Fluid Imbalances and Renal Management in Nursing

What nursing intervention treats urinary incontinence for a client with MS?

Encouraging fluids of at least 2L per day.

What are the types of urinary incontinence?

1. Urge incontinence: urgent need to urinate. 2. Functional incontinence: loss of urine due to barriers preventing timely toilet access. 3. Overflow incontinence: leakage due to incomplete bladder emptying. 4. Stress incontinence: leakage during physical activity due to increased intraabdominal pressure.

What is the appropriate nursing diagnosis for a client with renal calculi?

Risk for infection.

What initial nursing intervention should be performed for a client with head trauma and high urine output?

Evaluate urine specific gravity.

What is the normal range for urine specific gravity?

1.010-1.030.

What does ADH stand for and what is its function?

Anti-diuretic Hormone; it helps hold urine.

What is SIADH and what are its effects?

Syndrome of Inappropriate Antidiuretic Hormone; it causes fluid retention, cerebral edema, hyponatremia, decreased urine output, and increased urine specific gravity.

What is the effect of Diabetes Insipidus (DI) on urine output and sodium levels?

It causes increased urine output (polyuria) and hypernatremia.

What hormone is produced by the adrenal cortex and what is its function?

Aldosterone; it promotes sodium retention and potassium excretion.

What are the signs of Fluid Volume Excess (FVE)?

Weight gain, edema, increased urine output, and decreased urine specific gravity.

What are the signs of Fluid Volume Deficit (FVD)?

Weight loss, dryness of mouth, skin, mucous membranes, decreased urine output, and increased urine specific gravity.

What is the maximum fluid intake for a male client in the oliguric phase of acute renal failure?

1200 mL/day.

What happens if fluid intake is not limited in the oliguric phase?

Fluid overload occurs, as the kidneys cannot excrete the excess fluid.

What are the phases of acute renal failure?

1. Oliguric phase: decreased urine output, increased BUN and creatinine. 2. Diuretic phase: increased urine output, improved GFR. 3. Recovery phase: normalization of urine output, GFR, BUN, and creatinine.

What is uremic frost?

A condition characterized by snowflake-like deposits on the skin due to the accumulation of uric acid.

What should fluid intake and urine output ideally relate to?

Fluid intake should be approximately equal to urine output.

What assessment finding suggests a client is experiencing acute renal failure?

Urine output of 400 mL/day.

What dietary recommendations are made for acute renal failure (ARF) and chronic renal failure?

ARF: Moderate protein; Chronic: Low protein.

What indicates a patent arteriovenous fistula for hemodialysis?

Palpation of a thrill over the fistula.

What client situation requires avoiding foods high in potassium?

An 18-year-old with renal disease.

What medication would be anticipated for a patient with a potassium level of 6.5 mEq/L?

Kayexalate.

What medication could cause elevated potassium levels in a patient?

Spironolactone.

How is ABG interpretation structured regarding pH, PCO2, and HCO3?

pH indicates acid/base status; PCO2 indicates respiratory status; HCO3 indicates metabolic status.

What does a fully compensated ABG indicate?

Normal pH with abnormal PCO2 and HCO3.

What does a partially compensated ABG indicate?

Abnormal pH with both PCO2 and HCO3 abnormal.