Chapter 44 Flashcards
A nursing instructor is talking with her clinical group about patients with acute glomerulonephritis. The instructor tells the students that the patient may exhibit which of the following clinical manifestations?
Hematuria
You are caring for a patient with acute renal failure. What is the most common clinical manifestation of acute renal failure?
Oliguria
The nurse is caring for a patient with a history of systemic lupus erythematosus who has been recently diagnosed with ESRD. The patient has an elevated phosphorus level and has been prescribed calcium acetate to bind the phosphorus. What is an important instruction that the nurse should give the patient about how to take the prescribed phosphorus-binding medication?
With each meal
The nurse is working on the renal transplant unit. To reduce the risk of infection in a patient with a transplanted kidney, it is imperative for the nurse to do what?
Wash hands carefully and frequently.
The nurse is caring for a patient receiving hemodialysis treatments. The patient has had surgery to form an arteriovenous fistula. What is most important for the nurse to be aware of when providing care for this patient?
Taking a blood pressure reading on the affected arm can cause clotting of the fistula.
A patient has a glomerular filtration rate (GFR) of 43 mL/min/1.73 m2. Based upon this GFR, the nurse interprets that the patient’s chronic kidney disease is at what stage?
Stage 3
A college football player is brought to the emergency room by paramedics after a blunt trauma injury received during a game. There is a high suspicion that the patient has sustained an injury to his kidneys from being tackled from behind. The emergency room nurse caring for the patient reviews the initial orders written by the physician and notes that an order has been written to collect all voided urine and send it to the laboratory for analysis. The nurse understands that this nursing intervention is important because
Hematuria is the most common manifestation of renal trauma and blood losses may be microscopic, so laboratory analysis is essential.
A patient admitted with nephrotic syndrome is being cared for on your unit. When writing this patient’s care plan, based upon the major clinical manifestation of nephrotic syndrome, what nursing diagnosis would you include?
Excess fluid volume related to generalized edema
The nurse coming on shift is taking a report on four patients. What patient does the nurse know is at the greatest risk of developing end-stage renal disease (ESRD)?
Diabetes mellitus with poorly controlled hypertension
A patient waiting for a kidney transplant asks the nurse what signs and symptoms most likely indicate rejection. What would be the nurse’s best response?
“Oliguria is a sign of rejection.”
The nurse is caring for a patient in acute renal failure. The nurse should expect hypertonic glucose, insulin infusions, and sodium bicarbonate to be used to treat:
Hyperkalemia.
Renal failure can have prerenal, renal, or postrenal causes. A patient presents with acute renal failure and is being assessed to determine where, physiologically, the cause is. If the cause is found to be prerenal, which condition most likely caused it?
Heart failure
A 45-year-old man with diabetic nephropathy has end-stage renal failure and is starting dialysis. He asks for information about hemodialysis. What would the nurse include in the teaching for this patient?
Hemodialysis is a treatment option that is required three times a week
A patient is receiving patient education prior to beginning continuous ambulatory peritoneal dialysis. What would the nurse teach the patient that the most common complication associated with this procedure is
Peritonitis
The nurse is planning patient teaching for a patient with end-stage renal disease who is scheduled for the creation of a fistula. The nurse would include which of the following in teaching the patient about the fistula?
A vein and an artery in your arm will be attached surgically.