During the oliguric phase of acute kidney injury the nurse monitors the patient for Quizlet
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Signs and symptoms of acute renal failure include: Show A. bradycardia, with decreased respiration, low serum bicarbonate, and elevated pH.
Nursing Management: Acute Kidney Injury and Chronic Kidney Disease Terms in this set (39)a, b, c, d, e. High-risk patients include those exposed Sets with similar termsSets found in the same folderOther sets by this creatorOther Quizlet setsRelated questionsb. ECG changes Rationale: The nurse monitors the patient in the oliguric phase of acute renal injury for the following: -Hypertension and pulmonary edema: When urinary output decreases, fluid retention occurs. The severity of the symptoms depends on the extent of the fluid overload. In the case of reduced urine output (i.e., anuria, oliguria), the neck veins may become distended with a bounding pulse. Edema and hypertension may develop. Fluid overload can eventually lead to heart failure (HF), pulmonary edema, and pericardial and pleural effusions. -Hyponatremia: Damaged tubules cannot conserve sodium. Consequently, the urinary excretion of sodium may increase, which results in normal or below-normal serum levels of sodium. -Electrocardiographic changes and hyperkalemia: Initially, clinical signs of hyperkalemia are apparent on electrocardiogram (ECG) demonstrating peaked T waves, widening of the QRS complex, and ST-segment depression. -Urinary specific gravity: Urinary specific gravity is fixed at about 1.010. ANS:A
Sets with similar termsTerms in this set (26)A. hypertension. Sets with similar termsUpgrade to remove ads Only SGD 41.99/year
Terms in this set (47)a Which descriptions characterize AKI? Select all that apply a. primary cause of death is infection b During the oliguric phase of AKI, the nurse monitors the patient for Select all that apply a. hypotension c If a patient is in the diuretic phase of AKI, the nurse must monitor for which serum electrolyte imbalances? a. hyperkalemia and hyponatremia b The nurse is caring for a 68-yr-old man who had coronary artery bypass surgery 3 weeks ago. During the oliguric phase of acute kidney disease, which action would be appropriate to include in the plan of care? a. Provide foods high in potassium. d When caring for a patient during the oliguric phase of acute kidney injury (AKI), which nursing action is appropriate? a. Weigh patient three times weekly. d Which patient diagnosis or treatment is most consistent with prerenal acute kidney injury (AKI)? a. IV tobramycin a The patient has rapidly progressing glomerular inflammation. Weight has increased and urine output is steadily declining. What is the priority nursing intervention? a. Monitor the patient's cardiac status. a Which assessment findings would alert the nurse that the patient has entered the diuretic phase of acute kidney injury (AKI)? Select all that apply a. Dehydration a An unlicensed assistive personnel (UAP) reports to the RN that a patient with acute kidney failure had a urine output of 350 mL over the past 24 hours after receiving furosemide 40 mg IV push. The UAP asks the nurse how this can happen. What is the nurse's best response? a. "During the oliguric phase of acute kidney failure, patients often do not respond well to either fluid challenges or diuretics." a The RN supervising a senior nursing student is discussing methods for preventing acute kidney injury (AKI). Which points would the RN be sure to include in this discussion? Select all that apply a. Encourage patients to avoid dehydration by drinking adequate fluids. c For which patient is the nurse most concerned about the risk for developing kidney disease? a. A 25-year-old patient who developed a urinary tract infection (UTI) during pregnancy d A patient with acute kidney injury (AKI) has an arterial blood pH of 7.30. The nurse will assess the patient for a. vasodilation. c A patient with severe heart failure develops elevated blood urea nitrogen (BUN) and creatinine levels. The nurse will plan care to meet the goal of a. replacing fluid volume. c A patient who has acute glomerulonephritis is hospitalized with acute kidney injury (AKI) and hyperkalemia. Which information will the nurse obtain to evaluate the effectiveness of the prescribed calcium gluconate IV? a. Urine output d Which information will be most useful to the nurse in evaluating improvement in kidney function for a patient who is hospitalized with acute kidney injury (AKI)? a. Blood urea nitrogen (BUN) level a In a patient with acute kidney injury (AKI) who requires hemodialysis, a temporary vascular access is obtained by placing a catheter in the left femoral vein. Which intervention will be included in the plan of care? a. Place the patient on bed rest. c Which information about a patient who was admitted 10 days previously with acute kidney injury (AKI) caused by dehydration will be most important for the nurse to report to the health care provider? a. The blood urea nitrogen (BUN) level is 67 mg/dL. d After noting lengthening QRS intervals in a patient with acute kidney injury (AKI), which action should the nurse take first? a. Document the QRS interval. b When caring for a dehydrated patient with acute kidney injury who is oliguric, anemic, and hyperkalemic, which of the following prescribed actions should the nurse take first? a. Insert a urinary retention catheter. c What are intrarenal causes of AKI? Select all that apply a. anaphylaxis c An 83 year old female patient was found lying on the bathroom floor. She said she fell 2 days ago and has not been able to take her heart medicine or eat or drink anything since then. What conditions could be causing prerenal AKI in this patient? Select all that apply a. anaphylaxis d ATN is the most common cause of intrarenal AKI. Which patient is most likely to develop ATN? a. patient with DM d What indicates to the nurse that a patient with oliguria has prerenal oliguria? a. urine testing reveals a low specific gravity d Metabolic acidosis occurs in the oliguric phase of AKI as a result of impairment of a. excretion of sodium d What indicates to the nurse that a patient with AKI is in the recovery phase? a. a return to normal weight d While caring for the patient in the oliguric phase of AKI, the nurse monitors the patient for associated collaborative problems. When should the nurse notify the HCP? a. urine output is 300 ml/day d In caring for the patient with AKI, of what should the nurse be aware? a. the most common cause of death is irreversible metabolic acidosis b A 68 year old man with a history of HF resulting from HTN has AKI as a result of the effects of nephrotoxic diuretics. Currently his serum potassium is 6.2 with cardiac changes, BUN is 108, serum creatinine 4.1, and serum HCO3 13. He is somnolent and disoriented. Which treatment should the nurse expect to be used for him? a. loop diuretics b A patient with AKI has a serum potassium level of 6.7 and the following ABG results: pH: 7.28, PaCO2: 30, PaO2: 86, HCO3: 18. The nurse recognizes that treatment of the acid-base problem with sodium bicarbonate would cause a decrease in which value? a. pH c A patient with AKI is a candidate for continuous renal replacement therapy (CRRT). What is the most common indication for use of CRRT? a. pericarditis c A nurse is planning care for a client who has prerenal AKI following abdominal aortic aneurysm repair. Urinary output is 60 ml in the past 2 hours, and BP is 92/58. The nurse should expect which of the following interventions? a. prepare the client for a CT scan with contrast dye c A nurse is assessing a client who has prerenal AKI. Which of the following findings should the nurse expect? Select all that apply a. reduced BUN a A client has been admitted with acute renal failure. What should the nurse do? Select all that apply a. elevate the HOB 30-45
degrees d Which initial manifestation of acute renal failure is most common? a. dysuria d The client who is in acute renal failure has an elevated BUN. What is the likely cause of this finding? a. fluid retention a A client with acute renal failure has an increase in the serum potassium level. The nurse should monitor the client for a. cardiac arrest d A high-carbohydrate, low-protein diet is prescribed for the client with acute renal failure. The intended outcome of this diet is to a. act as a diuretic a The client with acute renal failure asks the nurse for a snack. Because the client's potassium level is elevated, which snack is most appropriate? a. a gelatin dessert a In the oliguric phase of acute renal failure, the nurse should assess the client for a. pulmonary edema a The client in acute renal failure has an external cannula inserted in the forearm for hemodialysis. Which nursing measure is appropriate for the care of this client? a. use the unaffected arm for blood pressure measurements b During dialysis, the client has disequilibrium syndrome. The nurse should first a. administer oxygen per nasal cannula c Which abnormal blood value would not be improved by dialysis treatment? a. elevated serum creatinine level a The client with acute renal failure is recovering and asks the nurse, "will my kidneys ever function normally again?" The nurse's response is based on the knowledge that the client's renal status will most likely a. continue to improve over a period of weeks a A client with AKI has a serum potassium level of 7.0. The nurse should plan which actions as a priority? Select all that apply a. place the client on a cardiac monitor b Which assessment finding is commonly found in the oliguric phase of acute kidney injury (AKI)? a. Hypovolemia a Which patient has the greatest risk for prerenal AKI? a. The patient who is hypovolemic because
of hemorrhage. a Important nursing interventions for the patient with AKI are Select all that apply a. careful monitoring of intake and output. Sets with similar termsch 47 AKI24 terms morgeyg N123 Acute Kidney Injury23 terms nicolette_hughes1 Medical Surgical Chapter 47 Acute Kidney Injury an…90 terms Lux-LopePLUS
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helen_nesius8 Chapter 10 Coding Compliance, Clinical Doc. Improv…55 terms steviegreyling E733 Quiz 1 Souza80 terms bigdjr8824__ Lecture 1745 terms awangshine Related questionsQUESTION a lender questions a couple's mortgage application asking if they were planning to marry and have several children because their income is barely enough to support the mortgage payments. This behavior by the lender: 2 answers QUESTION Whats Newtons Second law of motion 15 answers QUESTION Author of "Annabel Lee" and "A Dream within a Dream" 3 answers QUESTION What playwright purposely uses cross-gender and nontraditional casting in order to raise questions about how attitudes toward gender and race have originated? 7 answers What is the oliguric phase of acute kidney injury?Oliguric Phase: The most common initial clinical mani- festation of AKI is oliguria, defined as a reduction in urine output less than 400 mL/day. Oliguria is manifested with- in 1 to 7 days of kidney injury. This phase typically lasts 10 to 14 days but can last months in some cases.
For which finding should the nurse monitor a client in the oliguric phase of acute kidney injury AKI )? Select all that apply?During the diuresis stage of AKI, the patient will be losing an excessive amount of urine (3-6 Liters/day) and is at risk for fluid volume deficient and electrolyte imbalance. The nurse must monitor the patient's electrolyte levels, especially potassium (hypokalemia).
What should be monitored in AKI?To inform management, assessment should be made of:. Volume status (including pulse, blood pressure, peripheral perfusion, jugular venous pressure).. Renal function and serum potassium level (to exclude hyperkalaemia).. Potential underlying causes.. Renal damage (urine dipstick testing).. What is an oliguric patient?Oliguria is defined as a urine output that is less than 1 mL/kg/h in infants, less than 0.5 mL/kg/h in children, and less than 400 mL daily in adults.
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