Ati med surg Woolery q6 (RENAL disorders)
Ati med surg Woolery q6 (RENAL disorders)
Total Questions : 23
Showing 10 questions Sign up for moreA client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?
Explanation
A. It helps to temporarily lower serum potassium levels by driving potassium into the cells. This effect is usually short-lived and is often used in emergency situations to quickly manage hyperkalemia.
B. Calcium Gluconate is used to stabilize the cardiac membrane in the setting of hyperkalemia, especially if there are ECG changes or symptoms of hyperkalemia. It does not lower the serum potassium level but helps protect the heart from the potential arrhythmias caused by elevated potassium levels.
C. Patiromer (Veltassa) is a potassium binder that helps to remove excess potassium from the body through the gastrointestinal tract. It binds potassium in the gut and facilitates its excretion in the stool.
D. Lisinopril is an ACE inhibitor used to treat hypertension and heart failure. It can actually increase potassium levels by decreasing the excretion of potassium through the kidneys.
The nurse is providing education to a male client who is newly-diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?
Explanation
A. Patients with PKD may have issues with kidney function over time, which can affect potassium levels. Typically, a high-potassium diet is not recommended for those with kidney problems because it can exacerbate hyperkalemia.
B. Polycystic kidney disease can lead to progressive loss of kidney function, and many patients eventually require dialysis or a kidney transplant as the disease advances and kidney function declines.
C. There is no general recommendation for a vasectomy solely based on having PKD. While PKD is a genetic condition, and individuals with PKD can pass the condition on to their children, there is no requirement for men with PKD to undergo sterilization.
D. People with PKD are potential candidates for kidney transplantation if their kidney function deteriorates to the point where dialysis is required. PKD itself does not disqualify individuals from receiving a kidney transplant.
A nurse is caring for a client who recently had a streptococcal infection of the throat, and is now experiencing new-onset flank pain. Urinalysis is positive for proteinuria and hematuria. The client's urine output for the past 24 hours has been 250 mL, and BUN and creatinine are elevated. On assessment, the nurse notes pitting edema to the bilateral lower extremities. Which of the following interventions is appropriate in the plan of care?
Explanation
A. Frequent ambulation could exacerbate the edema and is not a priority in the acute management of this condition.
B. Obtaining weight weekly is an appropriate intervention to monitor for changes in fluid status and guide treatment decisions.
C. A low-protein diet is not a standard treatment for PSGN.
D. Encouraging increased fluid intake is not recommended due to the client's oliguria and risk of fluid overload
A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?
Explanation
A. This method is the most reliable for measuring fluid retention. Weight changes are a direct indicator of fluid balance because fluid retention or loss affects body weight. By comparing the client's current weight to their post-dialysis weight, you can determine the amount of fluid they have retained.
B. Creatinine and blood urea nitrogen (BUN) levels are indicators of kidney function rather than fluid volume status. Elevated levels can indicate worsening kidney function but do not directly measure fluid retention or overload.
C. While assessing skin turgor and peripheral edema can provide some clues about fluid overload, these signs are less precise and subjective compared to weight measurements. Skin turgor changes and edema can be influenced by various factors, including skin elasticity and other conditions, making them less reliable for accurately measuring fluid volume changes since the last dialysis.
D. Crackles in lung sounds can indicate pulmonary congestion due to fluid overload, but this method is not as precise for quantifying the amount of fluid retained. Crackles suggest fluid accumulation in the lungs, which is a sign of more severe fluid overload but does not provide a specific measurement of fluid volume compared to changes in body weight.
A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?
Explanation
A. Calcium gluconate is used to treat or prevent calcium deficiencies and to manage conditions related to calcium imbalances, such as hypocalcemia. It is not typically used to prevent struvite stones.
B. Antibiotics are the most appropriate choice for preventing the recurrence of struvite stones. Since struvite stones are associated with urinary tract infections caused by urease-producing bacteria, antibiotic therapy is aimed at eliminating these infections. By treating or preventing UTIs, the conditions that lead to struvite stone formation are addressed, reducing the likelihood of recurrence.
C. Tamsulosin is an alpha-blocker used to relax the muscles in the prostate and bladder neck to improve urine flow in conditions like benign prostatic hyperplasia (BPH). It is not specifically used for preventing struvite stones.
D. Phosphate binders are used to reduce phosphate levels in the blood, which is important in managing conditions such as chronic kidney disease (CKD) where phosphate levels can be elevated.
Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?
Explanation
A. This is a pre-renal cause of acute kidney injury, related to decreased blood flow to the kidneys.
B. This is a post-renal cause of acute kidney injury, as it obstructs the outflow of urine.
C. This is an intrarenal cause of acute kidney injury, directly affecting the kidney tissue.
D. This is an intrarenal cause of acute kidney injury, related to damage to the small blood vessels in the kidneys.
A client with polycystic kidney disease is prescribed the medication Tolvaptan. What should the nurse include when educating the client about this medication.
Explanation
A. Tolvaptan does not increase the glomerular filtration rate. It actually works by blocking the action of a hormone that causes the kidneys to retain water, leading to increased urine output.
B. While Tolvaptan can slow the progression of polycystic kidney disease (PKD) and delay the need for dialysis or transplant, it does not guarantee prevention of these outcomes.
C. Tolvaptan is used to slow the growth of kidney cysts in patients with PKD.
D. Hyponatremia is a common side effect of Tolvaptan due to increased water loss through urine. However, this is not the primary role.
A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?
Explanation
A. Milk is low in purines and is not associated with an increase in uric acid levels or the formation of uric acid stones. In fact, dairy products like milk can be beneficial in a diet for managing kidney stones because they are low in purines and provide calcium, which may help prevent stone formation.
B. Liver is very high in purines. High-purine foods increase the levels of uric acid in the body, which can lead to the formation of uric acid stones in the kidneys. Therefore, clients with recurrent kidney stones due to excessive purine intake should avoid liver and other organ meats.
C. Spinach is considered to have a moderate level of purines. While it is not as high in purines as organ meats, it still contains a notable amount. However, in comparison to foods like liver, it is less of a concern for individuals who need to strictly limit purine intake.
D. Chocolate contains a moderate amount of purines, but it is not as high in purines as organ meats like liver. While it’s not completely free from purines, its purine content is generally lower compared to foods such as liver.
A patient who performs dialysis at home using a catheter placed through the abdominal wall reports nausea, vomiting, diarrhea, and fluid discharge from the catheter site. The laboratory reports reveal an increased white blood cell count (WBC). Which condition does the nurse suspect in the patient?
Explanation
A. This is an inflammation of the peritoneum, the lining of the abdominal cavity. It's a common complication of peritoneal dialysis (PD). Symptoms include nausea, vomiting, diarrhea, abdominal pain, and fever. Fluid discharge from the catheter site and an increased white blood cell count are also indicative of infection, supporting the diagnosis of peritonitis.
B. This is inflammation of the pericardium, the sac surrounding the heart. Symptoms typically include chest pain, shortness of breath, and irregular heartbeat.
C. This is inflammation of the pleura, the membranes surrounding the lungs. Symptoms include chest pain, shortness of breath, and dry cough.
D. This would present with severe abdominal pain, hypotension, and signs of shock. Nausea, vomiting, and diarrhea are not typical symptoms.
A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of untreated chronic kidney disease?
Explanation
A. These values are within normal ranges.
B. BUN is low, but potassium and creatinine are within normal ranges.
C. Elevated potassium (hyperkalemia), low hemoglobin (anemia), and elevated creatinine are all classic signs of chronic kidney disease.
D. BUN and creatinine are slightly elevated, but not to a level indicative of chronic kidney disease. Potassium is within normal range.
You just viewed 10 questions out of the 23 questions on the Ati med surg Woolery q6 (RENAL disorders) Exam. Subscribe to our Premium Package to obtain access on all the questions and have unlimited access on all Exams. Subscribe Now
