A nurse is caring for an elderly client in a medical unit.
For each nursing intervention listed below, indicate whether the intervention is appropriate for managing acute kidney injury (AKI), chronic kidney disease (CKD), or both. Each intervention may be associated with more than one condition
Educate on limiting foods high in phosphorus
Administer corticosteroids for nephrotic syndrome
Ensure informed consent for renal diagnostic procedures
Monitor fluid intake and output
The Correct Answer is {"A":{"answers":"B"},"B":{"answers":"A,B"},"C":{"answers":"A,B"},"D":{"answers":"A,B"}}
- Educating on limiting foods high in phosphorus is more specific to chronic kidney disease, where impaired renal excretion causes long-term hyperphosphatemia. This education helps prevent complications such as renal osteodystrophy and secondary hyperparathyroidism that occur in progressive CKD.
- Administering corticosteroids for nephrotic syndrome may be relevant in both acute and chronic presentations because nephrotic syndrome can occur as a complication of glomerular injury. Corticosteroids help reduce inflammation and proteinuria regardless of whether the renal impairment is acute or chronic.
- Ensuring informed consent for renal diagnostic procedures applies to both AKI and CKD since clients with either condition may require imaging, biopsy, or dialysis access placement. Informed consent ensures patient understanding and legal protection while promoting safety in invasive interventions.
- Monitoring fluid intake and output is essential in both AKI and CKD because altered kidney function leads to fluid imbalance. Careful monitoring helps guide fluid restriction or replacement, prevents overload, and assists in evaluating renal function changes over time.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Encourage intake of at least 3 L of fluids per day: Increasing fluid intake helps dilute the urine, reduces urinary stasis, and promotes the passage of stones. Adequate hydration is a cornerstone of both treatment and prevention of further stone formation in clients with urolithiasis.
B. Apply cold compress to the client's flank area: Cold therapy is not typically effective for renal colic pain, which is best managed with analgesics, hydration, and sometimes heat. Cold compresses may provide minimal relief but do not address the underlying problem.
C. Restrict protein intake to 2 servings per day: Protein restriction may be advised for certain metabolic disorders, but it is not a standard intervention for all patients with urolithiasis. Nutritional adjustments depend on the type of stone, and general protein restriction is not universally recommended.
D. Discourage ambulation: Ambulation is encouraged because movement can help facilitate the passage of kidney stones. Discouraging activity would prolong discomfort and delay recovery, making this an inappropriate action in the care plan.
Correct Answer is A
Explanation
A. RBC: Chronic glomerulonephritis often leads to anemia because the damaged kidneys produce less erythropoietin, a hormone necessary for red blood cell production. A decrease in RBC count is therefore an expected finding in this condition.
B. Potassium: Potassium levels usually increase rather than decrease in chronic glomerulonephritis because of reduced kidney function and impaired excretion. Hyperkalemia is a common complication that requires close monitoring.
C. Phosphate: Phosphate levels tend to rise in chronic kidney disease since the kidneys cannot excrete phosphate efficiently. This leads to hyperphosphatemia, which contributes to bone mineral imbalances, not a decrease.
D. Creatinine: Creatinine levels increase in chronic glomerulonephritis because of impaired filtration and reduced clearance. Elevated serum creatinine is one of the key indicators of declining kidney function.
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