Nokea
A client with renal insufficiency and a low red blood cell count asks, 'Is my anemia related to the renal insufficiency?' How should the nurse respond?
- A. Red blood cells produce erythropoietin, which increases blood flow to the kidneys.
- B. Your anemia and renal insufficiency are related to inadequate vitamin D and a loss of bone density.
- C. Erythropoietin is usually released from the kidneys and stimulates red blood cell production in the bone marrow.
- D. Kidney insufficiency inhibits active transportation of red blood cells throughout the blood.
Correct Answer: C
Rationale: The correct answer is C. Erythropoietin is produced in the kidney and is released in response to decreased oxygen tension in the renal blood supply. Erythropoietin stimulates red blood cell production in the bone marrow. Anemia in renal insufficiency is often due to decreased erythropoietin production. Anemia and renal insufficiency are not manifestations of vitamin D deficiency as stated in choice B. Choice A is incorrect as erythropoietin does not increase blood flow to the kidneys. Choice D is incorrect because kidney insufficiency does not inhibit active transportation of red blood cells throughout the blood; rather, it affects erythropoietin production and subsequent red blood cell formation.
You may also like to solve these questions
A client scheduled for the surgical creation of an ileal conduit expresses anxiety and asks about having a drainage tube. How should the nurse respond?
- A. I will ask the provider to prescribe you an antianxiety medication.
- B. Would you like to discuss the procedure with your doctor once more?
- C. I think it would be nice to not have to worry about finding a bathroom.
- D. Would you like to speak with someone who has an ileal conduit?
Correct Answer: D
Rationale: The most appropriate response for the nurse is to offer the client the opportunity to speak with someone who has undergone the same procedure. This allows the client to gain insight, ask questions, and share concerns with someone who has firsthand experience, which can help alleviate anxiety and promote a positive self-image. Seeking an antianxiety medication does not address the client's emotional concerns or promote a positive attitude towards the procedure. Discussing the procedure with the doctor again may provide more information but may not offer the same level of emotional support and understanding as speaking with someone who has lived through the experience. Commenting on the convenience of not having to search for a bathroom minimizes the client's anxiety and overlooks the emotional aspect of the client's concerns.
A client has just undergone insertion of a chest tube that is attached to a closed chest drainage system. Which action should the nurse plan to take in the care of this client?
- A. Assessing the client's chest for crepitus every 24 hours
- B. Taping the connections between the chest tube and the drainage system
- C. Adding 20 mL of sterile water to the suction control chamber every shift
- D. Recording the volume of secretions in the drainage collection chamber every 24 hours
Correct Answer: B
Rationale: The correct action for the nurse to take in caring for a client with a chest tube connected to a closed chest drainage system is to tape the connections between the chest tube and the drainage system. This is done to prevent accidental disconnection, ensuring the system functions properly. Assessing the client's chest for crepitus should be done more frequently than once every 24 hours to monitor for any air leaks. Adding sterile water to the suction control chamber is not necessary every shift; it should be done as needed to maintain the appropriate water level. Recording the volume of secretions in the drainage collection chamber should be done more frequently than every 24 hours, with hourly monitoring during the first 24 hours after insertion and every 8 hours thereafter to assess for changes or complications.
The nurse is preparing to administer intravenous gentamicin to an infant through an intermittent needle. The nurse notes that the infant has not had a wet diaper for several hours. The nurse will perform which action?
- A. Administer the medication and give the infant extra oral fluids.
- B. Contact the provider to request adding intravenous fluids when giving the medication.
- C. Give the medication and obtain a serum peak drug level 45 minutes after the dose.
- D. Hold the dose and contact the provider to request a serum trough drug level.
Correct Answer: D
Rationale: In this scenario, the infant not having a wet diaper for several hours indicates a potential decrease in urine output, which can be a sign of nephrotoxicity related to gentamicin. The correct action for the nurse is to hold the dose and contact the provider to request a serum trough drug level. This is important to monitor the drug levels and ensure that they are not reaching toxic levels. Administering the medication without addressing the decreased urine output could potentially lead to further nephrotoxicity. Contacting the provider to add intravenous fluids or obtaining a serum peak drug level are not the most appropriate actions in this situation as the priority is to assess for potential nephrotoxicity and ensure patient safety.
Prior to a percutaneous kidney biopsy, which actions should a nurse take? (Select all that apply.)
- A. Keep the client NPO for 4 to 6 hours.
- B. Obtain coagulation study results.
- C. Maintain strict bedrest in a supine position.
- D. A & B
Correct Answer: D
Rationale: Prior to a percutaneous kidney biopsy, the nurse should ensure that the client is kept NPO for 4 to 6 hours to prevent aspiration during the procedure. Obtaining coagulation study results is crucial to assess the risk of bleeding during and after the biopsy. Strict bedrest in a supine position is not necessary before the procedure. It is important to note that blood pressure medications should be carefully managed, but it is not a pre-procedure action. Keeping the client on bedrest or assessing for blood in the urine are interventions that are more relevant post-procedure to monitor for complications.
After teaching a client with renal cancer who is prescribed temsirolimus (Torisel), the nurse assesses the client's understanding. Which statement made by the client indicates a correct understanding of the teaching?
- A. I will take this medication with food and plenty of water.
- B. I shall keep my appointment at the infusion center each week.
- C. I'll limit my intake of green leafy vegetables while on this medication.
- D. I must not take this medication if I have an infection or am feeling ill.
Correct Answer: B
Rationale: The correct answer is B. Temsirolimus, also known as Torisel, is administered as a weekly intravenous infusion. This medication blocks protein needed for cell division, inhibiting cell cycle progression. It is not taken orally, so there is no need to take it with food or water. Keeping the weekly infusion center appointment is crucial for the client to receive the prescribed treatment effectively. Choice A is incorrect as temsirolimus is not taken with food or water. Choice C is incorrect because there is no need to limit the intake of green leafy vegetables while on this medication. Choice D is incorrect as having an infection or feeling ill does not prohibit the use of temsirolimus.