Altered Elimination Flashcards
A patient on a medical unit has a potassium level of 6.8 mEq/L. What is the priority action that the nurse should take?
a. Place the patient on a cardiac monitor.
b. Check the patient’s blood pressure (BP).
c. Instruct the patient to avoid high-potassium foods.
d. Call the lab and request a redraw of the lab to verify results.
a. Place the patient on a cardiac monitor.
In caring for the patient with AKI, of what should the nurse be aware?
a. The most common cause of death in AKI is irreversible metabolic acidosis.
b. During the oliguric phase of AKI, daily fluid intake is limited to 1000 mL plus the prior day’s measured fluid loss.
c. Dietary sodium and potassium during the oliguric phase of AKI are managed according to the patient’s urinary output.
d. One of the most important nursing measures in managing fluid balance in the patient with AKI is taking accurate daily weights.
d. One of the most important nursing measures in managing fluid balance in the patient with AKI is taking accurate daily weights.
A 68-yr-old man with a history of heart failure resulting from hypertension has AKI as a result of the effects of nephrotoxic diuretics. Currently his serum potassium is 6.2 mEq/L (6.2 mmol/L) with cardiac changes, his BUN is 108 mg/dL (38.6 mmol/L), his serum creatinine is 4.1 mg/dL (362 mmol/L), and his serum HCO3− is 14 mEq/L (14 mmol/L). He is somnolent and disoriented. Which treatment should the nurse expect to be used for him?
a. Loop diuretics
b. Renal replacement therapy
c. Insulin and sodium bicarbonate
d. One of the most important nursing measures in managing fluid balance in the patient with AKI is
taking accurate daily weights.
d. Sodium polystyrene sulfonate (Kayexalate)
b. Renal replacement therapy
Prevention of AKI is important because of the high mortality rate. Which patients are at increased risk for AKI? SATA
a. An 86-yr-old woman scheduled for a cardiac catheterization
b. A 48-yr-old man with multiple injuries from a motor vehicle accident
c. A 32-yr-old woman following a C-section delivery for abruptio placentae
d. A 64-yr-old woman with chronic heart failure admitted with bloody stools
e. A 58-yr-old man with prostate cancer undergoing preoperative workup for prostatectomy
all of the above
What indicates to the nurse that a patient with AKI is in the recovery phase?
a. A return to normal weight
b. A urine output of 3700 mL/day
c. Decreasing sodium and potassium levels
d. Decreasing blood urea nitrogen (BUN) and creatinine levels
d. Decreasing blood urea nitrogen (BUN) and creatinine levels
During the nursing assessment of the patient with renal insufficiency, the nurse asks the patient specifically about a history of
a. angina.
b. asthma.
c. hypertension.
d. rheumatoid arthritis.
c. hypertension.
An 83-yr-old female patient was found lying on the bathroom floor. She said she fell 2 days ago and has not been able to take her heart medicine or eat or drink anything since then. What conditions could be causing prerenal AKI in this patient? SELECT ALL THAT APPLY.
a. Anaphylaxis
b. Renal calculi
c. Hypovolemia
d. Nephrotoxic drugs
e. Decreased cardiac output
c. Hypovolemia
e. Decreased cardiac output
Which drugs will be used to treat the patient with CKD for mineral and bone disorder? SATA
a. Cinacalcet (Sensipar)
b. IV glucose and insulin
c. Calcium acetate (Eliphos)
d. IV 10% calcium gluconate
e. Sevelamer carbonate (Renvela)
a. Cinacalcet (Sensipar)
c. Calcium acetate (Eliphos)
e. Sevelamer carbonate (Renvela)
A patient with an obstruction of the renal artery causing renal ischemia exhibits hypertension. What is one factor that may contribute to the hypertension?
a. Increased renin release
b. Increased ADH secretion
c. Decreased aldosterone secretion
d. Increased synthesis and release of prostaglandins
a. Increased renin release
The nurse is reviewing a client’s record and notes that the primary health care provider has documented that the client has chronic kidney disease. On review of the laboratory results, the nurse most likely would expect to note which finding?
a. Elevated creatinine level
b. Decreased hemoglobin level
c. Decreased red blood cell count
d. Increased number of white blood cells in the urine
a. Elevated creatinine level
What is the most serious electrolyte disorder associated with kidney disease?
a. Hypocalcemia
b. Hyperkalemia
c. Hyponatremia
d. Hypermagnesemia
b. Hyperkalemia
Which complication of chronic kidney disease is treated with erythropoietin?
a. Anemia
b. Hypertension
c. Hyperkalemia
d. Mineral and bone disorder
a. Anemia
A dehydrated patient is in the Injury stage of the RIFLE staging of AKI. What would the nurse first anticipate in the treatment of this patient?
a. Assessment of daily weight
b. IV administration of fluid and furosemide (Lasix)
c. IV administration of insulin and sodium bicarbonate
d. Urinalysis to check for sediment, osmolality, sodium, and specific gravity
b. IV administration of fluid and furosemide (Lasix)
In replying to a patient’s questions about the seriousness of her chronic kidney disease (CKD), the nurse knows that the stage of CKD is based on what?
a. Total daily urine output
b. Glomerular filtration rate (GFR)
c. Degree of altered mental status
d. Serum creatinine and urea levels
b. Glomerular filtration rate (GFR)
While caring for the patient in the oliguric phase of AKI, the nurse monitors the patient for associated collaborative problems. When should the nurse notify the HCP?
a. Urine output is 300 mL/day.
b. Edema occurs in the feet, legs, and sacral area.
c. Cardiac monitor reveals a depressed T wave and elevated ST segment.
d. The patient experiences increasing muscle weakness and abdominal cramping.
d. The patient experiences increasing muscle weakness and abdominal cramping.
