Nokea
A 15-year-old is admitted to the renal unit with a diagnosis of postinfectious glomerular disease. The nurse should recognize that this form of kidney disease may have been precipitated by what event?
- A. Psychosocial stress
- B. Hypersensitivity to an immunization
- C. Menarche
- D. Streptococcal infection
Correct Answer: D
Rationale: Postinfectious causes of postinfectious glomerular disease are group A beta-hemolytic streptococcal infection of the throat that precedes the onset of glomerulonephritis by 2 to 3 weeks. Menarche, stress, and hypersensitivity are not typical causes.
You may also like to solve these questions
A patient with ESKD is scheduled to begin hemodialysis. The nurse is working with the patient to adapt the patients diet to maximize the therapeutic effect and minimize the risks of complications. The patients diet should include which of the following modifications? Select all that apply.
- A. Decreased protein intake
- B. Decreased sodium intake
- C. Increased potassium intake
- D. Fluid restriction
- E. Vitamin D supplementation
Correct Answer: A,B,D
Rationale: Restricting dietary protein decreases the accumulation of nitrogenous wastes, reduces uremic symptoms, and may even postpone the initiation of dialysis for a few months. Restriction of fluid is also part of the dietary prescription because fluid accumulation may occur. As well, sodium is usually restricted to 2 to 3 g/day. Potassium intake is usually limited, not increased, and there is no particular need for vitamin D supplementation.
A patient with chronic kidney disease has been hospitalized and is receiving hemodialysis on a scheduled basis. The nurse should include which of the following actions in the plan of care?
- A. Ensure that the patient moves the extremity with the vascular access site as little as possible.
- B. Change the dressing over the vascular access site at least every 12 hours.
- C. Utilize the vascular access site for infusion of IV fluids.
- D. Assess for a thrill or bruit over the vascular access site each shift.
Correct Answer: D
Rationale: The bruit, or thrill, over the venous access site must be evaluated at least every shift. Frequent dressing changes are unnecessary and the patient does not normally need to immobilize the site. The site must not be used for purposes other than dialysis.
A 45-year-old man with diabetic nephropathy has ESKD and is starting dialysis. What should the nurse teach the patient about hemodialysis?
- A. Hemodialysis is a treatment option that is usually required three times a week.
- B. Hemodialysis is a program that will require you to commit to daily treatment.
- C. This will require you to have surgery and a catheter will need to be inserted into your abdomen.
- D. Hemodialysis is a treatment that is used for a few months until your kidney heals and starts to produce urine again.
Correct Answer: A
Rationale: Hemodialysis is the most commonly used method of dialysis. Patients receiving hemodialysis must undergo treatment for the rest of their lives or until they undergo successful kidney transplantation. Treatments usually occur three times a week for at least 3 to 4 hours per treatment.
Renal failure can have prerenal, renal, or postrenal causes. A patient with acute kidney injury is being assessed to determine where, physiologically, the cause is. If the cause is found to be prerenal, which condition most likely caused it?
- A. Heart failure
- B. Glomerulonephritis
- C. Ureterolithiasis
- D. Aminoglycoside toxicity
Correct Answer: A
Rationale: By causing inadequate renal perfusion, heart failure can lead to prerenal failure. Glomerulonephritis and aminoglycoside toxicity are renal causes, and ureterolithiasis is a postrenal cause.
A patient with ESKD receives continuous ambulatory peritoneal dialysis. The nurse observes that the dialysate drainage fluid is cloudy. What is the nurses most appropriate action?
- A. Inform the physician and assess the patient for signs of infection.
- B. Flush the peritoneal catheter with normal saline.
- C. Remove the catheter promptly and have the catheter tip cultured.
- D. Administer a bolus of IV normal saline as ordered.
Correct Answer: A
Rationale: Peritonitis is the most common and serious complication of peritoneal dialysis. The first sign of peritonitis is cloudy dialysate drainage fluid, so prompt reporting to the primary care provider and rapid assessment for other signs of infection are warranted. Administration of an IV bolus is not necessary or appropriate and the physician would determine whether removal of the catheter is required. Flushing the catheter does not address the risk for infection.