Med-Surg II 7 Kidney Disoders Welcome to your MSII Kidney 7 A nurse is caring for a client diagnosed with chronic kidney disease (CKD) who is prescribed a low-protein diet. The client expresses frustration and dissatisfaction with the dietary restrictions. What is the nurse's most appropriate response? "I understand that the diet is challenging, but it is crucial for managing your condition and preventing further kidney damage." "It's okay to deviate from the diet occasionally to satisfy your cravings and make mealtime more enjoyable." "Let me speak with your healthcare provider to see if we can modify the diet to make it more palatable for you." "I can recommend some alternative protein sources that are lower in phosphorus and potassium to add variety to your meals." None A client with acute renal failure is receiving continuous renal replacement therapy (CRRT). The nurse notes that the client's potassium level is elevated, and the healthcare provider orders the administration of intravenous regular insulin and 50% dextrose. What is the primary purpose of this intervention? To promote diuresis and enhance potassium excretion. To shift potassium from the extracellular fluid into the cells. To inhibit the release of aldosterone and decrease potassium reabsorption. To increase urine output and flush out excess potassium. None A client with suspected renal dysfunction is scheduled for a renal biopsy. What information is essential for the nurse to include in the pre-procedure education for the client? "You will need to fast for 8 hours before the biopsy to ensure accurate test results." "Expect to experience frequent urination immediately after the procedure." "You will be placed in a prone position, and local anesthesia will be administered before the biopsy." "Renal biopsy is a painless procedure, and you can resume normal activities immediately afterward." None A client is scheduled for a renal arteriogram to evaluate renal blood flow. What nursing intervention is a priority for the client before the procedure? Administering an analgesic to manage potential post-procedural pain. Withholding food and fluids for at least 6 hours before the procedure. Encouraging the client to ambulate to prevent complications. Ensuring the client is well-hydrated before the procedure. None A client with a history of hypertension and diabetes mellitus is scheduled for renal function testing. The nurse reviews the client's laboratory results and notes an elevated blood urea nitrogen (BUN) level. What is the most appropriate nursing action? Instruct the client to increase dietary protein intake. Encourage increased fluid intake to flush out excess BUN. Monitor for signs and symptoms of dehydration. Notify the healthcare provider to discuss the elevated BUN level. None A client admitted with acute kidney injury is undergoing continuous monitoring of renal function, including serum creatinine levels. The nurse notes a sudden increase in the client's creatinine levels. What is the priority action for the nurse? Document the findings and continue routine monitoring. Administer a loop diuretic to enhance renal excretion. Increase intravenous fluids to promote renal perfusion. Prepare the client for emergent dialysis. None A client is scheduled for a urinalysis to assess renal function. The client asks the nurse why it is necessary. What is the most appropriate response by the nurse? "Urinalysis helps detect kidney stones by analyzing the mineral content in your urine." "This test provides information about the overall health of your kidneys by examining urine composition." "Urinalysis is primarily done to identify bacteria or viruses causing urinary tract infections." "It assesses the urine color to determine if you are adequately hydrated." None A client with a history of diabetes mellitus is undergoing urinalysis as part of routine monitoring. The nurse notes the presence of ketones in the urine. What is the most appropriate nursing action? Instruct the client to increase the intake of dietary fats. Advise the client to increase fluid intake to dilute ketones. Notify the healthcare provider and monitor blood glucose levels. Disregard the finding, as it is common in clients with diabetes. None A client with a history of kidney stones is scheduled for an abdominal computed tomography (CT) scan with contrast. The client expresses concern about the contrast dye and the possibility of an allergic reaction. What is the nurse's best response? "Allergic reactions to contrast dye are extremely rare, so there is no need to worry." "We will monitor you closely for any signs of an allergic reaction during the procedure." "It's important to fast for 12 hours before the CT scan to minimize the risk of an allergic response." "Contrast dye is not used in abdominal CT scans, so you don't need to be concerned." None A client is scheduled for a renal radiography to evaluate renal blood flow and identify any abnormalities in the urinary system. What information should the nurse provide to prepare the client for the procedure? "You will need to fast for 8 hours before the radiography to ensure accurate test results." "Expect to experience increased urination immediately after the procedure." "You may experience mild discomfort during the radiography, but it will be brief." "Radiography involves exposure to ionizing radiation, so inform the radiology team if you are pregnant." None A client with a suspected renal tumor is scheduled for a renal magnetic resonance imaging (MRI). The client expresses anxiety about the procedure. What is the most appropriate nursing action? Provide sedation to help the client relax during the MRI. Explain that MRI uses radiation to create detailed images of the kidneys. Reassure the client that MRI is a painless procedure without the use of radiation. Suggest canceling the MRI and exploring alternative diagnostic methods. None A pregnant client is scheduled for a renal ultrasound to assess kidney function. What information should the nurse provide to the client before the procedure? "Ensure you have a full bladder before the ultrasound to improve image quality." "Renal ultrasound involves the use of ionizing radiation, so inform the sonographer about your pregnancy." "There are no specific preparations for a renal ultrasound; you can eat and drink normally." "You may experience mild discomfort during the ultrasound, but it will be brief." None A pediatric client is scheduled for a voiding cystourethrogram (VCUG) to assess for possible vesicoureteral reflux. The parent expresses concern about the procedure's invasiveness. What is the nurse's best response? "VCUG is a noninvasive procedure that uses sound waves to create images of the urinary system." "The procedure involves injecting a contrast dye into the bladder through a catheter to assess for urinary reflux." "VCUG is a surgical procedure where a small tissue sample is taken from the kidney for further examination." "There's no need to worry; VCUG is a routine blood test to check for kidney function." None A client with suspected glomerulonephritis is scheduled for a renal biopsy. The client asks the nurse about the purpose of the procedure. What is the nurse's best response? "A renal biopsy involves injecting a contrast dye to visualize the blood flow in your kidneys." "The biopsy is done to remove a small sample of kidney tissue for examination and diagnosis." "It's a procedure to drain excess fluid from your kidneys and relieve pressure." "Renal biopsy is a minimally invasive surgery to remove kidney stones." None A client is scheduled for a cystoscopy to investigate recurrent urinary tract infections. The client expresses anxiety about the procedure. What is the most appropriate nursing action? Administer a sedative to help the client relax before the procedure. Inform the client that cystoscopy is a painful procedure but is brief. Reassure the client that cystoscopy is a painless procedure with minimal discomfort. Suggest canceling the cystoscopy and exploring alternative diagnostic methods. None A client is scheduled for a retrograde pyelogram to assess for urinary tract obstruction. What information should the nurse include in the pre-procedure education? "You will need to fast for 8 hours before the retrograde pyelogram to ensure accurate test results." "Expect to experience increased urination immediately after the procedure." "You may experience mild discomfort during the pyelogram, but it will be brief." "Inform the healthcare provider if you have a history of contrast dye allergies." None A client with a history of kidney disease is scheduled for a renal scan. The client asks the nurse about the purpose of the procedure. What is the nurse's best response? "The renal scan is performed to visualize the anatomy of your kidneys and urinary tract using X-rays." "It's a test to measure the pressure inside your kidneys and assess their blood flow." "A renal scan involves injecting a radioactive tracer to evaluate the structure and function of your kidneys." "The procedure is done to drain excess fluid from your kidneys and relieve pressure." None A client is scheduled for excretory urography to investigate recurrent urinary tract infections. What information should the nurse include in the pre-procedure education? "You will need to fast for 8 hours before the urography to ensure accurate test results." "Expect to experience increased urination immediately after the procedure." "You may experience mild discomfort during the urography, but it will be brief." "Inform the healthcare provider if you have a history of contrast dye allergies." None A client with end-stage renal disease (ESRD) is scheduled for hemodialysis. The client expresses concern about the procedure and potential complications. What is the most appropriate nursing response? "Hemodialysis is a painless procedure, and you can resume normal activities immediately afterward." "Complications are rare, but be aware that you may experience some discomfort during the process." "Hemodialysis is a surgical procedure where a small tube is inserted into your peritoneal cavity." "It's common to feel fatigued after hemodialysis, but this usually improves with time." None A client with chronic kidney disease is considering peritoneal dialysis as a treatment option. What information should the nurse provide about peritoneal dialysis? "Peritoneal dialysis involves the use of an external machine to filter your blood and remove waste products." "During peritoneal dialysis, a catheter is surgically placed in your neck to access the blood vessels." "You will need to follow a strict dietary regimen to ensure the success of peritoneal dialysis." "Peritoneal dialysis uses the lining of your abdominal cavity to filter and clean your blood." None A client is undergoing hemodialysis for the first time and expresses anxiety about the procedure. What is the most appropriate nursing action? Administer a sedative to help the client relax during the hemodialysis session. Explain that hemodialysis is a painful but necessary procedure for managing kidney disease. Reassure the client that hemodialysis is generally well-tolerated and relatively painless. Suggest canceling the hemodialysis and exploring alternative treatment options. None During a hemodialysis session, the nurse notes that the client's blood pressure has dropped significantly. What is the priority nursing intervention? Slow down the rate of blood flow through the dialyzer. Administer a bolus of intravenous fluids to raise blood pressure. Notify the healthcare provider and prepare for an emergency dialysis stoppage. Elevate the client's legs and monitor for signs of improvement. None A client undergoing hemodialysis develops restlessness, headache, and nausea toward the end of the session. The nurse suspects disequilibrium syndrome. What is the priority nursing action? Administer an antiemetic to alleviate nausea. Continue with the hemodialysis session as planned. Stop the hemodialysis session immediately. Encourage the client to take slow, deep breaths. None A client is receiving hemodialysis for end-stage renal disease. The nurse educates the client about preventing disequilibrium syndrome. What information should be included in the education? "Consume a large meal before each hemodialysis session to stabilize your blood sugar." "Ask your healthcare provider for anti-anxiety medications to take before each session." "Notify the healthcare team if you experience any new neurological symptoms during or after hemodialysis." "Increase your fluid intake before each session to prevent dehydration." None A client on peritoneal dialysis presents with signs of hyperlipidemia. What education should the nurse provide to help manage this complication? "Consume a low-fat diet to help control your blood lipid levels." "Increase your intake of simple carbohydrates to provide energy during dialysis." "Hyperlipidemia is a common side effect of peritoneal dialysis and does not require any specific dietary changes." "Include more protein in your diet to help manage hyperlipidemia." None A client with end-stage renal disease is undergoing peritoneal dialysis. The nurse is providing education about the procedure. The client asks, "How does peritoneal dialysis work?" What is the most accurate response by the nurse? "Peritoneal dialysis uses a machine to filter your blood and remove waste products." "During peritoneal dialysis, a catheter is inserted into your neck to access your blood vessels." "A special fluid is introduced into your abdominal cavity, and waste products diffuse across the peritoneal membrane." "Peritoneal dialysis involves the injection of contrast dye to visualize your kidneys on X-ray images." None A client undergoing peritoneal dialysis experiences cloudy dialysate drainage during an exchange. What is the nurse's priority action? Administer an antibiotic to address a potential infection. Increase the flow rate of the dialysate to enhance clearance. Assess the client for signs of respiratory distress. Notify the healthcare provider and obtain a culture of the drainage. None A client undergoing peritoneal dialysis develops hyperglycemia. What is the nurse's priority intervention? Administer insulin as prescribed. Increase the glucose concentration of the dialysate. Encourage the client to consume a high-protein diet. Discontinue peritoneal dialysis immediately. None A client undergoing peritoneal dialysis experiences significant protein loss. What is the nurse's priority intervention? Increase the protein concentration of the dialysate. Administer a protein supplement orally. Monitor the client's serum albumin levels. Encourage the client to consume a low-protein diet. None A client with end-stage renal disease is scheduled for a kidney transplant. The client asks the nurse about the potential risks of the procedure. What is the most appropriate nursing response? "Kidney transplant is a relatively risk-free procedure, and complications are uncommon." "While kidney transplant is generally safe, there are risks such as infection, rejection, and complications from immunosuppressive medications." "There's no need to worry; kidney transplant is a routine surgery with minimal complications." "Complications are rare, but you may experience pain and discomfort after the transplant." None A client who has undergone a kidney transplant asks the nurse about the purpose of immunosuppressive medications. What is the most accurate response by the nurse "Immunosuppressive medications are given to prevent the recurrence of kidney stones after the transplant." "These medications help boost your immune system to prevent infections after the kidney transplant." "Immunosuppressive drugs are used to suppress your immune system and prevent rejection of the transplanted kidney." "These medications are given to manage high blood pressure, a common complication after kidney transplantation." None A client with chronic kidney disease is being evaluated for a potential kidney transplant. What clinical indications would make the client a suitable candidate for a kidney transplant? Controlled hypertension and mild proteinuria. Advanced age and well-managed type 2 diabetes. Persistent hyperkalemia and acute kidney injury. Progressive decline in kidney function despite medical management. None A client is being assessed for eligibility for a kidney transplant. Which risk factor may impact the client's candidacy for a kidney transplant? History of well-controlled hypertension. History of a previous organ transplant. Absence of diabetes mellitus. Active tobacco smoking. None A client is scheduled to undergo a kidney transplant. The client asks the nurse about the procedure. What is the most accurate response by the nurse? "Kidney transplant involves removing your kidneys and replacing them with healthy donor kidneys." "During the kidney transplant, a small incision is made, and the new kidney is connected to your existing kidneys." "The surgeon will place the new kidney in your lower abdomen and connect it to blood vessels and the bladder." "Kidney transplant is a laparoscopic procedure that requires several small incisions for the placement of the new kidney." None A client who has undergone a kidney transplant develops signs of graft rejection. What clinical manifestations may be indicative of graft rejection? Increased urine output and weight gain. Elevated blood pressure and mild fatigue. Decreased serum creatinine levels. Fever, tenderness over the transplant site, and a decrease in urine output. None A client who recently underwent a kidney transplant presents with severe graft dysfunction within minutes of transplantation. The nurse suspects hyperacute rejection. What is the most appropriate action? Administer high-dose immunosuppressive medications immediately. Contact the transplant surgeon for urgent evaluation and intervention. Monitor vital signs and encourage the client to ambulate to improve blood flow. Administer pain medication and reposition the client for comfort. None A client who underwent a kidney transplant several weeks ago is now showing signs of graft rejection, including increased serum creatinine levels and tenderness over the transplant site. What type of rejection is likely occurring? Hyperacute rejection. Acute rejection. Chronic rejection. Delayed graft function. None A client who underwent a kidney transplant is at risk for ischemia due to reduced blood flow to the transplanted kidney. What nursing intervention is essential to prevent ischemic complications? Administering high-dose diuretics to maintain urine output. Encouraging the client to maintain a supine position at all times. Monitoring blood pressure closely and administering antihypertensive medications as prescribed. Administering pain medication to manage postoperative discomfort. None A client who received a kidney transplant presents with hypertension, decreased urine output, and elevated serum creatinine levels. The healthcare provider suspects renal artery stenosis. What diagnostic test is most appropriate to confirm this condition? Renal ultrasound. Magnetic resonance imaging (MRI). Renal arteriogram. Urinalysis. None A client who recently underwent a kidney transplant is experiencing sudden and severe pain over the transplant site, accompanied by a decrease in urine output. The nurse suspects renal artery thrombosis. What is the priority nursing action? Administering pain medication to alleviate the client's discomfort. Elevating the client's legs to promote venous return and reduce swelling. Notifying the healthcare provider immediately for urgent intervention. Encouraging the client to ambulate to enhance blood flow to the transplant site. None A client who underwent a kidney transplant is being monitored for infection. The nurse observes signs of infection, including fever, chills, and tenderness over the transplant site. What is the priority nursing action? Administering broad-spectrum antibiotics as prescribed. Encouraging increased fluid intake to flush out the infection. Applying a warm compress over the transplant site for comfort. Continuing to monitor vital signs and symptoms for further changes. None A client is diagnosed with bladder cancer and is scheduled for a cystoscopy. The client asks the nurse about the purpose of the procedure. What is the most appropriate response by the nurse? "Cystoscopy is done to remove bladder tumors and assess for cancerous cells." "It's a diagnostic procedure to visualize the inside of the bladder and assess for tumors." "Cystoscopy is performed to drain excess fluid from the bladder and alleviate pressure." "The procedure involves injecting a contrast dye to check for blockages in the urinary tract." None A client is diagnosed with renal cell carcinoma. The nurse is educating the client about the potential signs and symptoms. Which statement by the client indicates a need for further education? "I should report any blood in my urine to the healthcare provider." "Back pain and abdominal swelling can be signs of kidney cancer." "Frequent urination is a common symptom of renal cell carcinoma." "I will monitor for unintentional weight loss as a possible symptom." None A client with suspected kidney cancer reports experiencing persistent back pain. What is the nurse's priority action? Administering over-the-counter pain medication for relief. Documenting the client's report and monitoring for additional symptoms. Encouraging the client to apply a heating pad to the affected area. Immediately notifying the healthcare provider for further evaluation. None A client with suspected kidney cancer is scheduled for diagnostic studies. Which test is commonly used to confirm the diagnosis of kidney cancer? Complete blood count (CBC). Magnetic resonance imaging (MRI). Urinalysis. Computed tomography (CT) scan. None A client with a history of smoking is scheduled for a cystoscopy to investigate hematuria. The client asks the nurse about the purpose of the procedure. What is the most appropriate response by the nurse? "Cystoscopy is done to remove bladder tumors and assess for cancerous cells." "It's a diagnostic procedure to visualize the inside of the bladder and assess for tumors." "Cystoscopy is performed to drain excess fluid from the bladder and alleviate pressure." "The procedure involves injecting a contrast dye to check for blockages in the urinary tract." None A client with bladder cancer is scheduled to undergo surgical therapy. The client asks the nurse about the purpose of the surgery. What is the most appropriate response by the nurse? "The surgery is primarily done to remove cancerous tumors from the bladder." "The goal of the surgery is to drain excess fluid from the bladder and alleviate pressure." "Surgical therapy is focused on boosting your immune system to fight cancer." "It involves using radiation to target and destroy cancer cells in the bladder." None A client with urinary tract cancer is undergoing radiation therapy. The client asks the nurse about potential side effects. What is the most accurate response by the nurse? "Radiation therapy is unlikely to cause any side effects; it's a safe and well-tolerated treatment." "You may experience fatigue, skin changes, and gastrointestinal symptoms as side effects of radiation therapy." "Radiation therapy primarily affects your blood cell counts, leading to an increased risk of infection." "Side effects are limited to the area being treated, so you may not notice any systemic symptoms." None A client with advanced urinary tract cancer is receiving chemotherapy. The nurse explains that chemotherapy works by: Boosting the immune system to target cancer cells. Inhibiting the growth and division of cancer cells. Directly targeting and removing cancerous tumors. Reducing inflammation and promoting tissue healing. None A client with urinary tract cancer is receiving immunotherapy. What is the primary goal of immunotherapy in cancer treatment? Directly killing cancer cells. Enhancing the body's immune response against cancer cells. Reducing inflammation and promoting tissue healing. Inhibiting the growth and division of cancer cells. None A client with bladder cancer is prescribed intravesical therapy. The client asks the nurse about the purpose of this treatment. What is the most appropriate response by the nurse? "Intravesical therapy is administered to remove cancerous tumors from the bladder." "The goal is to deliver chemotherapy directly into the bladder to treat cancer cells." "It's a type of radiation therapy that targets cancer cells within the bladder." "This therapy is used to boost the immune system against bladder cancer." None A client receiving intravesical therapy reports discomfort and urgency during urination. What is the priority nursing action? Administering an analgesic to manage the client's discomfort. Encouraging increased fluid intake to flush out the bladder. Notifying the healthcare provider of the client's symptoms. Instructing the client to avoid voiding for a few hours after therapy. None A client with urinary incontinence reports leakage of urine when laughing or sneezing. The nurse identifies this type of incontinence as: Stress incontinence. Urge incontinence. Overflow incontinence. Functional incontinence. None A client with urinary incontinence experiences a sudden and intense urge to urinate, leading to involuntary urine leakage. The nurse identifies this type of incontinence as: Stress incontinence. Urge incontinence. Overflow incontinence. Functional incontinence. None A client with urinary incontinence experiences a constant dribbling of urine and reports difficulty emptying the bladder completely. The nurse identifies this type of incontinence as: Stress incontinence. Urge incontinence. Overflow incontinence. Functional incontinence. None A client with urinary incontinence has difficulty reaching the bathroom due to physical limitations and requires assistance with toileting. The nurse identifies this type of incontinence as: Stress incontinence. Urge incontinence. Overflow incontinence. Functional incontinence. None A client with stress incontinence is considering treatment options. The nurse explains that surgical therapy is often recommended for stress incontinence when: A) The client prefers a non-invasive approach to manage symptoms. B) Medications have failed to provide relief. C) The client desires a reversible and temporary intervention. None Time's up Post navigation Previous Previous post: Med-Surg II 6Next Next post: Med-Surg II 8
