Chronic kidney disease HESI case study (for unit 2 exam)

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