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After a diagnosis of chronic renal failure, a client was started on epoetin alfa (Epogen®). Which finding should a nurse expect when evaluating the desired therapeutic effectiveness of the medication?

• Decrease in serum creatinine levels (SCr)
• Increase in white blood cells (WBCs)
• Increase in serum hematocrit (Hct)
• Decrease in blood pressure (BP)

A client hospitalized with a diagnosis of chronic renal failure (CRF) is experiencing hypotension, cold and clammy skin, and dysrhythmias. An arterial blood gas (ABG) is drawn with orders to notify the physician if abnormal. Based on the following results, a nurse should notify the physician to report that the client is experiencing:

• Full compensated metabolic acidosis
• Full compensated respiratory alkalosis.
• partially compensated metabolic acidosis.
• uncompensated metabolic acidosis.

A nurse is initiating peritoneal dialysis for a client with renal failure. During the infusion of the dialysate, the client reports abdominal pain. Which intervention by the nurse is most appropriate?

• Stopping the dialysis and reschedule after 2 days
• Asking if the client is constipated, a take the lactulose medication
• Explaining that the pain will subside after a few exchanges
• Investigate further, this is maybe a sign of infection

Which of the following is NOT TRUE about nephrons

• Nephrons are the functional unit of the kidneys. Each kidney has approximately 1 million
• Active transport and reabsorption happens in the proximal and distal tubules
• Passive transport and reabsorption happens in the collecting duct
• The glomerulus is a special type of capillaries found beside the bowman's capsule

What are the most common causes of Chronic Kidney Disease? (2 answers)

• Hyperglycemia
• Hypertension
• Hypotension
• Chronic glomerulonephritis
• Kidney stones/ renal calculi

A nurse is concerned that a client receiving peritoneal dialysis may be experiencing peritonitis. Which finding noted on the nurse’s assessment supported this concern?

• Pain in the Left upper quadrant
• Cloudy dialysis output
• Radiating sternal pain
• Decreased white blood cells

Uremia occurs in stage 3 & 4 of CKD. It is characterized by:

• Orthostatic hypotension
• Low WBC and platelet count
• Frost like deposits on the skin
• Itching combined by bronchoconstriction and thick secretions

The associated problems in CKD are the following except for one;

• Due to high blood volume, the blood pressure is expected to be elevated
• Decrease in immune system happen due to toxins retained in the blood
• High calcium and low potassium blood levels are expected to happen in CKD
• Hyponatremia is related to high blood volume or hemodilution

For the nutritional therapy of patients with CKD. What are the recommendations? Tick the choices below for the correct answers (3 answers).

• Low potassium
• Low sodium
• High Calorie
• High protein
• High fat

Which notation should a nurse document as an appropriate outcome in the plan of care for a client with chronic kidney disease?

• Consumption of three large meals daily without nausea
• Daily weight gain of no more than 5 pounds
• Reduced serum albumin levels within 1 week
• Absence of bleeding