Nokea
The nurse performing the health interview of a patient with a new onset of periorbital edema has completed a genogram, noting the health history of the patients siblings, parents, and grandparents. This assessment addresses the patients risk of what kidney disorder?
- A. Nephritic syndrome
- B. Acute glomerulonephritis
- C. Nephrotic syndrome
- D. Polycystic kidney disease (PKD)
Correct Answer: D
Rationale: PKD is a genetic disorder characterized by the growth of numerous cysts in the kidneys. Nephritic syndrome, acute glomerulonephritis, and nephrotic syndrome are not genetic disorders.
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The critical care nurse is monitoring the patients urine output and drains following renal surgery. What should the nurse promptly report to the physician?
- A. Increased pain on movement
- B. Absence of drain output
- C. Increased urine output
- D. Blood-tinged serosanguineous drain output
Correct Answer: B
Rationale: Urine output and drainage from tubes inserted during surgery are monitored for amount, color, and type or characteristics. Decreased or absent drainage is promptly reported to the physician because it may indicate obstruction that could cause pain, infection, and disruption of the suture lines. Reporting increased pain on movement has nothing to do with the scenario described. Increased urine output and serosanguineous drainage are expected.
An 84-year-old woman diagnosed with cancer is admitted to the oncology unit for surgical treatment. The patient has been on chemotherapeutic agents to decrease the tumor size prior to the planned surgery. The nurse caring for the patient is aware that what precipitating factors in this patient may contribute to AKI? Select all that apply.
- A. Anxiety
- B. Low BMI
- C. Age-related physiologic changes
- D. Chronic systemic disease
- E. NPO status
Correct Answer: C,D
Rationale: Changes in kidney function with normal aging increase the susceptibility of elderly patients to kidney dysfunction and renal failure. In addition, the presence of chronic, systemic diseases increases the risk of AKI. Low BMI and anxiety are not risk factors for acute renal disease. NPO status is not a risk, provided adequate parenteral hydration is administered.
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.
The nurse is caring for a patient who has returned to the postsurgical suite after post-anesthetic recovery from a nephrectomy. The nurses most recent hourly assessment reveals a significant drop in level of consciousness and BP as well as scant urine output over the past hour. What is the nurses best response?
- A. Assess the patient for signs of bleeding and inform the physician.
- B. Monitor the patients vital signs every 15 minutes for the next hour.
- C. Reposition the patient and reassess vital signs.
- D. Palpate the patients flanks for pain and inform the physician.
Correct Answer: A
Rationale: Bleeding may be suspected when the patient experiences fatigue and when urine output is less than 30 mL/h. The physician must be made aware of this finding promptly. Palpating the patients flanks would cause intense pain that is of no benefit to assessment.