A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Increasing hematocrit

Decreasing serum potassium

Decreasing platelets

Increasing white blood cells

Answer and Explanation

The Correct Answer is A

A.   Hematocrit measures the proportion of blood volume that is occupied by red blood cells. Epoetin alfa stimulates red blood cell production, so a therapeutic effect would be indicated by an increase in hematocrit levels. This is a key laboratory result to monitor when assessing the effectiveness of epoetin alfa in treating anemia in CKD patients.
B.   Serum potassium levels are important to monitor in CKD patients due to the risk of hyperkalemia, but they are not directly affected by epoetin alfa. Decreasing serum potassium is not a primary indicator of the therapeutic effect of epoetin alfa.
C.   Platelet count measures the number of platelets in the blood, which are crucial for blood clotting. Epoetin alfa is not designed to affect platelet counts; thus, a change in platelet count is not an indicator of the medication's therapeutic effect.
D.   White blood cell count reflects the immune system's status and is not directly influenced by epoetin alfa. This medication specifically targets red blood cell production and does not impact white blood cell counts.

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Correct Answer is A

Explanation

A. This method is the most reliable for measuring fluid retention. Weight changes are a direct indicator of fluid balance because fluid retention or loss affects body weight. By comparing the client's current weight to their post-dialysis weight, you can determine the amount of fluid they have retained.

B. Creatinine and blood urea nitrogen (BUN) levels are indicators of kidney function rather than fluid volume status. Elevated levels can indicate worsening kidney function but do not directly measure fluid retention or overload.
C. While assessing skin turgor and peripheral edema can provide some clues about fluid overload, these signs are less precise and subjective compared to weight measurements. Skin turgor changes and edema can be influenced by various factors, including skin elasticity and other conditions, making them less reliable for accurately measuring fluid volume changes since the last dialysis.
D. Crackles in lung sounds can indicate pulmonary congestion due to fluid overload, but this method is not as precise for quantifying the amount of fluid retained. Crackles suggest fluid accumulation in the lungs, which is a sign of more severe fluid overload but does not provide a specific measurement of fluid volume compared to changes in body weight.

A. Gentamicin B. Daily potassium supplement C. Captopril D. Metformin

Correct Answer is C

Explanation

A. Gentamicin is an aminoglycoside antibiotic used to treat bacterial infections. It is not appropriate for managing CKD directly and is generally avoided in patients with kidney impairment due to its potential nephrotoxicity.
B. Potassium supplements are typically not recommended unless there is a documented deficiency in potassium. In stage 3a CKD, managing potassium levels is crucial, but supplements are not usually needed unless potassium levels are low.
C. Captopril is an angiotensin-converting enzyme (ACE) inhibitor. ACE inhibitors are beneficial for patients with CKD as they help lower blood pressure and provide renal protective effects. They can reduce proteinuria (protein in urine), which is common in CKD, and may slow the progression of kidney disease.
D. Metformin is an oral medication used to manage type 2 diabetes by improving insulin sensitivity and lowering blood glucose levels. Although it is important to monitor blood glucose in CKD patients, this
client’s fasting blood glucose is within normal range (83 mg/dL), so Metformin is not indicated unless there was evidence of diabetes or significant glucose dysregulation.

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A client with chronic kidney disease is receiving epoetin alfa. Which laboratory result would indicate a therapeutic effect of the medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

Correct Answer is A

Explanation

Correct Answer is C

Explanation

A client with rapidly progressing end-stage renal disease (ESRD) asks about the possibility of a kidney transplant. In responding to the client, the nurse understands that which of the following is a contraindication for receiving a kidney transplant?

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

A client who received a kidney transplant last month is in the nephrology clinic for a follow-up visit. Which education should the nurse provide to the client regarding complications which can arise after a kidney transplant?

A client has had recurrent kidney stones. Upon lab analysis of the client's urine, it is found that excessive purine intake is the underlying cause. Which of the following high-purine foods should the nurse instruct the client to avoid?

During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

The nurse is providing education to a male client who is newly-diagnosed with polycystic kidney disease. Which of the following statements should be included in the client teaching?

A patient who performs dialysis at home using a catheter placed through the abdominal wall reports nausea, vomiting, diarrhea, and fluid discharge from the catheter site. The laboratory reports reveal an increased white blood cell count (WBC). Which condition does the nurse suspect in the patient?