulation of the colon Pneumonia | Hypovolemic shock caused by hemorrhage |
| A patient is scheudled for CT scan with contrast. Creatinine is 3mg/dL. What intervention is used to reduce the risk of kidney injury? Performing test without contrast Hydrating w/saline IV prior to test Give sodium bicarbonate after the procedure | Hydrating w/saline IV prior to test |
| A patient with kidney disease has a potassium level of 6.5 mEq/L; ECG shows peaked T waves. Which medication would be prescribed to reduce potassium level? Insulin drip Loop diuretic Sodium bicarbonate Sodium polystyrene sulfonate | sodium polystyrene sulfonate |
| A patient receives calcium acetate for ESKD. When is the best time to administer this medication? 2 hours before meals 2 hours after meals With food At bedtime with 8oz of fluid | With food |
| A patient with ESKD is scheduled to have an arteriovenous fistula created. The fistula will have to mature before use, so a temporary catheter will be used. How long does it take for the fistula to mature? 1-2 weeks 2-3 weeks 1 month 2-3 months | 2-3 months |
| A patient is on hemodialysis for 1st time & reports headache, nausea, begins to vomiting, & have a decreased level of consciousness. What is occurring? Dialysis to rapidly Allergic reaction to dialysate Cerebral fluid shift Too much fluid pulled off | Cerebral fluid shift |
| ______________ and diabetes cause approximately 70% of the cases of chronic kidney disease. | Hypertension |
| Two forms of nephrosclerosis are benign and ______________. | Acute hypertensive |
| Two blood levels that are significantly increased in acute kidney injury (AKI) are BUN and _____________ | Creatinine |
| The most common and serious complication of continuous ambulatory peritoneal dialysis. | Peritonitis |
| The most accurate indicator of fluid loss or gain in an acutely ill patient. | Weight |
| The major manifestation of nephrotic syndrome. | Edema |
| Type of kidney disease characterized by increased glomerular permeability and manifested by massive proteinuria. | Nephrotic syndrome |
Created by:
mcnabb
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