A client is diagnosed with chronic kidney disease, stage 5. The nurse knows at this stage the client will have to include which of the following in their treatment that has not been needed in previous stages?

Choice a reason: Assessing kidney function is typically done using less invasive tests, such as blood tests to measure serum creatinine and blood urea nitrogen (BUN), and urine tests to assess protein levels, blood, and other markers. While renal biopsy provides detailed information about kidney tissue, it is not the primary method used solely for assessing kidney function.
Choice b reason: Diagnosing kidney diseases is the primary purpose of a renal biopsy. This procedure involves taking a small sample of kidney tissue, which is then examined under a microscope. A renal biopsy can provide detailed information about the type, severity, and progression of kidney disease, helping healthcare providers to make accurate diagnoses and develop appropriate treatment plans. It is particularly useful in cases of unexplained kidney dysfunction, nephrotic syndrome, and certain types of glomerulonephritis.
Choice c reason: Treating kidney infections is typically done through medication, primarily antibiotics. A renal biopsy is not used as a treatment method for infections. While it may help diagnose conditions that predispose to infections, the biopsy itself does not serve as a treatment for kidney infections.
Choice d reason: Removing kidney stones is performed through various surgical and non-surgical methods, such as lithotripsy, ureteroscopy, or percutaneous nephrolithotomy. A renal biopsy is not used for the removal of kidney stones. Instead, it focuses on obtaining tissue samples for diagnostic purposes, not for treating or removing physical obstructions like stones.

Choice a reason: Specific gravity measures the concentration of solutes in the urine. In glomerulonephritis, urine may be more dilute due to the kidneys' inability to concentrate urine properly, leading to a decrease rather than an increase in specific gravity.
Choice b reason: Creatinine clearance is a measure of the rate at which creatinine is cleared from the blood by the kidneys. In glomerulonephritis, kidney function is impaired, resulting in decreased creatinine clearance. Therefore, an increase in creatinine clearance is not expected in this condition.
Choice c reason: BUN (blood urea nitrogen) and serum creatinine are waste products filtered out of the blood by the kidneys. In glomerulonephritis, the kidneys' filtering capability is compromised, leading to the accumulation of these waste products in the blood. Hence, an increase in BUN and serum creatinine levels is expected in clients with glomerulonephritis, indicating reduced kidney function.
Choice d reason: RBC (red blood cell) count in the blood is not typically affected by glomerulonephritis. However, microscopic hematuria (the presence of red blood cells in urine) is a common finding in glomerulonephritis, indicating damage to the glomeruli. The RBC count in the blood itself is not expected to increase as a result of glomerulonephritis.