Solutions
When educating a patient about prevention of future kidney
stones, the nurse should instruct the patient
to:Rationale: Staying hydrated helps prevent kidney stone
formation by diluting the urine, reducing the concentration of
stone-forming substances.
Drink enough fluids to produce at least 2 liters of urine per day.
A patient with CKD is prescribed erythropoietin injections. The
nurse explains that this medication is used
to:Rationale: Erythropoietin is used in CKD to treat anemia by
stimulating red blood cell production, as kidney failure often
leads to a deficiency in natural erythropoietin production.
Help the body produce red blood cells
A patient with end-stage renal disease (ESRD) is prescribed
sevelamer. The nurse explains that this medication is used
to:Rationale: Sevelamer is a phosphate binder that helps to
reduce serum phosphate levels, which are often elevated in
ESRD due to reduced kidney function.
Lower serum phosphate levels.
The nurse is monitoring a patient with CKD and notes a
potassium level of 5.9 mEq/L. What is the priority nursing
intervention?Rationale: Hyperkalemia (high potassium) poses a
risk for cardiac complications. Calcium gluconate stabilizes the
,heart muscle, protecting against hyperkalemia-induced
dysrhythmias.
Administer calcium gluconate as ordered.
A patient with CKD is at risk for fluid overload. Which finding
indicates that the patient may be experiencing fluid overload?
Rationale: A common sign of fluid overload due to increased
venous pressure. Dry mucous membranes, weight loss, and
increased urine output would suggest dehydration rather than
fluid overload.
Jugular vein distention.
The nurse is educating a patient with CKD on dietary choices.
Which food should the nurse advise the patient to avoid?
Rationale: Are high in potassium, which CKD patients need to
limit due to the kidneys' decreased ability to excrete potassium.
Apples, cauliflower, and rice are typically safer choices with
lower potassium content.
Bananas.
A patient with CKD reports difficulty adhering to a fluid
restriction. Which suggestion should the nurse provide?
Rationale: Ice chips can provide a sense of hydration without
significantly increasing fluid intake. This approach helps
patients better adhere to fluid restrictions.
"Try sucking on ice chips instead of drinking water."
,A patient with AKI has a urinary output of 25 mL in the last
hour. Which is the nurse’s priority action?Rationale: Oliguria
(reduced urine output) can indicate worsening kidney function
or fluid imbalance. The healthcare provider should be notified
promptly to assess and intervene as needed.
Notify the healthcare provider.
The nurse notes that a renal patient’s urine output is gradually
decreasing. The patient’s serum creatinine level is also elevated.
Which condition does the nurse suspect?Rationale: Decreased
urine output and elevated creatinine suggest AKI, where the
kidneys fail to maintain normal function. Hypovolemia and
dehydration can cause similar symptoms but are typically
accompanied by low blood pressure.
Acute kidney injury
A patient with CKD has a hemoglobin level of 8.5 g/dL. The
nurse should anticipate which intervention?Rationale: Low
hemoglobin in CKD patients is commonly treated with
erythropoietin, which stimulates red blood cell production.
Increasing dietary iron alone would not be sufficient to raise
hemoglobin in CKD.
Administer erythropoietin as prescribed.
The nurse is reviewing lab results for a patient with CKD.
Which finding is most concerning and should be reported
immediately?Rationale: A potassium level of 6.8 mEq/L is
critically high and increases the risk of life-threatening cardiac
dysrhythmias. This finding requires immediate intervention.
, Serum potassium of 6.8 mEq/L.
The nurse is assessing a patient with CKD who is on epoetin alfa
therapy. Which laboratory value should the nurse monitor to
assess the effectiveness of the therapy?Rationale: Epoetin alfa
therapy is used to treat anemia by increasing red blood cell
production. Hemoglobin levels are monitored to assess the
effectiveness of the therapy
Hemoglobin level.
A patient with heart failure is experiencing shortness of breath
and swelling in their legs. What should the nurse's initial action
be?Rationale: High-Fowler's position helps to alleviate dyspnea
by promoting lung expansion. This position is particularly
helpful for patients with heart failure experiencing shortness of
breath.
Position the patient in high-Fowler's position.
The nurse is caring for a patient with stable angina. Which
patient teaching is most appropriate?Rationale: Nitroglycerin is
often prescribed to manage angina, and it should be taken as
soon as chest pain begins to reduce cardiac workload and
alleviate pain.
"Take nitroglycerin at the first sign of chest pain."
A patient presents with signs of acute myocardial infarction
(AMI). What is the priority nursing action?
Rationale: Administering oxygen helps increase oxygen supply
to the heart, which is critical in AMI. Early intervention with
oxygen can reduce myocardial damage.