Chronic kidney disease HESI case study (for unit 2 exam) – Flashcards
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What is the best description of chronic kidney disease?
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it is a fatal disorder UNLESS renal replacement therapy is received
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What additional information in Louellen's history may be related to the onset of ESRD (kidney failure)?
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hypertension
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Which lab value is likely to be decreased in a client with chronic kidney disease?
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serum calcium
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What is the underlying pathology causing this abnormal lab value?
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fewer red blood cells are being formed
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What assessment finding is consistent with ESRD (kidney failure)?
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yellow-gray pallor
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Which explanation best describes the pathology resulting in her hypertension?
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activation of the renin-angiotensin cycle and excretion of aldosterone causes hypertension
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Which assessment finding indicated to the nurse that the desired outcome of the calcium acetate (Phoslo) has been achieved?
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serum phosphorus of 4.0 mg/dL
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Which assessment should the nurse perform to determine if the desired outcome of the Captopril (Capoten) has been achieved?
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blood pressure
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Which assessment data indicates to the nurse that the desired outcome of the Epoetin Alfa (Epogen) has been achieved?
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conjunctival sac returns to a reddish-pink color
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Based on these diagnoses, which nursing intervention should be included in Louellen's plan of care?
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monitor and record daily weights
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"eggs are a source of high biologic value protein" is said by a patient demonstrating ________
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understanding of nursing teaching
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How much fluid will Louellen be allowed to drink during the next 24 hours?
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720 ml of fluid
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What is the best nursing intervention?
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hold the dose of Kay Ciel and contact the health care provider to report the serum potassium level
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What intervention should the nurse implement?
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ask to speak directly with the health care provider
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What factor is related to the use of hemodialysis?
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high risk for air embolus
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Lourellen is at increased risk for the development of which problem while receiving hemodialysis?
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hepatitis B and C
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what is the best description of an AV graft?
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synthetic tubing tunneled under the skin connecting an artery to a vein
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What finding should the nurse enter into the nurses' notes?
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thrill present and palpated
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What intervention should the nurse include in Louellen's plan of care?
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perform sterile dressing changes at the dual-lumen catheter site
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What expected outcome should be included in the nurse's teaching plan?
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client will select foods high in iron and calcium from a menu
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What is the maximum amount of weight that Louellen should gain between each dialysis treatment?
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1.5 kg or 3.3 pounds of weight
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Which nursing assessment has the highest priority during the first 24- hour postoperative period?
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vital signs
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What intervention should be included in the plan of care during the immediate postoperative period?
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monitor Louellen's urinary output hourly using an urimeter
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What nursing diagnosis has the greatest priority when caring for a client receiving immunosuppressive agents?
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risk for infection
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What should be the first implementation done for complaints of increased pain?
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administer an analgesic
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What should be the first initial response be by the nurse for complaints of increased pain?
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describe the location and type of pain you're having
