HealthStudyPro 2025/2026
Comprehensive Summary & Test
Bank
Lewis’s Medical-Surgical Nursing,
12th Edition
Chapter 68: Acute and Chronic
Kidney Disease
,HealthStudyPro 2025/2026
Chapter 68 Summary: Acute and Chronic Kidney
Disease
Chapter 68 of Lewis’s Medical-Surgical Nursing, 12th
Edition, addresses the pathophysiology, clinical features,
diagnostics, and management of acute kidney injury (AKI)
and chronic kidney disease (CKD). It highlights the critical
roles of the kidneys in fluid balance, electrolyte regulation,
acid-base homeostasis, and waste elimination, and
describes how dysfunction leads to significant systemic
consequences.
Acute kidney injury is characterized by a rapid decline in
kidney function, resulting in the accumulation of waste
products and dysregulation of fluid and electrolyte balance.
Causes are categorized as prerenal, intrarenal, or postrenal.
Common triggers include hypotension, nephrotoxic drugs,
and obstructive uropathies. Clinical management includes
fluid resuscitation, medication adjustment, and renal
replacement therapy if indicated.
Chronic kidney disease is defined as kidney damage or
decreased glomerular filtration rate (GFR) lasting for more
than three months. Major causes include diabetes,
hypertension, and glomerulonephritis. CKD is progressive
and leads to end-stage kidney disease (ESKD),
necessitating dialysis or transplantation. Clinical
,HealthStudyPro 2025/2026
manifestations span multiple systems: uremia, anemia,
bone disorders, cardiovascular disease, and neurological
complications.
Diagnosis involves monitoring serum creatinine, BUN,
GFR, urine output, and imaging studies. Management
includes lifestyle modifications, dietary restrictions,
pharmacologic therapy (e.g., antihypertensives, phosphate
binders, erythropoietin), and timely planning for renal
replacement therapy.
Nurses play an essential role in patient education, symptom
monitoring, medication management, and emotional
support. Teaching focuses on dietary adherence, fluid
management, and recognizing early signs of complications.
The chapter also reviews dialysis modalities (hemodialysis,
peritoneal dialysis) and kidney transplantation, including
nursing care priorities for each. Emphasis is placed on
holistic and interdisciplinary approaches to optimize patient
outcomes and quality of life for individuals with kidney
disease.
, HealthStudyPro 2025/2026
NCLEX-Style Test Bank – Chapter 68: Acute and
Chronic Kidney Disease
1. Which of the following laboratory findings is most
indicative of worsening chronic kidney disease?
A. Decreased serum creatinine
B. Elevated glomerular filtration rate (GFR)
C. Increased serum potassium and BUN
D. Decreased serum phosphate
Correct Answer: C
2. Which of the following laboratory findings is most
indicative of worsening chronic kidney disease?
A. Decreased serum creatinine
B. Elevated glomerular filtration rate (GFR)
C. Increased serum potassium and BUN
D. Decreased serum phosphate
Correct Answer: C
3. Which of the following laboratory findings is most
indicative of worsening chronic kidney disease?
A. Decreased serum creatinine
B. Elevated glomerular filtration rate (GFR)
Comprehensive Summary & Test
Bank
Lewis’s Medical-Surgical Nursing,
12th Edition
Chapter 68: Acute and Chronic
Kidney Disease
,HealthStudyPro 2025/2026
Chapter 68 Summary: Acute and Chronic Kidney
Disease
Chapter 68 of Lewis’s Medical-Surgical Nursing, 12th
Edition, addresses the pathophysiology, clinical features,
diagnostics, and management of acute kidney injury (AKI)
and chronic kidney disease (CKD). It highlights the critical
roles of the kidneys in fluid balance, electrolyte regulation,
acid-base homeostasis, and waste elimination, and
describes how dysfunction leads to significant systemic
consequences.
Acute kidney injury is characterized by a rapid decline in
kidney function, resulting in the accumulation of waste
products and dysregulation of fluid and electrolyte balance.
Causes are categorized as prerenal, intrarenal, or postrenal.
Common triggers include hypotension, nephrotoxic drugs,
and obstructive uropathies. Clinical management includes
fluid resuscitation, medication adjustment, and renal
replacement therapy if indicated.
Chronic kidney disease is defined as kidney damage or
decreased glomerular filtration rate (GFR) lasting for more
than three months. Major causes include diabetes,
hypertension, and glomerulonephritis. CKD is progressive
and leads to end-stage kidney disease (ESKD),
necessitating dialysis or transplantation. Clinical
,HealthStudyPro 2025/2026
manifestations span multiple systems: uremia, anemia,
bone disorders, cardiovascular disease, and neurological
complications.
Diagnosis involves monitoring serum creatinine, BUN,
GFR, urine output, and imaging studies. Management
includes lifestyle modifications, dietary restrictions,
pharmacologic therapy (e.g., antihypertensives, phosphate
binders, erythropoietin), and timely planning for renal
replacement therapy.
Nurses play an essential role in patient education, symptom
monitoring, medication management, and emotional
support. Teaching focuses on dietary adherence, fluid
management, and recognizing early signs of complications.
The chapter also reviews dialysis modalities (hemodialysis,
peritoneal dialysis) and kidney transplantation, including
nursing care priorities for each. Emphasis is placed on
holistic and interdisciplinary approaches to optimize patient
outcomes and quality of life for individuals with kidney
disease.
, HealthStudyPro 2025/2026
NCLEX-Style Test Bank – Chapter 68: Acute and
Chronic Kidney Disease
1. Which of the following laboratory findings is most
indicative of worsening chronic kidney disease?
A. Decreased serum creatinine
B. Elevated glomerular filtration rate (GFR)
C. Increased serum potassium and BUN
D. Decreased serum phosphate
Correct Answer: C
2. Which of the following laboratory findings is most
indicative of worsening chronic kidney disease?
A. Decreased serum creatinine
B. Elevated glomerular filtration rate (GFR)
C. Increased serum potassium and BUN
D. Decreased serum phosphate
Correct Answer: C
3. Which of the following laboratory findings is most
indicative of worsening chronic kidney disease?
A. Decreased serum creatinine
B. Elevated glomerular filtration rate (GFR)
