A nurse reviews laboratory results for a client with ...

[lak]

A nurse reviews laboratory results for a client with glomerulonephritis. The client's glomerular filtration rate (GFR) is 40 mL/min as measured by a 24-hour creatinine clearance. How should the nurse interpret this finding? (Select all that apply.)
 
  a. Excessive GFR
  b. Normal GFR
  c. Reduced GFR
  d. Potential for fluid overload
  e. Potential for dehydration

Question 2

A nurse teaches a client with polycystic kidney disease (PKD). Which statements should the nurse include in this client's discharge teaching? (Select all that apply.)
 
  a. Take your blood pressure every morning.
  b. Weigh yourself at the same time each day.
  c. Adjust your diet to prevent diarrhea.
  d. Contact your provider if you have visual disturbances.
  e. Assess your urine for renal stones.

[Dunkey]

Answer to Question 1

ANS: C, D
The GFR refers to the initial amount of urine that the kidneys filter from the blood. In the healthy adult, the normal GFR ranges between 100 and 120 mL/min, most of which is reabsorbed in the kidney tubules. A GFR of 40 mL/min is drastically reduced, with the client experiencing fluid retention and risks for hypertension and pulmonary edema as a result of excess vascular fluid.

Answer to Question 2

ANS: A, B, D
A client who has PKD should measure and record his or her blood pressure and weight daily, limit salt intake, and adjust dietary selections to prevent constipation. The client should notify the provider if urine smells foul or has blood in it, as these are signs of a urinary tract infection or glomerular injury. The client should also notify the provider if visual disturbances are experienced, as this is a sign of a possible berry aneurysm, which is a complication of PKD. Diarrhea and renal stones are not manifestations or complications of PKD; therefore, teaching related to these concepts would be inappropriate.