A 56-year-old man is admitted to the ED because of shortness of breath. He has a history of congestive heart failure, myocardial infarction, and hypertension. Assessment findings reveal the following: blood pressure 220/110 mmHg, pulse rate 100 beats/minute-full and bounding, and respiration rate 34 breaths/minute, deep, fast, and labored. Auscultation reveals pericardial friction rub and crackles in both lung bases. EKG monitoring reveals normal sinus rhythm with tall, tented T waves. The nurse notes that the patient has distended jugular veins and edema of the hands, feet, periorbital areas, and sacrum. Indwelling urinary catheterization yields 20 mL of dark amber urine. Arterial blood gas studies show PH 7.25, PO2 60 mmHg, PCO2 36 mmHg, and HCO3 – 14 mEq/L. Laboratory results reveal a serum BUN level of 50 mg/dL and a serum creatinine level of 5.5 mg/dL. The physician diagnoses acute renal failure (ARF). The physician determines that hemodialysis is necessary for this patient. The nurse should explain to the patient that:

A 58-year-old male has arrived at the ED complaining that he has not been able to urinate for 3 days. After inserting an indwelling urinary catheter and draining 2,500 mL of urine from the patient’s bladder, the nurse formulates a nursing diagnosis of:

Your patient, with known acute renal failure, has a potassium level of 6.0 mEq/dl. What EKG findings would commonly be seen with hyperkalemia?

A 52-year-old diabetic man with a 1-year history of chronic renal failure that is treated with continuous ambulatory peritoneal dialysis is unconscious when admitted to the ED. His blood pressure is 190/100 mmHg; serum potassium level, 7.8 mEq/L; serum BUN level, 200 mg/dL, and serum creatinine level, 10 mg/dL. Available medical records indicate that 2 years ago he had been receiving 28 units of NPH insulin daily. The nurse anticipates that the patient’s hyperkalemia will be treated with:

A critically high potassium value was just received on a patient with end state renal failure. Of the following medications, which would be most useful to temporarily decrease the potassium level?

A 35-year-old woman arrives at the ED complaining of nausea, vomiting, malaise, and a decreased urine output. She recently completed a 2-week course of cephradine (Velosef) for a UTI. Urinalysis reveals a sodium level of 40 mEq/L with a urine specific gravity of 1.0. Urine sediment includes casts, with few red blood cells (RBCs) or white blood cells (WBCs). Other laboratory findings include a serum BUN level of 40 mg/dL and a serum creatinine level of 4 mg/dL. Which condition is suggestive of the patient’s assessment findings?

When administering PD dialysate solution, the nurse should assess for signs of:

If a patient with acute renal failure (ARF) exhibits a pericardial friction rub, the nurse should immediately:

Which symptom is considered the hallmark assessment finding in a patient with acute renal failure (ARF)?

A 35-year-old woman arrives at the ED complaining of nausea, vomiting, malaise, and a decreased urine output. She recently completed a 2-week course of cephradine (Velosef) for a UTI. Urinalysis reveals a sodium level of 40 mEq/L with a urine specific gravity of 1.0. Urine sediment includes casts, with few red blood cells (RBCs) or white blood cells (WBCs). Other laboratory findings include a serum BUN level of 40 mg/dL and a serum creatinine level of 4 mg/dL. Which condition is suggestive of the patient’s assessment findings?

A client who has been diagnosed with chronic kidney disease is talking to the nurse about his overall health. Which best describes the difference between health promotion and disease management in this situation?

An 18-year-old has chronic kidney insufficiency and must take an injection of growth hormone. He takes his own injections and his parents bring him to the healthcare clinic every four weeks for follow-up evaluation. What laboratory levels would need to be monitored in a client taking growth hormones?

A provider has ordered a serum creatinine test for a client who is being assessed for chronic kidney disease. The client asks the nurse about the test. Which of the following responses correctly explains serum creatinine?

A client with severe, uncontrolled hypertension is being evaluated for chronic kidney disease. The provider checks the glomerular filtration rate and determines that it is 22 mL/min. Which stage of chronic kidney disease does this GFR place the client?

The nurse is caring for a client who has been diagnosed with chronic kidney failure. Which of the following aspects of this client’s history could have contributed to this?

A diabetic client has recently been diagnosed with stage one chronic kidney disease. Which of the following topics must the nurse include when teaching this client?

The nurse is admitting a client with a history of chronic kidney disease. Which of the following lab values is inconsistent with chronic kidney disease?

The nurse is caring for a client who has chronic kidney disease. Which of the following medications would the nurse question?