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Explain energy needs when providing nutrition care of clients with chronic kidney disease.​

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because malnutrition is a common complic...

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Extracorporeal shock wave lithotripsy is a procedure that involves surgically removing a kidney stone while the patient is under general anesthesia.​

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A client is admitted to the emergency room and is found to have proteinuria, a low serum albumin, edema, and elevated blood lipids. The nurse recognizes these symptoms as those associated with _____.​


A) ​rejection of a kidney transplant
B) ​acute kidney injury
C) ​nephrotic syndrome
D) ​kidney stones
E) ​renal colic

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Approximately _____ percent of patients with end-stage renal disease receive a kidney transplant.​


A) ​5
B) ​15
C) ​24
D) ​30
E) ​42

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One primary function of the kidneys is to ____.​


A) ​produce albumin
B) ​aid in the digestion of fats
C) ​maintain acid-base balance
D) ​convert vitamin K to its active form
E) ​produce enzymes that protect the body from viral infections

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The most common cause of chronic kidney disease is _____​


A) ​diabetes
B) ​infection
C) ​a genetic disorder
D) ​inflammation
E) ​peripheral vascular disease

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Matching​ -end-stage renal disease


A) ​the rate at which filtrate is formed within the kidneys
B) a steroid hormone secreted by the adrenal cortex that promotes sodium retention and potassium excretion​
C) ​the substances that pass through the glomerulus and travel through the nephron's tubules, eventually forming urine
D) ​the waste product of creatine, a nitrogen-containing compound in muscle cells that supplies energy for muscle contraction
E) ​a syndrome caused by significant urinary protein losses (more than 3 to 31⁄2 grams daily) , as a result of severe glomerular damage
F) ​increased urine production
G) ​defined as a urine output that is less than about 50 to 75 mL/day
H) ​low plasma albumin concentrations
I) ​crystals of magnesium ammonium phosphate
J) ​an advanced stage of chronic kidney disease in which dialysis or a kidney transplant is necessary to sustain life
K) ​a cuplike component of the nephron that surrounds the glomerulus and collects the filtrate that is passed to the tubules
L) ​removal of fluids and solutes from the blood by using pressure to transfer the blood across a semipermeable membrane
M) ​a genetic disorder characterized by the elevated urinary excretion of several amino acids, including cystine
N) ​the rapid decline of kidney function over a period of hours or days
O) ​a machine used in hemodialysis to filter the blood
P) ​accumulation of nitrogenous and various other waste products in the blood
Q) ​the infusion of nutrients during hemodialysis, often providing amino acids, dextrose, lipids, and some trace minerals
R) ​a high number of kcalories per unit weight of food

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What describes an advantage of peritoneal dialysis over hemodialysis?​


A) ​It is less likely to cause blood clots.
B) ​Its dialyzer is typically more effective.
C) ​It is less likely to cause infection.
D) ​It requires fewer dietary restrictions.
E) ​It can be used for longer periods.

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Adults with chronic kidney disease frequently develop wasting and PEM.​

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​Supplementation of all fat-soluble vitamins is necessary in clients with chronic kidney disease.

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Dialysis removes excess fluids and wastes from the blood by employing the principles of diffusion, osmosis, and ultrafiltration.​

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​What food is a good source of phosphorus?


A) ​Chicken
B) ​Peanut butter
C) ​Peas
D) ​Broccoli
E) ​Cantaloupe

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Matching​ -​filtrate


A) ​the rate at which filtrate is formed within the kidneys
B) a steroid hormone secreted by the adrenal cortex that promotes sodium retention and potassium excretion​
C) ​the substances that pass through the glomerulus and travel through the nephron's tubules, eventually forming urine
D) ​the waste product of creatine, a nitrogen-containing compound in muscle cells that supplies energy for muscle contraction
E) ​a syndrome caused by significant urinary protein losses (more than 3 to 31⁄2 grams daily) , as a result of severe glomerular damage
F) ​increased urine production
G) ​defined as a urine output that is less than about 50 to 75 mL/day
H) ​low plasma albumin concentrations
I) ​crystals of magnesium ammonium phosphate
J) ​an advanced stage of chronic kidney disease in which dialysis or a kidney transplant is necessary to sustain life
K) ​a cuplike component of the nephron that surrounds the glomerulus and collects the filtrate that is passed to the tubules
L) ​removal of fluids and solutes from the blood by using pressure to transfer the blood across a semipermeable membrane
M) ​a genetic disorder characterized by the elevated urinary excretion of several amino acids, including cystine
N) ​the rapid decline of kidney function over a period of hours or days
O) ​a machine used in hemodialysis to filter the blood
P) ​accumulation of nitrogenous and various other waste products in the blood
Q) ​the infusion of nutrients during hemodialysis, often providing amino acids, dextrose, lipids, and some trace minerals
R) ​a high number of kcalories per unit weight of food

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​What condition that leads to acute kidney injury is considered a prerenal factor?


A) ​Urinary obstruction
B) ​Drug exposure
C) ​Heart failure
D) ​Trauma
E) ​Exposure to toxins

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A patient's lab results reveal hypoalbuminemia. The nurse realizes that this is likely to cause _____ in the patient.​


A) ​edema
B) ​infection
C) ​rickets
D) ​altered blood lipids
E) ​hypertension

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Matching​ -ystinuria


A) ​the rate at which filtrate is formed within the kidneys
B) a steroid hormone secreted by the adrenal cortex that promotes sodium retention and potassium excretion​
C) ​the substances that pass through the glomerulus and travel through the nephron's tubules, eventually forming urine
D) ​the waste product of creatine, a nitrogen-containing compound in muscle cells that supplies energy for muscle contraction
E) ​a syndrome caused by significant urinary protein losses (more than 3 to 31⁄2 grams daily) , as a result of severe glomerular damage
F) ​increased urine production
G) ​defined as a urine output that is less than about 50 to 75 mL/day
H) ​low plasma albumin concentrations
I) ​crystals of magnesium ammonium phosphate
J) ​an advanced stage of chronic kidney disease in which dialysis or a kidney transplant is necessary to sustain life
K) ​a cuplike component of the nephron that surrounds the glomerulus and collects the filtrate that is passed to the tubules
L) ​removal of fluids and solutes from the blood by using pressure to transfer the blood across a semipermeable membrane
M) ​a genetic disorder characterized by the elevated urinary excretion of several amino acids, including cystine
N) ​the rapid decline of kidney function over a period of hours or days
O) ​a machine used in hemodialysis to filter the blood
P) ​accumulation of nitrogenous and various other waste products in the blood
Q) ​the infusion of nutrients during hemodialysis, often providing amino acids, dextrose, lipids, and some trace minerals
R) ​a high number of kcalories per unit weight of food

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Mr. Bradley is a 70-year-old man with a long medical history including uncontrolled diabetes mellitus since age 45 who presents to the West Smithtown Dialysis Center with new-onset end-stage kidney disease. Mr. Bradley lives in an assisted living facility where he receives full-time nursing care. As a dialysis nurse, your role is to review the nutrition guidelines with Mr. Bradley, who has diabetic retinopathy and loss of vision. He is a non-ambulatory war veteran, former smoker, and former alcohol abuser whose BMI is normal, though he has lost 3% of his body weight since being diagnosed with kidney failure one month ago. A food frequency questionnaire shows that Mr. Bradley generally meets his recommended intakes of all food groups, but his fiber intake is low, and his dairy foods consumption exceeds the recommendation by double due to his love of milk, ice cream, cheese, and other dairy products. ​ -What principle regarding fluid is correctly conveyed to Mr. Bradley?​


A) ​"Gelatin, soups, fruit ices, and frozen fruit juice bars contribute to your fluid intake."
B) ​"Water losses from the skin and lungs are deducted from your fluid allowance."
C) ​"Solid foods do not contribute to your fluid intake."
D) ​"Your average fluid gain between dialysis treatments should ideally be 10 pounds."
E) ​"Most of your fluid intake should come when you take your medications."

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In oliguric patients, recovery from kidney injury sometimes begins with a period of _____, in which large amounts of fluid (up to 3 liters daily) are excreted.​


A) ​hemodialysis
B) ​proteinuria
C) ​anuria
D) ​diuresis
E) ​peritoneal dialysis

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Total parenteral nutrition may be necessary for a patient with acute kidney injury when _____.​


A) ​the patient has severe dysphagia
B) ​the patient cannot tolerate tube feedings
C) ​the patient has urine output of less than 400 mL per day
D) ​the patient has hyponatremia
E) ​the patient will need dialysis

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Matching​ -acute kidney injury


A) ​the rate at which filtrate is formed within the kidneys
B) a steroid hormone secreted by the adrenal cortex that promotes sodium retention and potassium excretion​
C) ​the substances that pass through the glomerulus and travel through the nephron's tubules, eventually forming urine
D) ​the waste product of creatine, a nitrogen-containing compound in muscle cells that supplies energy for muscle contraction
E) ​a syndrome caused by significant urinary protein losses (more than 3 to 31⁄2 grams daily) , as a result of severe glomerular damage
F) ​increased urine production
G) ​defined as a urine output that is less than about 50 to 75 mL/day
H) ​low plasma albumin concentrations
I) ​crystals of magnesium ammonium phosphate
J) ​an advanced stage of chronic kidney disease in which dialysis or a kidney transplant is necessary to sustain life
K) ​a cuplike component of the nephron that surrounds the glomerulus and collects the filtrate that is passed to the tubules
L) ​removal of fluids and solutes from the blood by using pressure to transfer the blood across a semipermeable membrane
M) ​a genetic disorder characterized by the elevated urinary excretion of several amino acids, including cystine
N) ​the rapid decline of kidney function over a period of hours or days
O) ​a machine used in hemodialysis to filter the blood
P) ​accumulation of nitrogenous and various other waste products in the blood
Q) ​the infusion of nutrients during hemodialysis, often providing amino acids, dextrose, lipids, and some trace minerals
R) ​a high number of kcalories per unit weight of food

Correct Answer

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