Which sign signals the onset of end-stage renal disease (ESRD) in a client who has chronic renal failure?
a. polyuria
b. nocturia
c. severe fluid and electrolyte imbalances
d. blood urea nitrogen (BUN) of at least 20 mg/dL
C
The onset of ESRD occurs when at least 90 percent of the nephrons fail. BUN and creatinine levels rise, polyuria changes to oliguria, and severe fluid and electrolyte imbalances are evident. The diagnosis is confirmed when the BUN is at least 50 mg/dL and the serum creatinine level is greater than 5 mg/dL. All systems are affected by ESRD. Lifetime dialysis becomes inevitable unless kidney transplantation is performed and is successful.
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The parents ask about preparation of their toddler for hospital admission. The nurse suggests the child be told:
a. a week prior. b. 2 weeks prior. c. the day of admission. d. only two or three days before.
The nurse is assessing a new orientee's knowledge of when to take vital signs. The following statement indicates a need for more education
a. I should take vital signs upon admission. b. I should take vital signs when there is any change in condition. c. I should take vital signs at the beginning and end of a blood transfusion. d. I should take vital signs if a patient reports feeling different.
The caregiver of a preschool child is concerned that her 4-year-old does not talk as much or as well as her other children did at that age. What question should the nurse ask this mother?
A) "How often do you or a family member read to your child?" B) "Has your child had her hearing tested?" C) "Does your child have opportunities to have conversations with other people?" D) "Do you praise and give your child encouragement when she tries to talk with you?"
The nurse caring for a client in renal failure should question an order for which drug?
1. Ibuprofen (Advil) 800 mg three times daily 2. Erythromycin (E-Mycin) 500 mg four times daily 3. Aluminum hydroxide gel 30 mL every 4 hours as needed 4. Acetylsalicylic acid (aspirin) 162 mg daily