Renal

Question 1

During preadmission planning for a client scheduled for a renal transplant, the client should be educated by the nurse regarding which of the following?

1. Remind family and friends that there is restricted visiting for at least 72 hours postoperatively.
2. Arrange all live plants received postoperatively in one section of the room.
3. Continue intermittent peritoneal dialysis for 3 months following surgery.
4. Limit consumption of sodium-free liquids for 1 year postoperatively.

Answer 1

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Strategy: Answers are implementations. Determine the outcome of each answer choice. Is it desired?

(1) correct—transplant clients require protective isolation following surgery
(2) can’t have live plants in the room at all
(3) no need for dialysis following transplant
(4) need to force fluids, not restrict them

Question 2

An intravenous pyelogram (IVP) is ordered for a client scheduled to have the left kidney removed due to renal disease and hypertension. Which of the following nursing actions has the highest priority the evening before the IVP?

1. Administer a cathartic enema to cleanse the bowel.
2. Obtain information about client allergies.
3. Instruct the client to be NPO after midnight.
4. Teach the client that x-rays will be taken at multiple intervals.

Answer 2

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Strategy: Answers are a mix of assessments and implementations. Is the assessment appropriate? Yes.

(1) implementation; contains correct information, but is not a priority
(2) correct—assessment; clients sensitive to iodine can develop anaphylaxis; client should be asked specifically about allergies to iodine; iodine is present in the radiopaque material that is injected IV
(3) implementation; contains correct information, but is not a priority
(4) implementation; test may be canceled if the client is allergic to iodine

Question 3

A middle-aged adult is seen in the emergency department for complaints of severe right-flank pain. The client is 20 pounds overweight, lives a sedentary lifestyle, and was treated for renal calculi 4 years ago. Which of the following actions, if performed by the nurse, is MOST important?

1. Ensure that the client has nothing to eat or drink.
2. Obtain a "clean-catch" urine specimen for analysis.
3. Provide warm packs to relieve discomfort.
4. Measure and strain the client's urine.

Answer 3

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Strategy: “MOST important” indicates discrimination is required to answer the question.

(1) should force fluids to 3,000 mL/day to assist client to pass stone
(2) not most important, used to identify infection
(3) not most important, analgesics given to reduce discomfort
(4) correct—will document passage of stone and allow composition to be analyzed