Exam 1 265

The nurse has provided discharge instructions to a client who is newly diagnosed with nephrotic syndrome. Which of the following client statements indicates a correct understanding of the teaching?

• I should take all prescribed antibiotics until their gone

• I should avoid using any type of salt substitute on my food

• I must decrease my intake of foods high in potassium

• I must protect myself from developing an infection

The nurse is reviewing the laboratory results of an assigned client; it is a priority for the nurse to follow up with the PCP if the client

• is receiving prescribed digoxin and has a BUN level that has increased from 15 to 19mg/dl over the past 3 days

• had a mitral mechanical valve replacement and taking prescribed warfarin that has an INR that is 3.2

• is receiving prescribed enoxaparin post op cardiac surgery and the platelets have decreased from 200,000 to 175,000 over the past 2 days

• had a AAA repair 2 days ago and has a creatinine that has increased from 0.9 to 2.5mg/dl

The nurse is caring for a client who has been hospitalized for 8 days with AKI caused by dehydration. Which of the following should the nurse report immediately to the PCP?

• a BUN level of 67mg/dl

• a rhythm strip reading that has tall, peaked T waves

• a decreased GFR

• a creatinine level of 3mg/dl

The nurse is caring for a client who is receiving gentamicin IV for infection and has developed oliguria and increased blood pressure. Which of the following actions should the nurse take first?

• collect a urine sample to check specific gravity

• obtain a prescription for gentamicin peak and trough levels

• insert a prescribed urinary catheter

• raise the head of the bed to a 45-degree angle

The nurse is caring for a client with CKD, the client is reporting muscle weakness, diarrhea, and tingling in the hands. Which action should the nurse take first?

• notify the PCP

• check the client’s most recent serum electrolyte levels

• evaluate the client’s urine output for the past 4 hrs

• determine if the client is scheduled to receive hemodialysis

The nurse is talking with a client who has CKD and has been receiving hemodialysis 3x week. Which of the following client statements is a priority follow-up by the nurse?

• I try and limit my intake of dietary sodium to 5g a day

• I have noticed that my skin looks like it has a layer of frost on it

• I have noticed that my breath has developed a very unpleasant odor

• I will make sure that I consume at least 50g of protein every day

The nurse is teaching a client who is in the late stage of CKD. Which of the following client statements indicates a correct understanding of the teaching?

• I should obtain much of my protein from dairy products and eggs

• I can expect to have an increase in my energy level after dialysis treatment

• Hemodialysis will be performed 2x week in an output center

• If I develop and fatigue or weakness I should report it to my doctor

The nurse is caring for a client who has returned from receiving hemodialysis treatment. It requires immediate follow up by the nurse if the client has

• developed a bp of 90/58mmhg

• develop a temperature of 99.4F

• K+ level that decrease from 6.1 to 5.1

• reports of feeling tired and no desire to eat

The nurses came for assigned client. Which of the following actions should the nurse take?

• place mask on the client when changing the client peritoneal dialysis catheter dressing

• walk a client to the bathroom during the peritoneal dialysis infusion cycle

• apply a pressure dressing on a clients AV fistula between hemodialysis treatments

• obtain a blood specimen from a client’s AV fistula

The nurse preceptor is observing a newly hired nurse care for a client who is receiving peritoneal dialysis. It indicates correct technique if the newly hired nurse is observed

• obtaining a prescription to give the client an enema prior to beginning dialysis

• placing the PD dialysate bag in the microwave to warm the solution

• starting dialysis prior to cleaning the catheter site

• repositioning the client to High Fowler’s during dialysis to improve dialysate drainage