Nokea
A nurse is caring for a patient with impaired renal function. A creatinine clearance measurement has been ordered. The nurse should facilitate collection of what samples?
- A. A fasting serum potassium level and a random urine sample
- B. A 24-hour urine specimen and a serum creatinine level midway through the urine collection process
- C. A BUN and serum creatinine level on three consecutive mornings
- D. A sterile urine specimen and an electrolyte panel, including sodium, potassium, calcium, and phosphorus values
Correct Answer: B
Rationale: To calculate creatinine clearance, a 24-hour urine specimen is collected. Midway through the collection, the serum creatinine level is measured.
You may also like to solve these questions
The staff educator is giving a class for a group of nurses new to the renal unit. The educator is discussing renal biopsies. In what patient would the educator tell the new nurses that renal biopsies are contraindicated?
- A. A 64-year-old patient with chronic glomerulonephritis
- B. A 57-year-old patient with proteinuria
- C. A 42-year-old patient with morbid obesity
- D. A 16-year-old patient with signs of kidney transplant rejection
Correct Answer: C
Rationale: There are several contraindications to a kidney biopsy, including bleeding tendencies, uncontrolled hypertension, a solitary kidney, and morbid obesity. Indications for a renal biopsy include unexplained acute renal failure, persistent proteinuria or hematuria, transplant rejection, and glomerulopathies.
The nurse caring for a patient with suspected renal dysfunction calculates that the patients weight has increased by 5 pounds in the past 24 hours. The nurse estimates that the patient has retained approximately how much fluid?
- A. $1,300 \mathrm{~mL}$ of fluid in 24 hours
- B. $2,300 \mathrm{~mL}$ of fluid in 24 hours
- C. $3,100 \mathrm{~mL}$ of fluid in 24 hours
- D. $5,000 \mathrm{~mL}$ of fluid in 24 hours
Correct Answer: B
Rationale: An increase in body weight commonly accompanies edema. To calculate the approximate weight gain from fluid retention, remember that1 \mathrm{~kg}$ of weight gain equals approximately1,000 \mathrm{~mL}$ of fluid. Five lbs=2.27 \mathrm{~kg}=2,270 \mathrm{~mL}$.
A patient asks the nurse why kidney problems can cause gastrointestinal disturbances. What relationship should the nurse describe?
- A. The right kidneys proximity to the pancreas, liver, and gallbladder
- B. The indirect impact of digestive enzymes on renal function
- C. That the peritoneum encapsulates the GI system and the kidneys
- D. The left kidneys connection to the common bile duct
Correct Answer: A
Rationale: The proximity of the right kidney to the colon, duodenum, head of the pancreas, common bile duct, liver, and gallbladder may cause GI disturbances. The proximity of the left kidney to the colon (splenic flexure), stomach, pancreas, and spleen may also result in intestinal symptoms. Digestive enzymes do not affect renal function and the left kidney is not connected to the common bile duct.
A patients most recent laboratory findings indicate a glomerular filtration rate (GFR) of58 \mathrm{~mL} / \mathrm{min}$. The nurse should recognize what implication of this diagnostic finding?
- A. The patient is likely to have a decreased level of blood urea nitrogen (BUN).
- B. The patient is at risk for hypokalemia.
- C. The patient is likely to have irregular voiding patterns.
- D. The patient is likely to have increased serum creatinine levels.
Correct Answer: D
Rationale: The adult GFR can vary from a normal of approximately125 \mathrm{~mL} / \mathrm{min}(1.67$ to2.0 \mathrm{~mL} / \mathrm{sec})$ to a high of200 \mathrm{~mL} / \mathrm{min}$. A low GFR is associated with increased levels of BUN, creatinine, and potassium.
A nurse is caring for a 73-year-old patient with a urethral obstruction related to prostatic enlargement. When planning this patients care, the nurse should be aware of the consequent risk of what complication?
- A. Urinary tract infection
- B. Enuresis
- C. Polyuria
- D. Proteinuria
Correct Answer: A
Rationale: An obstruction of the bladder outlet, such as in advanced benign prostatic hyperplasia, results in abnormally high voiding pressure with a slow, prolonged flow of urine. The urine may remain in the bladder, which increases the potential of a urinary tract infection. Older male patients are at risk for prostatic enlargement, which causes urethral obstruction and can result in hydronephrosis, renal failure, and urinary tract infections.