22 hours ago A female patient with chronic kidney disease (CKD) is receiving peritoneal dialysis with 2 L inflows. Which information should the nurse report immediately to the health care provider? a. The patient has an outflow volume of 1800 mL. b. The patient's peritoneal effluent appears … >> Go To The Portal
The nurse assesses the client who has chronic renal failure and notes the following: crackles in the lung bases, elevated blood pressure, and weight gain of 2 pounds in one day. Based on these data, which of the following nursing diagnoses is appropriate?
A good breakfast, of course, gets your blood sugar leveled and gives you the energy you need to get started. It also helps sustain you until your next meal. With chronic kidney disease, you likely have dietary restrictions that need to be followed closely.
Weakness, tingling, and cardiac arrhythmias suggest hyperkalemia, which is associated with renal failure. Hypotension, tachycardia, and tachypnea signal hemorrhage, another dialysis complication. The nurse is caring for a client diagnosed with acute renal failure.
Raw carrots, tomatoes, and orange juice are high potassium foods that clients with advanced kidney disease or on hemodialysis should avoid (option C) -Low protein diet (0.6-0.8 g/kg/day) helps prevent kidney disease progression. If the client is already on dialysis, liberal protein intake is recommended to prevent malnutrition.
Blood tests. A sample of your blood may reveal rapidly rising levels of urea and creatinine — two substances used to measure kidney function. Imaging tests. Imaging tests such as ultrasound and computerized tomography may be used to help your doctor see your kidneys.
Diagnosis. Based on the assessment data, the following nursing diagnoses for a patient with chronic renal failure were developed: Excess fluid volume related to decreased urine output, dietary excesses, and retention of sodium and water.
Researchers led by Alex Chang, MD, MS of Johns Hopkins University found that people with normal kidney function whose diet quality was poor—high in red and processed meats, sugar-sweetened beverages and sodium, and low in fruit, legumes, nuts, whole grains and low-fat dairy—were more likely to develop kidney disease.
You may need to make changes to your diet when you have chronic kidney disease (CKD). These changes may include limiting fluids, eating a low-protein diet, limiting salt, potassium, phosphorous, and other electrolytes, and getting enough calories if you are losing weight.
Bleeding diatheses are characteristic findings in patients with end-stage renal disease (ESRD). The pathogenesis of uremic bleeding tendency is related to multiple dysfunctions of the platelets. The platelet numbers may be reduced slightly, while platelet turnover is increased.
According to KDIGO, acute renal failure can be diagnosed if any one of the following is present: An increase in SCr by 0.3 mg/dL or more within 48 hours. An increase in SCr of at least 150 percent within a seven-day period. A urine volume of less than 0.5 ml/kg/h over a six-hour period.
Patients with acute renal failure also are often highly catabolic; increments of serum urea nitrogen of 20 to 50 mg/dL or more each day, and net protein losses up to 30 to 120 g/day or greater are not uncommonly observed.
Protein. Your body needs protein to help build muscle, repair tissue, and fight infection. If you have kidney disease, you may need to watch how much protein you eat. Having too much protein can cause waste to build up in your blood, and your kidneys may not be able to remove all the extra waste.
Dietary protein consumption increases serum creatinine level through protein catabolism rather than decreased clearance. Hence, serum creatinine may be less reliable for estimating GFR or estimating a glomerular hyperfiltration response in studies that manipulate dietary protein.
Kidney failure - the kidneys cannot get rid of extra fluid from the body. Congestive heart failure - excess fluid builds up in the body. Diuretics (water pills) - makes the body get rid of more sodium in the urine.
The more protein waste that needs to be removed, the harder the kidneys need to work to get rid of it. This can be stressful for your kidneys, causing them to wear out faster. For people with kidney disease who are not on dialysis, a diet lower in protein is recommended.
Normal range: Sodium: 135 to 145 mEq/L. Potassium: 3.5 to 5.0 mEq/L. Calcium: 8.5 to 10.5 mg/dL....Understanding Your Lab Work.StageGFR Level and DescriptionStage 1>90 mL/min; normal or high GFRStage 260 to 89 mL/min; mild decrease in GFRStage 3A45 to 59 mL/min; moderate decrease in GFRStage 3B30 to 44 mL/min; moderate decrease in GFR2 more rows
Acute renal failure is characterized by oliguria and rapid accumulation of nitrogen waste in the blood. Kidneys excrete medications, so the nurse should monitor the client closely for drug toxicity. With decreased urinary output or no output, enuresis shouldn't occur.
The nurse also can delay assessing respirations and temperature because these aren't affected by the serum potassium level. A client admitted with a gunshot wound to the abdomen is transferred to the intensive care unit after an exploratory laparotomy.
CRF may cause metabolic acidosis, not metabolic alkalosis, secondary to inability of the kidneys to excrete hydrogen ions. A client with chronic renal failure (CRF) is receiving a hemodialysis treatment. After hemodialysis, the nurse knows that the client is most likely to experience: 1. hematuria. 2. weight loss.
A client is admitted for treatment of chronic renal failure (CRF). The nurse knows that this disorder increases the client's risk of: 1. water and sodium retention secondary to a severe decrease in the glomerular filtration rate. 2. a decreased serum phosphate level secondary to kidney failure.
Metabolic acidosis results from the inability to excrete hydrogen ions. Anemia results from a lack of erythropoietin. Hypertension (from fluid overload) may or may not be present in chronic renal failure. Hypotension, metabolic alkalosis, and polycythemia aren't present in renal failure.
Uremia . Uremia is the buildup of nitrogenous wastes in the blood, evidenced by an elevated blood urea nitrogen and creatine levels. Uremia , anemia, and acidosis are consistent clinical manifestations of chronic renal failure. Metabolic acidosis results from the inability to excrete hydrogen ions.
3. "Increase your carbohydrate intake.". Extra carbohydrates are needed to prevent protein catabolism. In a client with CRF, unrestricted intake of sodium, protein, potassium, and fluid may lead to a dangerous accumulation of electrolytes and protein metabolic products, such as amino acids and ammonia.
Acute renal failure can occur when elevated myoglobin (protein found in muscle tissue) levels overwhelm the kidneys' filtration ability. The nurse's priority is to prevent kidney damage using rapid IV fluid resusitation to flush the damaging myoglobin pigment from the body.
The diet for a client with chronic kidney disease may need to be restricted in fluids, sodium, potassium, and phosphorus. Dairy products (eg, milk, yogurt) and certain fruits (eg, bananas, oranges, coconuts, watermelons, and avocados) contain high potassium levels. Dairy products also contain high phosphorus levels.
Examples of allowable foods for CKD clients include apples, pears, grapes, pineapple, blackberries, blueberries, and plums. (Option B): Avocados are high in potassium; the chips may be high in sodium. (Options C and D):
Decreased bicarbonate reabsorption would produce metabolic acidosis; this would occur as a compensation for primary respiratory alkalosis. (Option B): When the respiratory rate is decreased, PaCO2 would increase, creating a respiratory acidosis; this would occur in response to a primary metabolic alkalosis.
Most men are used to urinating when standing up; therefore, the nurse or UAP should help the client out of bed rather than offer a urinal for use in bed. The nurse should first try noninvasive methods to help the client urinate in a normal position and provide privacy to help the client relax. (Option A):
Insertion of an indwelling catheter is not necessary to perform a kidney biopsy and is not part of the usual protocol. (Option C): Post-procedure, the client should be positioned on the affected side for 30-60 minutes to provide pressure and help prevent bleeding. 64% answered correctly.
Common tests of renal function include BUN, serum creatinine, creatinine clearance, and renal concentration tests . Arterial blood gas analysis is a test of respiratory function. A 32 year old female client has come to your clinic with a complaint of hematuria, or the presence of red blood cells in the urine.
After a kidney transplant, rejection and failure can occur within 24 hours (hyperacute), within 3 to 14 days (acute), or after many years. A hyperacute rejection is caused by an immediate antibody-mediated reaction that leads to generalized glomerular capillary thrombosis and necrosis.
The primary presenting features of an acute glomerular inflammation are hematuria, edema, azotemia (an abnormal concentration of nitrogenous wastes in the blood), and proteinuria (excess protein in the urine) (Porth & Matfin, 2009).
The fluid infuses within 10 minutes, dwells for 20 minutes, and then drains in about 20 minutes. The diffusion on the small particles into the dialysate peaks in the first 10 minutes. Because of difficulties with hemodialysis, peritoneal dialysis is initiated to treat a client's uremia.
a) Recent history of streptococcal infection. Glomerulonephritis can occur as a result of infections from group A beta-hemolytic streptococcal infections, bacterial endocarditis, or viral infections such as hepatitis B or C or human immunodeficiency virus (HIV).
An increased WBC count indicates infection, probably resulting from peritonitis, which may have been caused by insertion of the peritoneal catheter into the peritoneal cavity . Peritonitis can cause the peritoneal membrane to lose its ability to filter solutes; therefore, ...
Immediately after a dialysis treatment, the access site should be covered with adhesive bandages, not gauze. Blood pressure readings or venipunctures shouldn't be taken in the arm with the AV fistula. The nurse is caring for a patient who underwent a kidney transplant.