Renal and Urological Disorders Flashcards

A patient with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L and peaked T waves on ECG. The nurse's priority action is:

Answer: Prepare to administer calcium gluconate and notify the provider immediately

Hyperkalemia with ECG changes is a cardiac emergency; calcium gluconate is administered first to stabilize the myocardium while definitive treatment is arranged.

A patient with chronic kidney disease (CKD) stage 4 asks why they need to restrict dietary phosphorus. The best response is:

Answer: 'Your kidneys cannot excrete phosphorus well, which causes it to build up and leach calcium from bones.'

In CKD, impaired phosphorus excretion leads to hyperphosphatemia, which stimulates PTH release and causes calcium to be pulled from bone (renal osteodystrophy).

A patient with nephrotic syndrome has 4+ pitting edema and serum albumin of 1.8 g/dL. The edema is primarily caused by:

Answer: Loss of albumin in urine reducing plasma oncotic pressure

Massive protein (albumin) loss in urine lowers plasma oncotic pressure, allowing fluid to shift into the interstitium, causing profound edema.

A patient with a urinary tract infection (UTI) is prescribed trimethoprim-sulfamethoxazole (TMP-SMX). The nurse should instruct the patient to:

Answer: Take the full course of antibiotics even if symptoms resolve

Completing the full antibiotic course eradicates the infection completely and prevents recurrence and antibiotic resistance.

A patient on hemodialysis reports shortness of breath and a 4 kg weight gain since the last dialysis session. The nurse's priority assessment is:

Answer: Lung sounds and oxygen saturation

Rapid weight gain between dialysis sessions indicates fluid overload; dyspnea and crackles on auscultation suggest pulmonary edema requiring urgent assessment.

Which dietary restriction is essential for a patient with end-stage renal disease (ESRD) on hemodialysis?

Answer: Restrict potassium, phosphorus, sodium, and fluid intake

ESRD patients on hemodialysis must restrict potassium (arrhythmia risk), phosphorus (bone disease), sodium (fluid retention), and fluids (pulmonary edema risk).