Hurst 11 - Renal
Hurst 11 - Renal
Hurst 11 - Renal
Renal
2. When a client has glomerulonephritis, are they in a fluid volume deficit or a fluid volume
excess?
FVE
3. When a client has glomerulonephritis. Why do they develop malaise and headache?
buildup of toxins
4. When a client has glomerulonephritis, why does their urine output go down?
kidneys are failing
5. When a client has glomerulonephritis, why does their BUN and creatinine go up?
unable to excrete the urea and creatinine through the kidneys
6. When a client has glomerulonephritis, why do they get protein in their urine?
glomerulus has holes in it so protein can leak out
10. With any type of kidney disease, it is common for the BUN to be elevated; therefore, why
11. If you add protein to the diet of anyone with renal disease, what will happen to their BUN?
increase
13. When determining fluid replacement for a renal disease client (glomerulonephritis), you
always give them what they lost in a 24- hour period plus 500 mL. What is the purpose of
adding 500 mLs?
to account for the insensible fluid loss
14. Once diuresis begins in glomerulonephritis, will the client be at risk for a fluid volume
15. When a client has nephrotic syndrome, what is the major element that is leaking out in their
urine?
protein
16. What will protein or albumin hold onto in the vascular space?
fluid
17. If a client does not have protein or albumin in their vascular space (blood), what is going to
happen to all the fluid that is supposed to stay in their vascular system?
goes out into the interstitial space tissue
19. Therefore, will the nephrotic syndrome client (in the acute stages) be in a fluid volume
20. When a client has nephrotic syndrome, they develop total body edema, what is the proper
21. When a client has nephrotic syndrome, it is common for them to be placed on prednisone.
Why?
to decrease inflammation, decrease the size of the holes in the glomerulus so protein can no
longer leak out
22. Does the nephrotic syndrome client need a high-sodium diet or a low-sodium diet? Explain
why.
low sodium diet is needed to decrease further edema
23. Does the nephrotic syndrome client need a high-protein diet or a low-protein diet? Explain
why.
high protein diet to help offset the amount of protein this client is losing through their
glomerulus
24. How can bradycardia cause renal failure?
decreases perfusion
28. How can glomerulonephritis, nephrotic syndrome, or diabetes cause renal failure?
vascular damage
32. When a client is in renal failure, why does their BUN and creatinine go up?
bc the client is unable to excrete ura and the creatinine
35. Why does the renal failure client’s blood pressure go up?
because they are retaining fluid
36. Why is the renal failure client at risk for heart failure?
because they are retaining fluid
37. Why does the renal failure client develop anorexia, nausea, and vomiting?
because buildup of toxins
38. Why does the renal failure client develop an itching frost?
urea builds up in the blood and eventually will escape through the pores onto the skin
39. Why does the renal failure client have to worry about osteoporosis?
Because the renal failure client retains phosphorus; therefore, that makes them excrete their
calcium, which lowers the serum calcium then the client starts pulling calcium from the bone
40. There are two phases of renal failure. The first phase is an oliguric phase, if a client is
41. Why does the oliguric client go into a fluid volume excess?
retaining fluid
43. The second phase of renal failure is called the diuretic phase. When a client is diuresing,
44. Why will a client who is diuresing go into a fluid volume deficit?
losing volume
45. If a client goes into a fluid volume deficit, what will happen to their blood pressure?
decrease
47. When a client is diuresing, their serum potassium level goes down (hypokalemia). Explain
why.
because potassium is being excreted through the kidneys
50. Does the client who is being hemodialyzed have to watch what they eat and drink in
51. Explain the basic nursing care for a circulatory access (A-V shunt, fistula, or graft).
no BP, no punctures in extremity, do not wear watch on that extremity, check it for adequate
circulation
52. Why can’t a client who has an alternate circulatory access device have blood pressures or
venipunctures in that extremity?
because these could cause a clot to occur in the circulatory access device
54. When a client is having peritoneal dialysis, where is the fluid going into?
abdomen- peritoneal cavity
55. What would you do if you instilled 1,000 mL of fluid into the peritoneal dialysis client and
57. What would be signs and symptoms of infection with peritoneal dialysis?
cloudy or dark fluid return
58. When a client has peritoneal dialysis for renal failure, why do they have to increase protein
59. When a client has peritoneal dialysis, why do they have a constant sweet taste and why do
61. What is the number one thing you need to remember with kidney stones?
fluids!!!
63. What type of specimen do you need to test a creatinine level on a client?
blood
64. Is the BUN affected by what we eat?
yes