Nokea
The client diagnosed with CKD has a new arteriovenous fistula in the left forearm. Which intervention should the nurse implement?
- A. Teach the client to carry heavy objects with the right arm.
- B. Perform all laboratory blood tests on the left arm.
- C. Instruct the client to lie on the left arm during the night.
- D. Discuss the importance of not performing any hand exercises.
Correct Answer: A
Rationale: To protect the new AV fistula, the client should avoid stress on the left arm. Carrying heavy objects with the right arm prevents fistula damage. Blood tests should avoid the fistula arm, lying on it risks compression, and hand exercises are encouraged to promote fistula maturation.
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The client with a history of renal calculi calls the clinic and reports having burning on urination, chills, and an elevated temperature. Which instruction should the nurse discuss with the client?
- A. Increase water intake for the next 24 hours.
- B. Take two (2) Tylenol to help decrease the temperature.
- C. Come to the clinic and provide a urinalysis specimen.
- D. Use a sterile 4×4 gauze to strain the client’s urine.
Correct Answer: C
Rationale: Burning, chills, and fever suggest a UTI, possibly related to calculi. A urinalysis specimen is needed to diagnose and guide treatment. Increasing fluids, taking Tylenol, or straining urine are secondary.
Which intervention should the nurse implement when caring for the client with a nephrostomy tube?
- A. Change the dressing only if soiled by urine.
- B. Clean the end of the connecting tubing with Betadine.
- C. Clean the drainage system every day with bleach and water.
- D. Assess the tube for kinks to prevent obstruction.
Correct Answer: D
Rationale: Assessing for kinks ensures patency of the nephrostomy tube, preventing urine backup and complications. Dressings are changed regularly, Betadine is not used for tubing, and bleach cleaning is inappropriate.
Which statements made by the client's spouse most closely correlate with the diagnosis of acute glomerulonephritis? Select all that apply.
- A. My spouse's face looks rather puffy lately.
- B. Recently my spouse has been quite forgetful.
- C. My spouse has been salting food heavily.
- D. My spouse has been eating very well.
- E. My spouse hasn't been eating very well.
- F. My spouse gets up at night to use the bathroom.
Correct Answer: A,F
Rationale: Facial puffiness and nocturia are symptoms of glomerulonephritis, reflecting fluid retention and impaired kidney function.
The nurse is preparing a teaching care plan for the client diagnosed with nephrotic syndrome. Which intervention should the nurse include?
- A. Stop steroids if a moon face develops.
- B. Provide teaching for taking diuretics.
- C. Increase the intake of dietary sodium.
- D. Report a decrease in daily weight.
Correct Answer: B
Rationale: Diuretics are commonly prescribed in nephrotic syndrome to manage edema. Teaching proper diuretic use (e.g., timing, side effects like hypokalemia) is essential. Stopping steroids for moon face is incorrect, increasing sodium worsens edema, and weight loss is expected, not a concern.
The nurse observes red urine and several large clots in the tubing of the normal saline continuous irrigation catheter for the client who is one (1) day postoperative TURP. Which intervention should the nurse implement?
- A. Remove the indwelling catheter.
- B. Titrate the NS irrigation to run faster.
- C. Administer protamine sulfate IVP.
- D. Administer vitamin K slowly.
Correct Answer: B
Rationale: Red urine and clots indicate bleeding. Increasing the irrigation rate clears clots and prevents catheter obstruction. Removing the catheter is premature, and protamine/vitamin K are for anticoagulant reversal, not surgical bleeding.