A home care visiting nurse suspects that an older adult client is developing chronic renal disease. Since the client has no history of cardiovascular disease, what data should the nurse assess further?
Reports of joint pain.
Increase in appetite.
Progressive edema.
Recent increase in thirst.
The Correct Answer is C
A. Reports of joint pain: Joint pain is more indicative of musculoskeletal issues rather than chronic renal disease. While joint pain can occur in some types of kidney disease, progressive edema is a more specific symptom.
B. Increase in appetite: An increase in appetite is not typically associated with chronic renal disease. Instead, clients with kidney disease may experience a decrease in appetite due to various factors such as nausea, vomiting, and changes in taste.
C. Progressive edema: Progressive edema, especially in the lower extremities and around the eyes (periorbital edema), can be a significant indicator of declining kidney function. It results from fluid retention due to impaired kidney filtration.
D. Recent increase in thirst: While increased thirst can be a symptom of chronic renal disease, it is not as specific as progressive edema. Increased thirst may occur due to other conditions or factors such as diabetes mellitus or dehydration.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. "High blood pressure reduces renal blood flow and harms the kidney tissue, causing this diagnosis." Chronic renal disease often develops as a complication of long-standing
hypertension. Persistent high blood pressure can damage the small blood vessels in the kidneys, reducing blood flow and causing kidney tissue damage over time.
B. "Thickening of the kidney structures and gradual death of nephrons has caused this diagnosis." This statement describes changes seen in conditions like diabetic nephropathy but is not specific to the development of renal disease in hypertension.
C. "Cysts compress renal tissue, which destroys the kidneys, causing this diagnosis." This statement describes the pathogenesis of polycystic kidney disease, not chronic renal disease due to hypertension.
D. "Immune complexes form in the kidney tissue and produce inflammation, causing this diagnosis." This statement describes the pathogenesis of glomerulonephritis, not chronic renal disease due to hypertension.
Correct Answer is C
Explanation
A. Docusate Sodium (Colace) is a stool softener and is not contraindicated in chronic renal disease.
B. Acetaminophen (Tylenol) is generally safe for use in chronic renal disease, but dosing adjustments may be necessary based on renal function.
C. Meperidine (Demerol) is contraindicated in clients with chronic renal disease because its metabolites can accumulate in renal impairment, leading to neurotoxicity and seizures. It is often replaced with alternative opioid analgesics like morphine or fentanyl in these patients.
D. Atorvastatin (Lipitor) is a statin medication used to lower cholesterol levels and is generally safe in chronic renal disease, although dosing adjustments may be needed depending on the severity of renal impairment.
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