Chapter 63. Concepts of Care for
Patients with Acute Kidney Injury and
Chronic Kidney Disease MS2 NUR
2212 WK 13 Review Question
nativities. Medical-Surgical Nursing,
10th Edition
The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI).
Which condition would the nurse expect to find in the patient's recent history? -
answerb. Dehydration
a. Pyelonephritis
b. Dehydration
c. Bladder cancer
d. Kidney stones
Prerenal causes of AKI are related to a decrease in perfusion, such as in clients who
have prolonged dehydration. Pyelonephritis is an intrinsic or intrarenal cause of AKI
related to kidney damage. Bladder cancer and kidney stones are postrenal causes of
AKI related to urine flow obstruction
A marathon runner comes into the clinic and states "I have not urinated very much in
the last few days." The nurse notes a heart rate of 110 beats/min and a blood pressure
of 86/58 mm Hg. Which action by the nurse is most appropriate? - answera. Give the
client a bottle of water immediately.
a. Give the client a bottle of water immediately.
b. Start an intravenous line for fluids.
c. Teach the patient to drink 2 to 3 L of water daily.
d. Perform an electrocardiogram.
This athlete is mildly dehydrated as evidenced by the higher heart rate and lower blood
pressure. The nurse can start hydrating the client with a bottle of water first, followed by
teaching the patient to drink 2 to 3 L of water each day. An intravenous line may be
needed later, after the patient's degree of dehydration is assessed. An
electrocardiogram is not necessary at this time
, A client comes into the emergency department with a serum creatinine of 2.2 mg/dL
(1944 mcmol/L) and a blood urea nitrogen (BUN) of 24 mL/dL (8.57 mmol/L). What
question would the nurse ask first when taking this client's history? - answera. "Have
you been taking any aspirin, ibuprofen, or naproxen recently?
a. "Have you been taking any aspirin, ibuprofen, or naproxen recently?
b. "Do you have anyone in your family with renal failure?"
c. "Have you had a diet that is low in protein recently?"
d. "Has a relative had a kidney transplant lately?"
There are some medications that are nephrotoxic, such as the nonsteroidal anti-
inflammatory drugs ibuprofen, aspirin, and naproxen. This would be a good question to
initially ask the patient since both the serum creatinine and BUN are elevated, indicating
some renal problems. A diet high in protein could be a factor in an increased BUN.
A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day.
What is the major concern of the nurse regarding this patient's care? - answerc.
Electrolyte and fluid imbalance
a. Edema and pain
b. Cardiac and respiratory status
c. Electrolyte and fluid imbalance
d. Mental health status
This client may have an inflammatory cause of AKI with proteins entering the
glomerulus and holding the fluid in the filtrate, causing polyuria. Electrolyte loss and fluid
balance are essential. Edema and pain are not usually a problem with fluid loss. There
could be changes in the client's cardiac, respiratory, and mental health status if the
electrolyte imbalance is not treated.
A client with acute kidney injury (AKI) has a blood pressure of 76/55 mm Hg. The
primary health care provider prescribed 1000 mL of normal saline to be infused over 1
hour to maintain perfusion. The client starts to develop shortness of breath. What is the
nurse's priority action? - answerd. Decrease the rate of the IV infusion.
a. Calculate the mean arterial pressure (MAP).
b. Ask for insertion of a pulmonary artery catheter.
c. Take the client's pulse.
d. Decrease the rate of the IV infusion.
The nurse would assess that the client could be developing fluid overload and
respiratory distress and slow down the normal saline infusion. The calculation of the
MAP also reflects perfusion. The insertion of a pulmonary artery catheter would
evaluate the client's hemodynamic status, but this would not be the initial or priority
action by the nurse. Vital signs are also important after adjusting the intravenous
infusion.
Patients with Acute Kidney Injury and
Chronic Kidney Disease MS2 NUR
2212 WK 13 Review Question
nativities. Medical-Surgical Nursing,
10th Edition
The nurse is assessing a client with a diagnosis of prerenal acute kidney injury (AKI).
Which condition would the nurse expect to find in the patient's recent history? -
answerb. Dehydration
a. Pyelonephritis
b. Dehydration
c. Bladder cancer
d. Kidney stones
Prerenal causes of AKI are related to a decrease in perfusion, such as in clients who
have prolonged dehydration. Pyelonephritis is an intrinsic or intrarenal cause of AKI
related to kidney damage. Bladder cancer and kidney stones are postrenal causes of
AKI related to urine flow obstruction
A marathon runner comes into the clinic and states "I have not urinated very much in
the last few days." The nurse notes a heart rate of 110 beats/min and a blood pressure
of 86/58 mm Hg. Which action by the nurse is most appropriate? - answera. Give the
client a bottle of water immediately.
a. Give the client a bottle of water immediately.
b. Start an intravenous line for fluids.
c. Teach the patient to drink 2 to 3 L of water daily.
d. Perform an electrocardiogram.
This athlete is mildly dehydrated as evidenced by the higher heart rate and lower blood
pressure. The nurse can start hydrating the client with a bottle of water first, followed by
teaching the patient to drink 2 to 3 L of water each day. An intravenous line may be
needed later, after the patient's degree of dehydration is assessed. An
electrocardiogram is not necessary at this time
, A client comes into the emergency department with a serum creatinine of 2.2 mg/dL
(1944 mcmol/L) and a blood urea nitrogen (BUN) of 24 mL/dL (8.57 mmol/L). What
question would the nurse ask first when taking this client's history? - answera. "Have
you been taking any aspirin, ibuprofen, or naproxen recently?
a. "Have you been taking any aspirin, ibuprofen, or naproxen recently?
b. "Do you have anyone in your family with renal failure?"
c. "Have you had a diet that is low in protein recently?"
d. "Has a relative had a kidney transplant lately?"
There are some medications that are nephrotoxic, such as the nonsteroidal anti-
inflammatory drugs ibuprofen, aspirin, and naproxen. This would be a good question to
initially ask the patient since both the serum creatinine and BUN are elevated, indicating
some renal problems. A diet high in protein could be a factor in an increased BUN.
A client is admitted with acute kidney injury (AKI) and a urine output of 2000 mL/day.
What is the major concern of the nurse regarding this patient's care? - answerc.
Electrolyte and fluid imbalance
a. Edema and pain
b. Cardiac and respiratory status
c. Electrolyte and fluid imbalance
d. Mental health status
This client may have an inflammatory cause of AKI with proteins entering the
glomerulus and holding the fluid in the filtrate, causing polyuria. Electrolyte loss and fluid
balance are essential. Edema and pain are not usually a problem with fluid loss. There
could be changes in the client's cardiac, respiratory, and mental health status if the
electrolyte imbalance is not treated.
A client with acute kidney injury (AKI) has a blood pressure of 76/55 mm Hg. The
primary health care provider prescribed 1000 mL of normal saline to be infused over 1
hour to maintain perfusion. The client starts to develop shortness of breath. What is the
nurse's priority action? - answerd. Decrease the rate of the IV infusion.
a. Calculate the mean arterial pressure (MAP).
b. Ask for insertion of a pulmonary artery catheter.
c. Take the client's pulse.
d. Decrease the rate of the IV infusion.
The nurse would assess that the client could be developing fluid overload and
respiratory distress and slow down the normal saline infusion. The calculation of the
MAP also reflects perfusion. The insertion of a pulmonary artery catheter would
evaluate the client's hemodynamic status, but this would not be the initial or priority
action by the nurse. Vital signs are also important after adjusting the intravenous
infusion.
