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Lewis Med-Surg Ch. 46 Acute Kidney Injury and CKD Guaranteed Success

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Lewis Med-Surg Ch. 46 Acute Kidney Injury and CKD Guaranteed Success After the insertion of an arteriovenous graft (AVG) in the right forearm, a patient complains of pain and coldness of the right fingers. Which action should the nurse take? a. Teach the patient about normal AVG function. ...

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  • October 31, 2024
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  • 2024/2025
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  • lewis med surg ch 46 acute kidney injury and ckd

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Lewis Med-Surg Ch. 46 Acute Kidney Injury and CKD
Guaranteed Success

After the insertion of an arteriovenous graft (AVG) in the right forearm, a patient complains

of pain and coldness of the right fingers. Which action should the nurse take?

a. Teach the patient about normal AVG function.

b. Remind the patient to take a daily low-dose aspirin tablet.

c. Report the patient's symptoms to the health care provider.

d. Elevate the patient's arm on pillows to above the heart level. ✔️✔️ANS: C

The patient's complaints suggest the development of distal ischemia (steal syndrome) and

may require revision of the AVG. Elevation of the arm above the heart will further decrease

perfusion. Pain and coolness are not normal after AVG insertion. Aspirin therapy is not used

to maintain grafts.

DIF: Cognitive Level: Apply (application) REF: 1088

TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity



Here’s another set of questions and answers focused on Acute Renal Injury (AKI) and Chronic Kidney
Disease (CKD):



What is the most common type of AKI?

The most common type of AKI is prerenal AKI, caused by inadequate blood flow to the kidneys. ✔️✔️



How does acute tubular necrosis relate to AKI?

Acute tubular necrosis (ATN) is a specific type of intrinsic AKI caused by damage to the kidney tubules,
often due to toxins or ischemia. ✔️✔️



What are some common risk factors for developing AKI in hospitalized patients?

Common risk factors include advanced age, pre-existing kidney disease, diabetes, and the use of certain
medications. ✔️✔️

,How can patients prevent AKI during hospital stays?

Patients can prevent AKI by staying hydrated, informing healthcare providers about all medications, and
monitoring their kidney function closely. ✔️✔️



What role do dietary proteins play in kidney health?

Excessive dietary protein can put a strain on the kidneys, especially in individuals with CKD, so
moderation is essential. ✔️✔️



What are the potential consequences of untreated CKD?

Untreated CKD can lead to end-stage renal disease (ESRD), requiring dialysis or kidney transplantation,
along with increased risk of complications. ✔️✔️



How does metabolic acidosis occur in CKD?

Metabolic acidosis occurs in CKD when the kidneys are unable to excrete enough acid or produce
adequate bicarbonate, leading to an acidic blood pH. ✔️✔️



What is the significance of anemia in CKD?

Anemia is common in CKD due to decreased erythropoietin production by the kidneys, leading to
reduced red blood cell production. ✔️✔️



What are the benefits of a kidney-friendly diet for CKD patients?

A kidney-friendly diet can help manage symptoms, slow disease progression, and reduce the risk of
complications related to CKD. ✔️✔️



How can managing cholesterol levels affect CKD progression?

Managing cholesterol levels can reduce cardiovascular risk and may slow the progression of CKD,
improving overall health outcomes. ✔️✔️



What is the purpose of kidney transplantation?

, Kidney transplantation aims to replace a non-functioning kidney with a healthy one, restoring kidney
function and improving quality of life. ✔️✔️



What are the signs that indicate worsening kidney function?

Signs of worsening kidney function may include increased fatigue, decreased urine output, swelling, and
elevated blood pressure. ✔️✔️



How does fluid restriction benefit CKD patients?

Fluid restriction helps prevent fluid overload, which can lead to complications such as hypertension,
swelling, and heart problems. ✔️✔️



What are the advantages of early referral to a nephrologist for CKD patients?

Early referral allows for specialized management of kidney disease, optimizing treatment plans, and
monitoring for potential complications. ✔️✔️



How do dialysis and kidney transplantation differ in treating kidney failure?

Dialysis is a treatment that replaces some functions of the kidneys by filtering blood, while kidney
transplantation involves replacing a failed kidney with a donor kidney. ✔️✔️



What is the importance of regular follow-up care for CKD patients?

Regular follow-up care helps monitor kidney function, manage complications, and adjust treatment
plans to improve patient outcomes. ✔️✔️



When a patient with acute kidney injury (AKI) has an arterial blood pH of 7.30, the nurse will

expect an assessment finding of

a. persistent skin tenting

b. rapid, deep respirations.

c. hot, flushed face and neck.

d. bounding peripheral pulses. ✔️✔️ANS: B

Patients with metabolic acidosis caused by AKI may have Kussmaul respirations as the lungs

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