Renal System

Question 1

A client with acute kidney injury has a serum potassium of 6.0mEq/L. The nurse should plan which action as a priority?

Answer 1

Place the client on a cardiac monitor.

The pt with hyperkalemia is at risk of developing cardiac dysrhythmias & cardiac arrest.

Question 2

A client arrives at the ER with complaints of low abdominal pain & hematuria. The client is afebrile. The nurse next assess the client to determine a hx of which condition?

Answer 2

Trauma to the bladder or abdomen.

Bladder trauma or injury should be considered or suspected in the client w/low abdominal pain & hematuria.

Question 3

The nurse monitoring a client receiving peritoneal dialysis notes that the client’s outflow is less than the inflow. Which actions should the nurse take?
SATA

Answer 3

1. Check the level of the drainage bag
2. Reposition the client to his/her side
3. Place the client in good body alignment
4. Check the peritoneal dialysis system for kinks

Question 4

A client being hemodialyzed suddenly becomes short of breath & complains of chest pain. The pt is tachycardic, pale, & anxious & the nurse suspects air embolism. What is the priority nursing action?

Answer 4

Discontinue dialysis & notify the HCP

Air embolism is an ER situation that affects the cardiopulmonary system suddenly.

Question 5

Normal Glomerular filtration rate:

Answer 5

The creatinine clearance test provides the best estimate of GFR: GFR is 125 mL/minute.

Question 6

Nephrons

Answer 6

1. Functional units of the kidney

2. Selectively absorbs & reabsorbs ions & filtrates, including fluid, wastes, electrolytes, acids, & bases.

Question 7

Antidiuretic hormone hormone (ADH)

Answer 7

Is primarily responsible for the reabsorption of water by the kidneys.

Question 8

ADH is stimulated?

Answer 8

ADH is stimulated by dehydration or high sodium intake & by a decrease in the blood volume.

Question 9

Kidneys secrete renin for?

Answer 9

Secrete renin to regulate the BP & erythropoietin to stimulate stimulate the bone marrow to produce RBCs.

Question 10

Kidneys also regulate:

Answer 10

Water volume, concentrations, pH levels

Question 11

Nephron

“Real business blood processing, pee making begins”

Answer 11

1. Glomerular filtration
2. Tubular reabsorption
3. Tubular secretion

Question 12

Glomerular Capsule aka “Bowman’s Capsule”

Answer 12

Fluid & particles from the blood such as electrolytes, glucose, amino acids, & metabolic waste (glomerular filtrate) are filtered through the glomerular membrane into fluid-filled space in Bowman’s capsule & then enters the proximal convoluted tubule (PCT)

Question 13

Leukocytes

Answer 13

Pyuria

UTI

Question 14

Leukocytes in the urine

Answer 14

Pyuria

UTI

Question 15

Glucose in the urine

Answer 15

Glycosuria

Diabetes

Question 16

Erythrocytes in the urine

Answer 16

Hematuria

Bleeding in the urinary tract

Question 17

Proteins in the urine

Answer 17

Proteinuria, Albuminuria
working out too much
Pregnancy
High BP
Severe HTN
Heart Failure

Question 18

Actual production of urine is affected by many factors

Answer 18

Production of urine must be influenced by blood, specifically:
Volume & Pressure

Question 19

Kidneys can only filter for so long, they have to maintain a constant flow of blood passing through the glomerulus every minute.

Answer 19

Glomerular Filtration Rate

Question 20

When ADH is lacking

Answer 20

The pt develops Diabetes Insipidus

Question 21

Pts who develop Diabetes Insipidus,

Answer 21

produce large amounts of dilute urine

TX is necessary because pt cannot drink enough water to survive.

Question 22

Urine production

Answer 22

As fluid flows through the tubules,
Water, electrolytes, & solutes are REABSORBED
Creatinine, Hydrogen ions & Potassium are SECRETED.

Question 23

Ureters

Answer 23

Contain smooth muscle

Question 24

Ureters

Answer 24

Contain smooth muscle that contracts to move urine through peristalsis