Chapter 30 Patient Management- Renal System

Chapter 30  Patient Management- Renal System

Complete Chapter Questions And Answers
 

Sample Questions

1.
A patient has just had a dual-lumen venous catheter inserted in his subclavian vein for hemodialysis for acute renal failure. What intervention or interventions should the nurse make in working with this patient? Select all that apply.
A)
Verify central line catheter placement radiographically before use.
B)
Inject all medications directly into the catheter.
C)
Leave the catheter unclamped to prevent clotting.
D)
Maintain sterile technique in handling vascular access.
E)
Observe catheter exit site for signs of inflammation.

2.
A patient with chronic renal failure has an arteriovenous fistula in her forearm for dialysis access. What intervention or interventions should the nurse make in working with this patient? Select all that apply.
A)
Take the patient’s blood pressure on the forearm containing the fistula.
B)
Palpate the fistula for thrill every 8 hours.
C)
Draw blood samples from the vein that forms the fistula.
D)
Avoid placing any restraints on the access arm.
E)
Check access patency less frequently in hypotensive patients.
F)
Occlude the fistula vein using firm pressure in the event of postdialysis bleeding from the needle site.

3.
An elderly patient in the ICU with chronic renal failure has just undergone surgery for a synthetic arteriovenous graft in her left forearm for dialysis access. The nurse recognizes that the most likely reason this patient received a graft instead of a fistula is which of the following?
A)
Thrombosis is less likely to occur with grafts than with fistulas.
B)
Fistulas are more prone to infection than are grafts.
C)
The patient’s own blood vessels were not adequate for fistula formation.
D)
An aneurysm is more likely to occur in a fistula than in a graft.

4.
A patient in the ICU is scheduled to begin peritoneal dialysis for acute renal failure. The patient tells the nurse that he understands hemodialysis but is not familiar with peritoneal dialysis. He asks her what the difference between them is. The nurse explains that the biggest difference between these two approaches is which of the following?
A)
Peritoneal dialysis relies on diffusion whereas hemodialysis relies on active transport.
B)
The peritoneum of the body serves as the semipermeable membrane in peritoneal dialysis, whereas an extracorporeal semipermeable membrane is used in hemodialysis.
C)
Hemodialysis uses a Tenckhoff catheter, whereas peritoneal dialysis uses a venous catheter.
D)
Hemodialysis uses machines called cyclers to cycle the infusion and removal of blood, whereas peritoneal dialysis uses the body’s own vascular system to do this.

5.
A patient in the ICU with severe hypotension is experiencing acute renal failure and uremia and needs dialysis. She requires a large infusion of intravenous fluids regularly. The nurse recognizes that which method of dialysis would be best for this patient?
A)
Continuous venovenous hemofiltration (CVVH)
B)
Continuous venovenous hemofiltration with dialysis (CVVH/D)
C)
Intermittent hemodialysis
D)
Peritoneal dialysis

Answer Key

1.
A, D, E
2.
B, D
3.
C
4.
B
5.
B