NCLEX chronic kidney disease and dialysis
NCLEX review for chronic kidney disease and dialysis covers essential nursing actions, normal lab values, safety priorities, and key differences in managing patients with renal issues.
Quiz(72 questions)
1. What is the definition of Chronic Kidney Disease (CKD)?
Terms in this Study Set(72)
Chronic Kidney Disease (CKD) Basics(16)
Define Chronic Kidney Disease (CKD).
A progressive loss of kidney function over time, characterized by reduced glomerular filtration rate (GFR) < 60 mL/min for 3 months or longer.
What are the stages of CKD?
Stage 1: GFR ≥ 90 mL/min Stage 2: GFR 60-89 mL/min Stage 3: GFR 30-59 mL/min Stage 4: GFR 15-29 mL/min Stage 5: GFR < 15 mL/min (ESRD)
True or False: CKD is reversible.
False. CKD is generally irreversible and progressive, leading to end-stage renal disease (ESRD) without intervention.
List key risk factors for CKD.
- Diabetes - Hypertension - Age > 60 - Family history - Obesity
What is the primary nursing assessment for CKD?
Monitor kidney function tests, including serum creatinine and GFR, as well as electrolyte levels and blood pressure.
Identify common symptoms of CKD.
- Fatigue - Swelling (edema) - Loss of appetite - Changes in urine output - Sleep disturbances
What laboratory values are critical in CKD?
Monitor: - Serum creatinine - Blood urea nitrogen (BUN) - Electrolytes (potassium, phosphorus) - Hemoglobin levels
Cause → Effect: Increased potassium levels in CKD.
Causes hyperkalemia, which can lead to dangerous cardiac arrhythmias and requires prompt treatment.
Fill in the blank: CKD can lead to ____ disease.
Cardiovascular disease due to fluid overload, electrolyte imbalances, and hypertension.
What dietary restrictions are recommended for CKD patients?
- Low protein (if stage 4 or 5) - Low sodium - Low potassium - Low phosphorus
Compare CKD Stage 1 and Stage 5.
Stage 1: Normal or increased GFR, no symptoms. Stage 5: GFR < 15 mL/min, requires dialysis or transplant.
What does a GFR < 15 mL/min indicate?
End-stage renal disease (ESRD), necessitating dialysis or kidney transplantation.
What is the significance of proteinuria in CKD?
Presence of protein in urine indicates kidney damage and is a marker for disease progression.
True or False: All patients with CKD will require dialysis.
False. Only patients with stage 5 CKD or those with severe complications may require dialysis.
Name two common complications of CKD.
- Anemia - Bone disease (renal osteodystrophy)
Calculate the estimated GFR (eGFR) using the formula:
Dialysis Overview(20)
What are the two main types of dialysis?
Hemodialysis and peritoneal dialysis.
Indications for dialysis include:
- End-stage renal disease - Acute kidney injury - Severe electrolyte imbalances - Drug overdose.
True or False: Hemodialysis can be done at home.
False. Hemodialysis typically requires a clinical setting, while peritoneal dialysis can be done at home.
What is the primary function of dialysis?
To remove waste products and excess fluid from the blood.
Fill in the blank: In hemodialysis, blood is filtered through a __________.
dialyzer (artificial kidney).
Comparison: Hemodialysis vs. Peritoneal dialysis.
Hemodialysis: - Uses a machine - 3 times/week Peritoneal dialysis: - Uses peritoneal cavity - Daily or every night.
What are common nursing actions during dialysis?
- Monitor vital signs - Assess access site - Observe for complications (e.g., hypotension, cramping).
True or False: Patients on dialysis should avoid high potassium foods.
True. High potassium foods can lead to dangerous levels in dialysis patients.
What is a common complication during hemodialysis?
Hypotension, which can occur due to rapid fluid removal.
Indications for starting dialysis in CKD patients:
- GFR < 15 mL/min - Severe symptoms of uremia.
What is peritoneal dialysis fluid commonly called?
Dialysate.
What is a key nursing consideration for patients on dialysis?
Ensure the patient is hydrated appropriately before treatment.
Fill in the blank: The target weight gain between dialysis sessions should not exceed __________.
2-3 kg.
What vital signs should be monitored during dialysis?
Blood pressure, heart rate, temperature.
What does a dialysis machine do?
It removes waste, excess fluids, and maintains electrolyte balance.
True or False: Patients can eat normally while on dialysis.
False. Diet must be modified, especially regarding protein, potassium, and phosphorus.
What is the purpose of anticoagulation during hemodialysis?
To prevent clotting in the dialysis circuit.
Common adverse effects during dialysis include:
- Nausea - Headache - Fatigue.
What is the typical duration for a hemodialysis session?
About 3 to 5 hours per session.
What lab values should be monitored during dialysis?
- Potassium - BUN - Creatinine.
Lab Values and Monitoring(20)
Normal serum creatinine levels?
0.6-1.2 mg/dL. Elevated in CKD.
What is the normal glomerular filtration rate (GFR)?
Normal GFR is ≥ 90 mL/min. < 60 indicates CKD.
True or False: BUN levels are always elevated in CKD.
False. BUN can vary based on protein intake.
Normal potassium (K+) level?
3.5-5.0 mEq/L. Hyperkalemia is common in CKD.
Calcium and phosphorus relationship?
Inverse relationship; low calcium can lead to high phosphorus.
What causes anemia in CKD?
Decreased erythropoietin production leads to reduced RBC production.
Normal sodium (Na+) levels?
135-145 mEq/L. Should be monitored closely in CKD.
What is the normal range for bicarbonate (HCO3-)?
22-28 mEq/L. Metabolic acidosis may occur in CKD.
Monitoring for fluid overload in dialysis patients?
Assess daily weight, BP, and lung sounds.
What is the normal albumin level?
3.5-5.0 g/dL. Low levels may indicate nephrotic syndrome.
Normal phosphate (PO4) level?
2.5-4.5 mg/dL. Elevated in CKD.
What is the importance of monitoring urine output?
Indicates kidney function and fluid balance.
Cause → Effect: Elevated creatinine.
→ Indicates decreased renal function.
Normal hemoglobin (Hb) levels?
13.5-17.5 g/dL for men; 12.0-15.5 g/dL for women.
What is the target systolic BP for CKD patients?
Less than 130 mmHg to reduce progression.
What is the significance of proteinuria?
Indicates kidney damage; often assessed with a dipstick.
Normal uric acid levels?
3.5-7.2 mg/dL. Elevated levels can lead to gout.
What is the normal range for LDH?
125-220 U/L. Elevated levels may indicate tissue damage.
Lab monitoring frequency for dialysis patients?
Typically every 1-3 months; more frequent if unstable.
What is the effect of decreased GFR on medications?
Increased risk of toxicity; dose adjustments may be needed.
Patient Education and Safety(16)
What dietary restrictions are common in CKD?
Limit protein, sodium, potassium, and phosphate intake. Focus on low-protein options.
True or False: Patients on dialysis can eat unlimited potassium.
False. High potassium can cause cardiac issues; dietary restriction is essential.
Fill in the blank: The primary purpose of dialysis is to remove _______.
waste products and excess fluid from the blood.
What should be monitored post-dialysis?
Blood pressure, weight, electrolytes, and access site for complications.
Cause → Effect: High phosphorus levels in CKD lead to _____.
bone disease and vascular calcification.
List key signs of fluid overload.
- Edema - Hypertension - Shortness of breath - Weight gain
What is the role of erythropoietin in CKD?
Stimulates red blood cell production to combat anemia.
True or False: Dialysis can fully replace kidney function.
False. Dialysis supports but does not fully replace kidney function.
What is a common complication of dialysis?
Hypotension due to fluid removal during treatment.
Normal range for serum creatinine in CKD?
0.6 - 1.2 mg/dL; levels may rise with worsening kidney function.
What immunizations should CKD patients receive?
Influenza, pneumococcal, and hepatitis B vaccines are recommended.
How often should patients on hemodialysis be educated?
At least every treatment session; ongoing education improves outcomes.
What to include in patient education about dialysis access care?
- Keep the access site clean - Monitor for signs of infection - Do not use the access for blood draws
Difference between hemodialysis and peritoneal dialysis?
Hemodialysis uses a machine; peritoneal dialysis uses the abdominal lining.
What is the target blood pressure for CKD patients?
Less than 130/80 mmHg to prevent cardiovascular complications.
What should CKD patients understand about their medications?
Adherence is critical; many medications require dosing adjustments.
Questions in this Study Set(72)
1. What is the definition of Chronic Kidney Disease (CKD)?
2. What is the primary purpose of hemodialysis?
3. What are the normal serum creatinine levels in adults?
4. What is the main dietary restriction for patients with chronic kidney disease (CKD)?
5. At what GFR level is Stage 3 CKD classified?
6. Which type of dialysis involves using a machine to filter blood?
7. What is the normal range for glomerular filtration rate (GFR)?
8. Which electrolyte level is critical to monitor in patients on dialysis?
9. True or False: Chronic Kidney Disease is a reversible condition.
10. Which of the following is a common indication for starting dialysis?
11. True or False: BUN levels are always elevated in chronic kidney disease (CKD).
12. Fill in the blank: The purpose of erythropoietin in CKD patients is to stimulate ______.
13. Which of the following is NOT a risk factor for CKD?
14. What is the typical frequency of hemodialysis sessions for most patients?
15. What is the normal potassium (K+) level for adults?
16. Which complication is commonly associated with hemodialysis?
17. What is the primary nursing action in managing a patient with CKD?
18. What is a common complication during hemodialysis?
19. Which of the following reflects the inverse relationship between calcium and phosphorus?
20. What should patients be educated about concerning their dialysis access site?
21. Which symptom is commonly associated with CKD?
22. Fill in the blank: During peritoneal dialysis, the solution used to draw waste products is called __________.
23. What is the primary cause of anemia in patients with CKD?
24. Which of the following is NOT a sign of fluid overload in CKD?
25. What laboratory value is most critical to monitor in CKD?
26. Which of the following dietary restrictions is essential for patients on dialysis?
27. What are the normal sodium (Na+) levels in adults?
28. Which immunization is recommended for CKD patients to prevent complications?
29. What does a GFR of less than 15 mL/min indicate?
30. True or False: Anticoagulation is used during hemodialysis to prevent blood clotting in the dialysis circuit.
31. What is the normal range for bicarbonate (HCO3-) in adults?
32. What is the normal range for serum creatinine in adults?
33. Which dietary restriction is recommended for stage 4 CKD patients?
34. What vital signs are crucial to monitor during dialysis sessions?
35. Which of the following is a key assessment for monitoring fluid overload in dialysis patients?
36. How often should patient education occur for those undergoing hemodialysis?
37. What is the significance of proteinuria in CKD?
38. What is the target weight gain between dialysis sessions for patients?
39. What is the normal albumin level in adults?
40. Which statement regarding dialysis is true?
41. Which of the following complications is commonly seen in CKD?
42. Which statement about dialysis duration is correct?
43. What is the normal phosphate (PO4) level in adults?
44. What is the target blood pressure for patients with CKD to manage cardiovascular risk?
45. What is the estimated GFR (eGFR) formula?
46. What lab values should be monitored closely during dialysis?
47. What is the importance of monitoring urine output in CKD patients?
48. Which dietary restriction is essential for managing high phosphorus levels in CKD?
49. Which stage of CKD requires dialysis or transplantation?
50. True or False: Patients on dialysis can maintain a normal diet without restrictions.
51. Elevated creatinine levels indicate which of the following?
52. Which of the following medications may require dosage adjustment in CKD?
53. True or False: Not all CKD patients will need to start dialysis.
54. In peritoneal dialysis, which of the following conditions would require immediate intervention?
55. What are the normal hemoglobin (Hb) levels for men?
56. What is the difference between hemodialysis and peritoneal dialysis?
57. Which of the following is a characteristic of Stage 1 CKD?
58. What is a major advantage of peritoneal dialysis compared to hemodialysis?
59. What is the target systolic blood pressure for CKD patients?
60. True or False: High potassium levels are safe for patients on dialysis.
61. Which stage of Chronic Kidney Disease (CKD) is characterized by a GFR of 30-59 mL/min?
62. Which of the following is NOT a common adverse effect during dialysis?
63. What does significant proteinuria indicate in a patient?
64. Which of the following statements about dietary restrictions for patients with chronic kidney disease is accurate?
65. Which statement best describes the process of peritoneal dialysis?
66. What are the normal uric acid levels in adults?
67. What is a key nursing action before initiating hemodialysis?
68. What is the normal range for lactate dehydrogenase (LDH) in adults?
69. Which of the following best describes the difference between hemodialysis and peritoneal dialysis?
70. How often should lab monitoring occur for stable dialysis patients?
71. In the context of dialysis, which situation would most likely indicate a need for immediate medical intervention?
72. What is the effect of decreased GFR on medication dosing?
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