Ch. 59 Kidney Conditions Flashcards
The nurse receives report on a client with hydronephrosis. Which laboratory values will the nurse monitor?
A. Hemoglobin and hematocrit (H&H)
B. White blood cell (WBC) count
C. Blood urea nitrogen (BUN) and creatinine
D. Lipid levels
C. Blood urea nitrogen (BUN) and creatinine
The nurse is preparing a client for nephrostomy tube insertion. Which data must be assessed by the nurse before the procedure?
A. Blood urea nitrogen (BUN) and creatinine
B. Hemoglobin and hematocrit (H&H)
C. Intake and output (I&O)
D. Prothrombin time (PT) and international normalized ratio (INR)
D. Prothrombin time (PT) and international normalized ratio (INR)
When assessing a client with acute glomerulonephritis, which assessment finding causes the nurse to notify the primary health care provider?
A. Purulent wound on the leg
B. Crackles throughout the lung fields
C. History of diabetes
D. Cola-colored urine
B. Crackles throughout the lung fields
The nurse is caring for a client who had a nephrostomy tube inserted 4 hours ago. Which assessment requires nursing action?
A. Dark pink-colored urine
B. Small amount of urine leaking around the catheter
C. Tube that has stopped draining
D. Creatinine of 1.8 mg/dL
C. Tube that has stopped draining
The nurse is caring for a client with chronic glomerulonephritis (GN). Which assessment data requires the nurse to contact the healthcare provider?
A. Mild proteinuria
B. Third heart sound (S3)
C. Serum potassium of 5.0 mEq/L
D. Itchy skin
B. Third heart sound (S3)
The nurse is completing discharge teaching for a client with kidney disease. What will the nurse include?
A. “Weigh yourself and take your blood pressure.”
B. “Eat breakfast and go to bed at the same time every day.”
C. “Check your blood sugar and do a urine dipstick test.”
D. “Drink 2 L of fluid and urinate at the same time every day.”
A. “Weigh yourself and take your blood pressure.”
The school nurse is counseling a teenage student about how to prevent kidney trauma. Which student statement indicates a need for further teaching?
A. “I always wear a seat belt in the car.”
B. “I will avoid riding motorcycles.”
C. “I always wear pads when playing football.”
D. “I can’t play contact sports since my brother had kidney cancer.”
D. “I can’t play contact sports since my brother had kidney cancer.”
A client is hesitant to talk to the nurse about genitourinary dysfunction symptoms. What is the best nursing response?
A. “Why are you hesitant?”
B. “Don’t worry, no one else will know.”
C. “Take your time. What is bothering you the most?”
D. “You need to tell me so we can determine what is wrong.”
C. “Take your time. What is bothering you the most?”
The nurse is performing discharge teaching for a client after a nephrectomy for renal cell carcinoma. Which client statement indicates that teaching has been effective?
A. “I’ll eventually require some type of renal replacement therapy.”
B. “Since renal cell carcinoma usually affects both kidneys, I’ll need frequent biopsies.”
C. “I need to decrease my fluid intake to prevent stress to my remaining kidney.”
D. “My remaining kidney will provide normal kidney function in a few days or weeks.”
D. “My remaining kidney will provide normal kidney function in a few days or weeks.”
A client, who is a mother of two, has autosomal dominant polycystic kidney disease (ADPKD). Which client statement indicates to the nurse that further education is needed?
A. “By maintaining a low-salt diet in our house, I can prevent ADPKD in my children.”
B. “Even though my children don’t have symptoms at the same age I did, they can still have ADPKD.”
C. “If my children have the ADPKD gene, they will have cysts by the age of 30.”
D. “My children have a 50% chance of inheriting the ADPKD gene that causes the disease.”
A. “By maintaining a low-salt diet in our house, I can prevent ADPKD in my children.”
A client with chronic kidney disease asks the nurse about the relationship between the disease and high blood pressure. What is the most appropriate nursing response?
A. “Because the kidneys cannot get rid of fluid, blood pressure goes up.”
B. “The damaged kidneys no longer release a hormone that prevents high blood pressure.”
C. “The waste products in the blood interfere with mechanisms that control blood pressure.”
D. “There is a compensatory mechanism that increases blood flow through the kidneys in an effort to get rid of some of the waste products.”
A. “Because the kidneys cannot get rid of fluid, blood pressure goes up.”
When caring for a client 24 hours after a nephrectomy, the nurse assesses abdominal distention. Which action will the nurse perform next?
A. Check vital signs
B. Notify the surgeon
C. Continue to monitor
D. Insert a nasogastric (NG) tube
A. Check vital signs
After receiving change-of-shift report on the urology unit, which client will the nurse assess first?
A. Client post radical nephrectomy whose temperature is 99.8 F
B. Client with glomerulonephritis who has cola-colored urine
C. Client who was involved in a motor vehicle collision and has hematuria
D. Client with nephrotic syndrome who has gained 2 kg since yesterday
C. Client who was involved in a motor vehicle collision and has hematuria
The nurse is caring for a client with hemorrhage secondary to kidney trauma. Which element does the nurse anticipate will be used for volume expansion?
A. Fresh-frozen plasma
B. Platelet infusions
C. 5% dextrose in water
D. Normal saline solution
D. Normal saline solution
The RN is working with assistive personnel (AP) in caring for a group of clients. Which action is best for the RN to delegate to AP?
A. Assessing the vital signs of a client who was just admitted with blunt flank trauma and hematuria
B. Assisting a client who had a radical nephrectomy 2 days ago to turn in bed
C. Helping the health care provider with a kidney biopsy for a client with acute glomerulonephritis
D. Palpating for bladder distention on a client recently admitted with a ureteral stricture
B. Assisting a client who had a radical nephrectomy 2 days ago to turn in bed
