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Roth 10e NCLEX Chapter 19
MULTIPLE CHOICE
1. A client with chronic renal failure who is not receiving dialysis is suffering from uremia. What nutrient
will the nurse tell this client to limit in an attempt to control the uremia?
a. carbohydrate
c. potassium
b. magnesium
d. protein
ANS: D
Uremia is a condition in which protein wastes that should normally have been excreted are instead
circulating in the blood. The diet may limit protein to as little as 40 grams a day for predialysis clients.
PTS: 1
REF: Classification of Renal Disease; Special Considerations For Clients With Renal Diseases
2. The nurse at the dialysis clinic notes when she reviews a client’s labs that the labs indicated
hyperkalemia. She makes a note to make sure the client is adhering to all dietary restrictions. Of the
following possibilities, which might the nurse ask about?
a. fiber supplements
c. salt substitutes
b. intake of whole grains
d. sugar substitutes
ANS: C
Potassium may be restricted in some clients because hyperkalemia tends to occur in end-stage renal
disease. Excess potassium can cause cardiac arrest. Because of this danger, renal clients should not use
salt substitutes or low-sodium milk because the sodium in these products is replaced with potassium.
PTS: 1
REF: Dietary Treatment of Renal Disease
3. The nurse is assessing a dialysis patient who is asking to receive continuous ambulatory peritoneal
dialysis (CAPD) instead of hemodialysis. Which of the following complications of CAPD will the
nurse review with the client? Select all that apply.
a. hypercalcemia
c. hyponatremia
b. hypertension
d. hypotension
ANS: D
Clients on CAPD have a more normal lifestyle than do clients on either hemodialysis or peritoneal
dialysis. Complications associated with CAPD include peritonitis, hypotension, and weight gain.
PTS: 1
REF: Dialysis
4. The nurse is calculating the protein requirement for a client who is switching from peritoneal dialysis
to hemodialysis. The client is 5’5” tall and weighs 140 pounds. How many grams of protein does this
client need per day?
a. 42 to 63
c. 64 to 76
b. 51 to 62
d. 76 to 96
ANS: C
A client on hemodialysis requires 1.0 to 1.2 grams of protein per kilogram of body weight.
The client weighs 64 kg so the requirement is 64 to 76.
PTS: 1
REF: Diet During Dialysis
MULTIPLE RESPONSES
1. The nurse is assessing an otherwise healthy client with renal disease. The client is taking several
supplements that are not indicated for clients who have renal disease. Which of the following will the
nurse think should be discontinued? Select all that apply.
a. iron
d. vitamin D
b. vitamin A
e. vitamin E
c. vitamin C
f. vitamin K
ANS: B, E, F
Renal clients often have an increased need for vitamins B, C, and D, and supplements are often given.
Vitamin A should not be given because the blood level of vitamin A tends to be elevated in uremia. If
a client is receiving antibiotics, a vitamin K supplement may be given. Otherwise, supplements of
vitamins E and K are not necessary.
PTS: 1
REF: Dietary Treatment of Renal Disease
2. The diet order for a client receiving hemodialysis is written as 80-3-3. When the nurse explains the
diet to the client, which of the following will be included in the teaching? Select all that apply.
a. 80 grams of fat are allowed per day
d. phosphorus is restricted to 3 grams a day
b. 80 grams of protein are allowed per day
e. potassium is restricted to 80 mg per day
c. potassium is restricted to 3 grams a day
f. sodium is restricted to 3 grams per day
ANS: B, C, F
A typical renal diet could be written as “80-3-3,” which means 80 grams of protein, 3 grams of
sodium, and 3 grams of potassium are allowed per day.
PTS: 1
REF: Diet During Dialysis
3. The nurse is educating a client who recently had a kidney transplant about the dietary changes that will
be necessary. Which of the following statements could the nurse make to the client? Select all that
apply.
a. additional calcium may be needed
d. fats may be limited
b. carbohydrates may be restricted
e. protein may be restricted
c. extra protein may be needed
f. sodium may be restricted
ANS: A, B, C, D, E, F
After kidney transplant, there may be a need for extra protein or for the restriction of protein.
Carbohydrate and sodium may be restricted. The appropriate amounts of these nutrients will depend
largely on the medications given at the time. Additional calcium and phosphorus may be necessary if
there was substantial bone loss before the transplant. There may be an increased appetite after
transplant, so fats and simple carbohydrates may be limited to prevent excessive weight gain.
PTS: 1
REF: Diet After Kidney Transplant
4. The nurse is educating the client about diet after the client was treated for calcium oxalate renal stones.
The nurse tells the client about foods that should be avoided to reduce the risk of development of
future renal stones. Which of the following foods could the nurse tell the client to avoid? Select all that
apply.
a. cheese
d. spinach
b. chocolate
e. strawberries
c. milk
f. tea
ANS: B, D, E, F
About 80% of the renal stones formed contain calcium oxalate. Recent studies provide no support for
the theory that a diet low in calcium can reduce the risk of calcium oxalate renal stones. In fact, higher
dietary calcium intake may decrease the incidence of renal stones for most people. Stones containing
oxalate are thought to be partially caused by a diet especially rich in oxalate, which is found in beets,
wheat bran, chocolate, tea, rhubarb, strawberries, and spinach.
PTS: 1
REF: Calcium Oxalate Stones