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Renal

1. What is the major cause of glomerulonephritis?

streptococcus

2. When a client has glomerulonephritis, are they in a fluid volume deficit or a fluid volume

excess?
FVE

3. When a client has glomerulonephritis. Why do they develop malaise and headache?
buildup of toxins

4. When a client has glomerulonephritis, why does their urine output go down?
kidneys are failing

5. When a client has glomerulonephritis, why does their BUN and creatinine go up?
unable to excrete the urea and creatinine through the kidneys

6. When a client has glomerulonephritis, why do they get protein in their urine?
glomerulus has holes in it so protein can leak out

7. Explain CVA tenderness.

this is costovertebral angle tenderness. Its when you tap over the kidneys and tenderness occurs

8. In glomerulonephritis, why does the blood pressure go up?

retaining fluid

9. And what will happen to the urine specific gravity?

increases

10. With any type of kidney disease, it is common for the BUN to be elevated; therefore, why

do we limit the protein in the diet?

protein makes your urine level in your blood go up

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11. If you add protein to the diet of anyone with renal disease, what will happen to their BUN?
increase

12. Why does the glomerulonephritis client need rest?

for diuresis and toxins make you fatigued

13. When determining fluid replacement for a renal disease client (glomerulonephritis), you

always give them what they lost in a 24- hour period plus 500 mL. What is the purpose of
adding 500 mLs?
to account for the insensible fluid loss

14. Once diuresis begins in glomerulonephritis, will the client be at risk for a fluid volume

deficit or fluid volume excess?

FVD

15. When a client has nephrotic syndrome, what is the major element that is leaking out in their

urine?
protein

16. What will protein or albumin hold onto in the vascular space?
fluid

17. If a client does not have protein or albumin in their vascular space (blood), what is going to

happen to all the fluid that is supposed to stay in their vascular system?
goes out into the interstitial space tissue

18. How does this affect the vascular space?

decreases the volume in the vascular space

19. Therefore, will the nephrotic syndrome client (in the acute stages) be in a fluid volume

deficit or fluid volume excess?

FVD

20. When a client has nephrotic syndrome, they develop total body edema, what is the proper

term for total body edema?

anasarca

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21. When a client has nephrotic syndrome, it is common for them to be placed on prednisone.

Why?
to decrease inflammation, decrease the size of the holes in the glomerulus so protein can no
longer leak out

22. Does the nephrotic syndrome client need a high-sodium diet or a low-sodium diet? Explain

why.
low sodium diet is needed to decrease further edema

23. Does the nephrotic syndrome client need a high-protein diet or a low-protein diet? Explain

why.
high protein diet to help offset the amount of protein this client is losing through their
glomerulus
24. How can bradycardia cause renal failure?
decreases perfusion

25. How can hypovolemia cause renal failure?

decreased perfusion

26. How can shock cause renal failure?

decreased perfusion

27. How can decreased cardiac output cause renal failure?

decreased perfusion

28. How can glomerulonephritis, nephrotic syndrome, or diabetes cause renal failure?
vascular damage

29. How can a kidney stone cause renal failure?

urine can be trapped in the kidney

30. How can ureteral swelling cause renal failure?

urine can be trapped in the kidney

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31. How can a tumor or an enlarged prostate cause renal failure?

urine can be trapped in the kidney

32. When a client is in renal failure, why does their BUN and creatinine go up?
bc the client is unable to excrete ura and the creatinine

33. What happens to the specific gravity in renal failure?

It usually goes up, but it can also become fixed. When it becomes fixed this means that the
client’s urine specific gravity does not respond to high volumes of fluids or restriction of fluids. It stays
the same.

34. Why can the renal failure client become anemic?

because erythropoietin can be altered

35. Why does the renal failure client’s blood pressure go up?
because they are retaining fluid

36. Why is the renal failure client at risk for heart failure?
because they are retaining fluid

37. Why does the renal failure client develop anorexia, nausea, and vomiting?
because buildup of toxins

38. Why does the renal failure client develop an itching frost?
urea builds up in the blood and eventually will escape through the pores onto the skin
39. Why does the renal failure client have to worry about osteoporosis?
Because the renal failure client retains phosphorus; therefore, that makes them excrete their
calcium, which lowers the serum calcium then the client starts pulling calcium from the bone

40. There are two phases of renal failure. The first phase is an oliguric phase, if a client is

oliguric, what has happened to the urine output?

urine output has decreased

41. Why does the oliguric client go into a fluid volume excess?
retaining fluid

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42. Why does the oliguric client develop hyperkalemia?

unable to excrete potassium

43. The second phase of renal failure is called the diuretic phase. When a client is diuresing,

what has happened to their urine output?

increasing

44. Why will a client who is diuresing go into a fluid volume deficit?
losing volume

45. If a client goes into a fluid volume deficit, what will happen to their blood pressure?
decrease

46. What will happen to their heart rate? Explain why.

increase. Trying to compensate for the decrease in volume

47. When a client is diuresing, their serum potassium level goes down (hypokalemia). Explain

why.
because potassium is being excreted through the kidneys

48. If a client is allergic to Heparin, they cannot be hemodialyzed. Why?

because heparin is used during the procedure

49. Is hemodialysis done every day?

no

50. Does the client who is being hemodialyzed have to watch what they eat and drink in

between treatment? Why?

yes because between treatments the client is unable to excrete excess electrolytes and fluids

51. Explain the basic nursing care for a circulatory access (A-V shunt, fistula, or graft).
no BP, no punctures in extremity, do not wear watch on that extremity, check it for adequate
circulation

52. Why can’t a client who has an alternate circulatory access device have blood pressures or
venipunctures in that extremity?
because these could cause a clot to occur in the circulatory access device

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53. Explain in your own words what peritoneal dialysis is.

Fluid is instilled into the abdomen. Fluid stays in for a period of time, then it is drained out of the
abdomen along with all of the excess electrolytes and toxins that have accumulated in the client’s body.

54. When a client is having peritoneal dialysis, where is the fluid going into?
abdomen- peritoneal cavity

55. What would you do if you instilled 1,000 mL of fluid into the peritoneal dialysis client and

only 700 mL came back?

turn the client from side to side or reposition the client

56. What should the drainage of peritoneal dialysis look like?

clear and straw colored

57. What would be signs and symptoms of infection with peritoneal dialysis?
cloudy or dark fluid return

58. When a client has peritoneal dialysis for renal failure, why do they have to increase protein

and fiber in their diet?

This client needs protein because protein can leak into the peritoneal cavity during the
procedure. The client needs fiber because of the constipation problems they have due to decreased
peristalsis

59. When a client has peritoneal dialysis, why do they have a constant sweet taste and why do

they have anorexia?

the dialysate that is used is a high glucose content

60. What are the major signs of kidney stones?

hematuria and pain

61. What is the number one thing you need to remember with kidney stones?
fluids!!!

62. Why is the serum creatinine not affected by what we eat?

because creatinine is constantly produced in our bodies due to skeletal muscle breakdown

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63. What type of specimen do you need to test a creatinine level on a client?
blood
64. Is the BUN affected by what we eat?
yes