Nokea
A client has a decreased secretion of erythropoietin from the kidneys due to end-stage kidney disease. The nurse explains that the decrease in erythropoietin will have what effect?
- A. Aemia from the decrease in maturation of red blood cells
- B. Decrease in blood sugar levels due to alteration in insulin levels
- C. Increase in blood sugar levels due to alteration in insulin levels
- D. Development of male sex characteristics
Correct Answer: A
Rationale: The kidneys secrete erythropoietin, which is a substance that promotes the maturation of red blood cells.
You may also like to solve these questions
A client with chronic glomerulonephritis has generalized edema. Which response by the nurse best describes why anasarca occurs with this disorder?
- A. Loss of serum protein causes the body's fluids to shift.
- B. High albumin levels in the blood attracts more fluid into the blood vessels.
- C. Too little sodium in the diet results in anasarca.
- D. When urine is retained in the body, it shifts the body's fluid into tissue spaces.
Correct Answer: A
Rationale: Anasarca is caused by the shift of fluid from the intravascular space to interstitial and intracellular locations, not by a shift of fluid from the tissues into the blood vessels. The fluid shift results from depletion of protein from the blood (serum) to the urine. Sodium intake should be limited in clients with renal disease, and too little sodium intake does not result in anasarca. Urinary retention is not indicated with anasarca.
A client is experiencing acute glomerulonephritis. Which assessment finding by the nurse is most important in determining the severity of the client's condition?
- A. Presence of albumin in the urine
- B. Dark smoky colored urine
- C. Blurred vision
- D. Peripheral edema
Correct Answer: C
Rationale: Visual disturbances can be indicative of rising blood pressure in a client with acute glomerulonephritis. Severe hypertension needs prompt treatment to prevent convulsions. Presence of albumin (protein) and RBCs in the urine, along with periorbital and peripheral edema, are common symptoms associated with glomerulonephritis.
A nephrostomy tube is inserted in a client with a large ureteral calculus. Which is the most important consideration in providing nursing care for this client?
- A. Clamp the tube for no longer than 2 hours at a time.
- B. Maintain free, continuous urine drainage.
- C. Leave nephrostomy site open to the air.
- D. Use only sterile NSS to irrigate the tube.
Correct Answer: B
Rationale: Clamping or kinking of the tube will create backup of urine into the renal pelvis, resulting in hydronephrosis and can contribute to renal damage. Always make sure the urine is allowed to flow continuously and freely and do not irrigate. The nephrostomy tube is inserted through a stab wound and enters the kidney. A sterile dressing should be used to prevent pathogen entry.
A client is administered dialystate solution through an abdominal catheter. The nurse notices that the return flow rate is slow, so the nurse advises the client to move to the other side. However, even after changing the client's position, the nurse does not observe an increase in return flow. Which of the following actions should the nurse perform to help accelerate the return flow rate?
- A. Disconnect the catheter and repay.
- B. Loosen the tubing clamp.
- C. Inform the physician that catheter may need repositioning.
- D. Stop the process for 5 minutes and resume later.
Correct Answer: C
Rationale: The nurse instills dialystate solution and clamps the tubing. If the return flow rate is slow, the nurse asks the client to move from side to side. If this maneuver is unsuccessful, the physician may need to reposition the catheter. The nurse should not tamper with the catheter settings because this may worsen the client's condition or damage the apparatus. Also, stopping the process and resuming it after 5 minutes will not help increase the return flow of the dialystate.
The nurse evaluates the client as experiencing symptoms of disequilibrium syndrome, following an initial hemodialysis treatment. Which is the appropriate action to be taken by the nurse?
- A. No action is needed.
- B. Hold the next scheduled treatment.
- C. Slow the dialysis process during future treatment.
- D. Notify the physician and manage the symptoms.
Correct Answer: C
Rationale: Disequilibrium syndrome is a neurologic condition believed to be caused by cerebral edema associated with rapid movement of water. The symptoms are self-limiting and disappear within several hours after dialysis but can be prevented by slowing the dialysis process to allow time for gradual equilibrium of water. The nurse should document the symptoms and notify the physician with repeated incidence.