Renal System Flashcards Preview

HESI NCLEX-RN EXAMINATION > Renal System > Flashcards

Flashcards in Renal System Deck (33)
Loading flashcards...
1

Normally, kidneys excrete approximately

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

2

Adults normal urine output

1500-2000ml

3

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

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

4

Body weight is a good indicator of

Fluid retention and renal status.

5

Obtain accurate weights of all clients with renal failure

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

6

Signs of excess fluid

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

7

Signs of fluid deficit syndrome

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

8

Signs of hyperkalemia

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

9

High Potassium foods

Bananas
Orange Juice
Cantaloupe
Strawberries
Avocados
Spinach
Fish

10

Clients with renal failure

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

11

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

protein intake

12

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

uremia

13

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

protein consumption

14

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

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

15

In CRF protein intake is

restricted

16

Signs of digoxin toxicity

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

17

Flank pain usu means the stone is in the

kidney or upper ureter

18

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

Ureter or bladder

19

excruciating spastic type pain is called

Colic

20

Percutaneous nephrostomy

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.

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

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

22

The solution used to irrigate for a TUPR must be

isotonic to prevent fluid and electrolyte imbalance.

23

Differentiate between acute renal failure and chronic renal failure

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

24

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

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

25

Identify two nursing interventions for the client on hemodialysis

-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

26

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

Risk for imbalance fluid volume

27

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

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.

28

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

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

29

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

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

30

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

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