Nokea
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.
You may also like to solve these questions
The client with chronic kidney disease is exhibiting signs of anemia. Which is the best nursing rationale for this symptom?
- A. Azotemia
- B. Diminished erythropoietin production
- C. Impaired immunologic response
- D. Electrolyte imbalances
Correct Answer: B
Rationale: Erythropoietin is a hormone produced in the kidneys, and this production is inadequate in chronic renal failure, which results in anemia. Azotemia, impaired immune response, and electrolyte imbalance are associated with chronic kidney disease but not indicated with anemia.
A client is diagnosed with polycystic kidney disease. Which symptom would the nurse most likely assess?
- A. Hypertension
- B. Flank pain
- C. Fever
- D. Periorbital edema
Correct Answer: A
Rationale: Hypertension is often present in clients with polycystic kidney disease at the time of diagnosis. Pain from retroperitoneal bleeding, lumbar discomfort, and abdominal pain also may be noted based on the size and effects of the cysts. Fever would suggest an infection. Periorbital edema is noted with acute glomerulonephritis.
The home health nurse reviews medications taken by the client with polycystic kidney disease. Which medication should be addressed first?
- A. Lovastatin
- B. Methylprednisolone
- C. Furosemide
- D. Ibuprofen
Correct Answer: D
Rationale: Nephrotoxic drugs are not administered to clients with renal disease unless no other therapeutic agent is available. Ibuprofen (Motrin) is a nephrotoxic drug and nephrotoxic medications, such as nonsteroidal anti-inflammatory drugs and cephalosporin antibiotics, should be avoided in treating clients with polycystic kidney disease. Lovastatin (Mevacor) (antihyperlipidemic agent) and methylprednisolone (Depo-Medrol) (steroid) are drugs presently being reviewed for slowing the rate of disease progression in clients with polycystic kidney disease and are not considered nephrotoxic. Furosemide (Lasix) is a diuretic and has no significance in causing renal damage.
A client with end-stage renal disease is scheduled to undergo a kidney transplant using a sibling donated kidney. The client asks if immunosuppressive drugs can be avoided. Which is the appropriate response by the nurse?
- A. Even a perfect match does not guarantee organ success.
- B. Immunosuppressive drugs guarantee organ success.
- C. The doctor may decide to delay the use of immunosuppressant drugs.
- D. Let's wait until after the surgery to discuss your treatment plan.
Correct Answer: A
Rationale: Even a perfect match does not guarantee that a transplanted organ will not be rejected. Immunosuppressive drugs are used in all organ transplants to decrease incidence of organ rejection. To provide the client with the information needed to provide informed consent, the treatment plan is reviewed and discussed prior to transplant.
The nurse is teaching a client diagnosed with polycystic kidney disease on the management of the disorder. Which statement made by the client indicates a need for further teaching?
- A. I inherited this disorder from one of my parents.
- B. The cysts can get quite large in size.
- C. As long as I have one normal kidney, I should be fine.
- D. If renal failure develops, I may need to consider dialysis.
Correct Answer: C
Rationale: Polycystic kidney disease is characterized by the formation of multiple cysts on both kidneys. Polycystic kidney disease is inherited as an autosomal dominant trait. The fluid-filled cysts can cause great enlargement of the kidneys and interfere with kidney function, which can eventually lead to renal failure.