Question 1

An 88-year-old client has glomerulonephritis, is quite edematous, and has an order for large doses of diuretics. Before administering the first dose, the most appropriate action by the nurse would be to
A) call the physician to clarify the order.
B) educate the client as to the drug's effects.
C) have the unlicensed assistive personnel take a set of vital signs.
D) plan to administer the diuretics evenly spaced throughout the day.

Accepted Answer

The diuretic will cause fluid volume shifting and hopefully, the excretion of extra fluid from the client. However, diuresis in an older client must be handled carefully as they are not able to tolerate sudden shifts in vascular volume. Before administering a large dose of a diuretic to this client, the nurse should clarify the order. Of course, option b is always a correct answer, and a set of vital signs would help the nurse monitor and assess the client's reaction. Depending on how the diuretics are ordered, option d may or may not be appropriate.

Question 2

A female client has recurrent urinary tract infections (UTIs). Important self-care measures the nurse could teach this client to protect her kidneys include (Select all that apply)
A) acidifying the urine by drinking cranberry juice.
B) ensuring adequate fluid intake.
C) seeking medical attention at the first sign of UTI.
D) wiping the perineal area from front to back.

Accepted Answer

All options are good health promotion measures to prevent UTIs, and hence prevent pyelonephritis.

Question 3

Health promotion measures the nurse could suggest to clients to prevent renal artery disease are
A) avoiding UTIs, or seeking prompt treatment if they occur.
B) eating a "Mediterranean" style diet.
C) the same as those for cardiovascular disease.
D) unknown; it appears that it is an inherited condition.

Accepted Answer

Ninety percent of all renal artery disease is caused by atherosclerosis or fibromuscular dysplasia. Health promotion activities are the same as those for atherosclerosis and cardiovascular disease. The Mediterranean style diet is being investigated for heart-healthy benefits, but is not proven. The other two options will not reduce risk for renal artery disease.

Question 4

In caring for a client who underwent renal angioplasty and stent placement, the nurse would anticipate administering a(n)
A) antiplatelet agent.
B) aminoglycoside antibiotic.
C) beta-adrenergic blocker.
D) diuretic.

Accepted Answer

If a stent is placed, an antiplatelet agent or anticoagulant may be prescribed to minimize the risk of acute thrombosis in the post-angioplasty client.

Question 5

The nurse explains that polycystic kidney disease ultimately results in
A) acute renal failure.
B) chronic renal failure.
C) glomerulonephritis.
D) pyelonephritis.

Accepted Answer

Polycystic disease ultimately results in chronic renal failure.

Quiz 35: Management of Clients with Renal Disorders

An 88-year-old client has glomerulonephritis, is quite edematous, and has an order for large doses of diuretics. Before administering the first dose, the most appropriate action by the nurse would be to

A female client has recurrent urinary tract infections (UTIs) . Important self-care measures the nurse could teach this client to protect her kidneys include (Select all that apply)

Health promotion measures the nurse could suggest to clients to prevent renal artery disease are

In caring for a client who underwent renal angioplasty and stent placement, the nurse would anticipate administering a(n)

The nurse explains that polycystic kidney disease ultimately results in