A nurse is caring for a client in the nephrology unit.
In the context of diabetes impacting kidney health, which nursing actions are anticipated or contraindicated in managing potential complications?
Administer NSAIDs for pain relief
Encourage high-protein diet
Assess for signs of fluid overload
Monitor blood glucose levels regularly
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"A"}}
- Administering NSAIDs for pain relief is contraindicated because NSAIDs can further impair kidney function by reducing renal perfusion and promoting nephrotoxicity. In a client with elevated BUN and creatinine, these drugs can accelerate kidney injury and worsen fluid retention or hypertension.
- Encouraging a high-protein diet is contraindicated in this scenario. Excess protein intake increases the workload on the kidneys and can exacerbate azotemia in clients with chronic kidney disease, particularly when BUN and creatinine are already elevated.
- Assessing for signs of fluid overload is an anticipated nursing action. The client presents with edema, periorbital swelling, and decreased urine output, indicating fluid retention. Monitoring for increased edema, lung sounds, weight gain, and blood pressure helps prevent complications such as pulmonary edema or worsening hypertension.
- Monitoring blood glucose levels regularly is an anticipated nursing action because diabetes contributes to kidney damage and can complicate the management of chronic kidney disease. Maintaining optimal glucose control reduces further renal injury and helps prevent acute complications such as hyperglycemia-related fluid shifts.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Hypertension: Hypertension is a frequent cardiovascular complication of kidney failure. Impaired renal function leads to sodium and fluid retention as well as activation of the renin-angiotensin-aldosterone system, all of which contribute to elevated blood pressure and increased cardiac workload.
B. Osteoporosis: Osteoporosis is a complication more closely associated with mineral and bone disorders in chronic kidney disease due to altered calcium and phosphate balance, but it is not considered a cardiovascular complication.
C. Atherosclerosis: Atherosclerosis can occur in patients with kidney failure, especially due to dyslipidemia and chronic inflammation, but hypertension is more directly and commonly linked as the primary cardiovascular complication.
D. Respiratory depression: Respiratory depression is not a cardiovascular complication. It may occur as a side effect of medications such as opioids or due to severe acidosis, but it is unrelated to the cardiovascular impact of kidney failure.
Correct Answer is B
Explanation
A. Apply absorbent adult incontinence diapers and pads over the bed linens: Absorbent products may help keep the skin dry, but it does not address the patient’s continence needs or promote independence. Prolonged use also increases risk of skin breakdown and infection.
B. Assist the patient to the bathroom every 2 hours during the day: Scheduled toileting supports continence, reduces the risk of falls, and promotes dignity. It also helps prevent skin complications from incontinence and reduces the likelihood of urinary tract infections.
C. Restrict fluids between meals and after the evening meal: Fluid restriction is not appropriate in dehydration, as the patient needs fluid replacement to restore balance. Limiting fluids could worsen confusion, impair perfusion, and further elevate the risk of complications
D. Insert an indwelling catheter until the symptoms have resolved: Indwelling catheters increase the risk of urinary tract infections, especially in older adults. Catheterization should be avoided unless absolutely necessary for close monitoring of urine output or in cases of urinary obstruction.
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