Renal Flashcards
A client is admitted for treatment of chronic kidney injury (CKI). The nurse knows that this disorder increased the client’s risk of… (select all that apply)
A: decreased serum phosphate levels secondary to kidney failure
B: decreased serum calcium levels secondary to kidney failure
C: water and sodium retention secondary to a severe decrease in the glomerular filtration rate
D: metabolic acidosis secondary to retention of hydrogen ions
B,C,D
would not be decreased phosphate levels because with CKI, phosphate is elevated.
*Remember Calcium is decreased in CKI due to bone loss and decreased calcium
They have an inverse relationship
A client is admitted with nausea, vomiting, and diarrhea. His blood pressure on admission is 74/30 mmHg. The client is oliguric and his blood urea nitrogen (BUN) and creatinine levels are elevated. Which physician’s order would the nurse most likely anticipate
A: start IV fluids with a normal saline solution bolus followed by maintenance dose
B: administer a diuretic IV (drug which cause increase passing of urine)
C: encourage oral fluids
D: start hemodialysis after a temporary access is obtained
A
DON’T GET CONFUSED BY BOLUS
you would start IV with isotonic solution 0.9 NaCl or Ringer’s Lactate
the question talks about fluid loss and dehydration, meaning potassium is decreased (fluid loss).
90% needs to be damaged to start hemodialysis in CKI
Which of the following would the nurse expect to find when reviewing the laboratory test results of a client renal failure A: increase RBC count B: decreased serum potassium C: increased serum calcium level D: increased serum creatinine level
D: increased serum creatinine level
BUN up K would be up RBC decreased Ca decreased P increase and Mg Vitamin D decreased
A nurse assesses a client shortly after living donor kidney transplant surgery. Which postoperative finding must the nurse report immediately A: serum sodium 135 B: serum potassium 4.9 C: temperature 37.3 D: urine output 20ml/hr
D: urine output should be at LEAST 30ml/hr
this is a very frequently asked question as it can cover:
- inflammation
- acids and bases
- fluids and lytes
A client develops decreased renal function and requires a change in antibiotic dosage. On which factor should the physician base the dosage change? A: therapeutic index B: GI absorption rate C: Liver function studies D: Creatinine clearance
D
kidney function
monitoring and gages the GFR
IF GFR IS LOW, KIDNEYS ARE IMPAIRED
A history of infection specifically caused by group A strep is associated with which of the following disorders A: acute glomerulonephritis B: acute renal failure C: nephrotic syndrome D: chronic renal failure
A
same with hepatitis B and EBV- bacteria
acute renal failure is due to HYPO-PROFUSION or kidney damage
nephrotic syndrome: children under 3 boys with orbital swelling
chronic renal failure is with diabetes, lupus, hypertension
retention of which electrolyte is the most life-threatening effect of renal failure A: potassium B: calcium C: phosphorus D: sodium
A
elevated T waves
A nurse expect which of the following assessment findings in the client in the diuretic phase of AKI A: dehydration B: crackles C: hypertension D: hyperkalemia
D: dehydration
DIURETIC phase: you are in the process of recovering.
starts to get better, pee everything out decreasing BP and increasing dehydration.
Which nursing assessment finding indicates that the client who has undergone renal transplant has not met expected outcomes A: weight loss B: fever C: absence of pain D: diuresis
B: fever
weight loss normal because maybe swelling
absence of pain: pain killers
diuresis: good
The nurse is caring for a client who reports nausea vomiting. He is currently receiving IV fluids. BUN increased. Which is intervention that is appropriate.
A: collect urine specimens for culture and sensitivity
B: continue routine care
C: decrease IV fluid infusion rate and limit oral fluid intake
D: evaluate urine output for amount and urine for specific gravity
D: evaluate urine output for amount and urine for specific gravity
K is decreasing but is being corrected by IV
make sure he is peeing everything out
increase BUN meaning increase Urine Specific Gravity- kidney injury
Stat serum electrolytes ordered for a client in acute renal failure reveal serum potassium level of 6.4. the physician is immediately notified to order 50ml of dextrose and 10U of insulin IV push.
The nurse administering these drugs know the rationale for this therapy.
insulin brings K into the cell reducing K in the blood
Dextrose decreases hypoglycaemia because insulin administration
