Nokea
A nurse is caring for a patient who is in the diuresis phase of AKI. The nurse should closely monitor the patient for what complication during this phase?
- A. Hypokalemia
- B. Hypocalcemia
- C. Dehydration
- D. Acute flank pain
Correct Answer: C
Rationale: The diuresis period is marked by a gradual increase in urine output, which signals that glomerular filtration has started to recover. The patient must be observed closely for dehydration during this phase; if dehydration occurs, the uremic symptoms are likely to increase. Excessive losses of potassium and calcium are not typical during this phase, and diuresis does not normally result in pain.
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A patient on the medical unit has a documented history of polycystic kidney disease (PKD). What principle should guide the nurses care of this patient?
- A. The disease is self-limiting and cysts usually resolve spontaneously in the fifth or sixth decade of life.
- B. The patients disease is incurable and the nurses interventions will be supportive.
- C. The patient will eventually require surgical removal of his or her renal cysts.
- D. The patient is likely to respond favorably to lithotripsy treatment of the cysts.
Correct Answer: B
Rationale: PKD is incurable and care focuses on support and symptom control. It is not self-limiting and is not treated surgically or with lithotripsy.
The nurse is caring for a patient in acute kidney injury. Which of the following complications would most clearly warrant the administration of polystyrene sulfonate (Kayexalate)?
- A. Hypernatremia
- B. Hypomagnesemia
- C. Hyperkalemia
- D. Hypercalcemia
Correct Answer: C
Rationale: Hyperkalemia, a common complication of acute kidney injury, is life-threatening if immediate action is not taken to reverse it. The administration of polystyrene sulfonate reduces serum potassium levels.
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.
A patient is scheduled for a CT scan of the abdomen with contrast. The patient has a baseline creatinine level of 2.3 mg/dL. In preparing this patient for the procedure, the nurse anticipates what orders?
- A. Monitor the patients electrolyte values every hour before the procedure.
- B. Preprocedure hydration and administration of acetylcysteine
- C. Hemodialysis immediately prior to the CT scan
- D. Obtain a creatinine clearance by collecting a 24-hour urine specimen.
Correct Answer: B
Rationale: Radiocontrast-induced nephropathy is a major cause of hospital-acquired acute kidney injury. Baseline levels of creatinine greater than 2 mg/dL identify the patient as being high risk. Preprocedure hydration and prescription of acetylcysteine (Mucomyst) the day prior to the test is effective in prevention. The nurse would not monitor the patients electrolytes every hour preprocedure. Nothing in the scenario indicates the need for hemodialysis. A creatinine clearance is not necessary prior to a CT scan with contrast.
A patient is being treated for AKI and the patient daily weights have been ordered. The nurse notes a weight gain of 3 pounds over the past 48 hours. What nursing diagnosis is suggested by this assessment finding?
- A. Imbalanced nutrition: More than body requirements
- B. Excess fluid volume
- C. Sedentary lifestyle
- D. Adult failure to thrive
Correct Answer: B
Rationale: If the patient with AKI gains or does not lose weight, fluid retention should be suspected. Short-term weight gain is not associated with excessive caloric intake or a sedentary lifestyle. Failure to thrive is not associated with weight gain.