Renal System

Question 1

Normally, kidneys excrete approximately

Answer 1

1ml of urine per kg of body weight per hour.

Question 2

Adults normal urine output

Answer 2

1500-2000ml

Question 3

In some cases, persons in ARF may not experience the oliguric phase but may progress

Answer 3

Directly to the diuretic phase, during which the urine output may be as much as 10L per day

Question 4

Body weight is a good indicator of

Answer 4

Fluid retention and renal status.

Question 5

Obtain accurate weights of all clients with renal failure

Answer 5

obtain weight on the same scale at the same time every day

Question 6

Signs of excess fluid

Answer 6

• Dyspnea
• Tachycardia
• Jugular vein distention
• Peripheral edema
• Pulmonary edema
• weight gain

Question 7

Signs of fluid deficit syndrome

Answer 7

• Decreased urine output
• Reduction in body weight
• Decreased skin turgor
• Dry mucous membranes
• Hypotension
• Tachycardia
• Weight loss

Question 8

Signs of hyperkalemia

Answer 8

• Dizziness
• weakness
• cardiac irregularities
• muscle cramps
• diarrhea
• nausea

Question 9

High Potassium foods

Answer 9

Bananas
Orange Juice
Cantaloupe
Strawberries
Avocados 
Spinach 
Fish

Question 10

Clients with renal failure

Answer 10

retain Na. Because of water retention serum levels may appear normal.

Question 11

During oliguric phase minimize protein breakdown and prevent rise in BUN by limiting

Answer 11

protein intake

Question 12

Accumulation of waste products from protein metabolism I the primary cause of

Answer 12

uremia

Question 13

The GFR is most often used as an indicator of the level of

Answer 13

protein consumption

Question 14

The major difference between dialysate for hemodialysis and peritoneal dialysis is the amount of

Answer 14

glucose
Peritoneal dialysis dialysate is much higher in glucose. Fro this reason if the dialysate is left in the peritoneal cavity too long hyperglycemia may occur

Question 15

In CRF protein intake is

Answer 15

restricted

Question 16

Signs of digoxin toxicity

Answer 16

• nausea
• vomiting
• anorexia
• visual disturbances
• restlessness
• headache
• cardiac dysrhythmias
• pulse >60

Question 17

Flank pain usu means the stone is in the

Answer 17

kidney or upper ureter

Question 18

If pain radiates to the abdomen or scrotum, the stone is likely to be in the

Answer 18

Ureter or bladder

Question 19

excruciating spastic type pain is called

Answer 19

Colic

Question 20

Percutaneous nephrostomy

Answer 20

A needle or catheter is inserted through the skin into the calyx of the kidney. The stone may be dissolved by percutaneous irrigation with a liquid that dissolves the stone or by ultrasonic sound waves that can directed through the needle or catheter to break up the stone. Stone is then eliminated through the urinary tract.

Question 21

Bladder spasms frequently occur after TUPR. Inform the client that the presence of the oversized balloon on the catheter with cause a continuous feeling of needing to void. The client should not

Answer 21

try to void around the catheter because this can precipitate a bladder spasm. Medications can reduce or prevent spasms should be given.

Question 22

The solution used to irrigate for a TUPR must be

Answer 22

isotonic to prevent fluid and electrolyte imbalance.

Question 23

Differentiate between acute renal failure and chronic renal failure

Answer 23

Acute: Reversible, abrupt
Chronic: Irreversible, slow, dialysis

Question 24

During the oliguric phase of renal failure, protein should be severely restricted, why?

Answer 24

Toxic metabolites that accumulate in the blood (urea, creatinine) are derived mainly from protein catabolism.

Question 25

Identify two nursing interventions for the client on hemodialysis

Answer 25

- Don't take blood pressure or perform venipuncture on the arm with AV shunt, fistula, or graft - Assess access site for a thrill and bruit

Question 26

What is the highest priority nursing diagnosis for clients with any type of renal failure?

Answer 26

Risk for imbalance fluid volume

Question 27

A client is renal failure asks why is being given antacids. How should the nurse reply?

Answer 27

Calcium and aluminum antacids bind phosphate and help to keep phosphates from being absorbed into the blood stream. Thereby preventing a rise in phosphate levels. Must be taken with meals.

Question 28

List four essential elements of a teaching plan for a clients with frequent UTI's?

Answer 28

- Fluid intake of 3L /day - Good handwashing - Void q 2-3 hrs during waking hours - Take all prescribed medications - Wear cotton undergarnments

Question 29

What are the most important nursing interventions for clients with possible renal calculi?

Answer 29

Straining all urine - accurate I and O documentation - administer analgesics as needed

Question 30

What discharge instructions should be given to a client who has had a renal calculi?

Answer 30

- Maintain high fluid intake 3-4L/day - Persue follow up care - Follow prescribed died based on calculi content - Avoid supine position

Question 31

Following a TURP resection of the prostate gland, hematuria should subside by what PO day?

Answer 31

Day 4

Question 32

After the urinary catheter is removed in the TUPR client, What are three priority nursing actions?

Answer 32

- Cont. strict I and O's - Cont observation for hematuria - Burning and frequency may last for a week

Question 33

After kidney surgery, What are the primary assessments the nurse should make?

Answer 33

Resp status Circulatory status Pain assessments urinary assessments