Question

Choose the correct answer

• Indicate a rational for the answer

V. A 57-year-old male patient with type 2 diabetes is now in stage 5 chronic kidney disease (CKD); he has been receiving hemodialysis via central catheters for the past month. He is now admitted to the telemetry unit and will undergo creation of an AV graft in his left forearm to receive his hemodialysis procedures.

25) Which of the following is important to include in your patient education sessions with this patient?

a) Always inform anyone taking your BP to place the cuff above the AV graft.

b) Always inform anyone taking your blood pressure (BP) to place the cuff below the AV graft.

c) Always inform anyone taking your BP to not use the arm with the AV graft.

d) Always inform phlebotomist to use any arm for blood draw

26) Which of the following complications are typically associated with CKD who receives regular hemodialysis?

a) Painful urination or urgency

b) Anemia and uremia

c) Abdominal pain and peritonitis

d) Creatinine level of 1.4

27) What is the leading cause of a patient developing chronic kidney disease (CKD)?

a) Diabetes

b) Hypertension

c) Renal cancer

d) Gastritis

28) How does the underlying pathophysiology of acute renal failure (ARF) and CKD differ?

a) AKI always precedes CKD.

b) The most common cause of AKI is acute tubular necrosis, an intrarenal event; CKD develops over time and is typically the result of long-standing diabetes, which is a prerenal cause.

c) Although both AKI and CKD involve decreased glomerular function, only CKD has a diuretic phase before the patient develops oliguria.

29) The patient is ready for discharge after his AV graft insertion. Which of the following statements by the patient confirms he understands his nutritional therapy?

a) "I will review foods that are high in potassium because I need the extra potassium with hemodialysis treatments."

b) "I will take vitamin supplements because I should avoid eating eggs and meat."

c) "I will limit my fluid intake to a maximum of 600 mL per day and eat a low-protein diet."

30) Which of the following medications would you expect to be prescribed for a patient with stage 5 CKD?

a) Phosphate binders and erythropoietin

b) Filgrastim and diazepam

c) Furosemide and digoxin

Answer 1

Answer 1: c) Always inform anyone taking your BP to not use the arm with the AV graft.

Rational: ( This is because may be at bleeding starts at some point and patient may feel uncomfortble)

Answer 2: b) Anemia and uremia

Rational: ( Due to circulating factor responsible for stimulating erythropoiesis, and the kidney as the main source of erythropoietin (EPO) Anemia is a common feature of CKD.)

Answer 3: a) Diabetes

Rational: (In diabetes, blood glucose, or blood sugar, levels are too high. Over time, this can damage kidneys)

Answer 4: b) The most common cause of AKI is acute tubular necrosis, an intrarenal event; CKD develops over time and is typically the result of long-standing diabetes, which is a prerenal cause.

Answer 5: a) "I will review foods that are high in potassium because I need the extra potassium with hemodialysis treatments.

Rational: ( Calcium and vitamin D supplementation reduces rates of bone disease, but should not be taken after grating.)

Answer 6: a) Phosphate binders and erythropoietin

Rational: (Erythropoietin, which is a chemical that prompts your body to make red blood cells.)