CKD and ESKD

CKD and ESKD

By Ramona Kofke

Multiple Select

Jane Doe is a 57 year old female client with a history of uncontrolled hypertension and is has been admitted (again) for a hypertensive crisis. During the visit, the hospitalist notifies Mrs. Doe that her GFR has dropped to 80 and is in stage 2 CKD. Which of the following will the nurse include in client education? Select all that apply.

• Lifestyle changes can reverse the damage to the kidney

• Eat low K, low phos diet

• Take antihypertensive medications as prescribed

• Exercise regularly

• Monitor BP at home

Multiple Choice

Eight months later, Mrs. Doe is being seen at her HCP for routine labs. She reports having pain and redness to her left great toe. Based on this information, the nurse anticipates an elevation in which lab value?

• Phosphorus

• Potassium

• Uric acid

• Calcium

Multiple Select

Mrs. Doe has a uric acid level of 6.4 and GFR of 40. Which dietary modifications will the nurse include in the client education? Select all that apply.

• Encourage a high protein diet

• Low sodium diet

• Avoid organ meats

• Avoid salt substitutes

• Encourage high phosphorus

Multiple Choice

One year later, the nurse is reviewing lab results prior to Mrs. Doe's scheduled follow up visit and finds that her GFR has decreased to 22. The nurse understands that which of the following will be an important part of the educational plan?

• Renal replacement therapy options

• Maintaining a healthy blood pressure to improve kidney function

• Signs and symptoms of hypokalemia

• Signs and symptoms of hypovolemia

Multiple Select

Mrs. Doe has been diagnosed with ESKD. Which of the following alterations does the nurse anticipate? Select all that apply.

• Hyperkalemia

• Hyperphosphatemia

• Hypercalcemia

• Metabolic alkalosis

• Anemia

Open Ended

Three months ago, Mrs. Doe was diagnosed with ESKD and had an AV fistula placed. What will the nurse assess for at the site?

Multiple Choice

The nurse is educating Mrs. Doe on which medications it is ok to take on the morning of her scheduled hemodialysis treatments. Which medication will the nurse instruct Mrs. Doe to take?

• MVI

• Calcium carbonate

• Furosemide

• Lisinopril

Multiple Choice

After 3 years of hemodialysis, Mrs. Doe decided to transition to peritoneal dialysis in order to have more freedom to travel. She has called into the HCP's office reporting, "I have a fever and that liquid that comes out is all cloudy looking." The nurse suspects which complication?

• Peritonitis

• Abdominal herniation

• Dialysis Disequilibrium Syndrome

• Peritoneal leakage

Multiple Choice

After 7 years on dialysis and continued compliance with her dialysis treatment, Mrs. Doe was matched with and received a kidney transplant. 10 days after transplant, she begins experiencing tenderness at that transplant site, decreased UOP, and a fever of 99.9 F. What interventions does the nurse anticipate?

• Administration of antithrombolytic medication

• Continued need for dialysis

• Immediate removal of the transplanted kidney

• Increase in immunosuppressive therapy