C HAPTER 19: K IDNEY D ISORDERS AND
T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient is admitted with sepsis and acute kidney injury (AKI). The
patient is started on continu ous renal replacement therapy (CRRT). The
nurse knows that fluid is removed each hour is charted as what on the
CRRT flow sheet?
a. Convection
b. Diffusion
c. Replacement fluid
d. Ultrafiltrate
ANS: D
The fluid that is removed each hour is not called urine; it is k nown as
ultrafiltrate. Typically, some of the ultrafiltrate is replaced through the
continuous renal replacement therapy circuit by a sterile replacement
fluid. Diffusion is the movement of solutes along a concentration
gradient from a high concentration t o a low concentration across a
semipermeable membrane. Convection occurs when a pressure gradient
is set up so that the water is pushed or pumped across the dialysis filter
and carries the solutes from the bloodstream with it.
PTS: 1 DIF: Cognitive Lev el: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Kidney
, Disorders and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
2. What is the most common site for short -term vascular access for
immediate hemodialysis?
a. Subclavian artery
b. Subclavian vein
c. Femoral artery
d. Radial vein
ANS: B
Subclavian and femoral veins are catheterized when short -term access
is required or when a graft or fistula vascular access is nonfunctional
in a patient requiring immediate hemodi alysis. Subclavian and femoral
catheters are routinely inserted at the bedside. Most temporary
catheters are venous lines onl y. Blood flows out toward the dial yzer
and flows back to the patient through the same catheterized vein. A
dual-lumen venous cathet er is most commonl y used.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Planning TOP: Kidney Disorders and
Therapeutic Management MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
3. The practitioner has orde red dial ysis for a patient with acute heart
failure who is unresponsive to diuretics. Which t ype of dial ysis would
the nurse anticipate being started on this patient?
a. Intermittent ultrafiltration
b. Continuous venovenous hemofiltration (CVVH)
T HERAPEUTIC M ANAGEMENT
Urden: Priorities in Critical Care Nursing, 8th Edition
MULTIPLE CHOICE
1. A patient is admitted with sepsis and acute kidney injury (AKI). The
patient is started on continu ous renal replacement therapy (CRRT). The
nurse knows that fluid is removed each hour is charted as what on the
CRRT flow sheet?
a. Convection
b. Diffusion
c. Replacement fluid
d. Ultrafiltrate
ANS: D
The fluid that is removed each hour is not called urine; it is k nown as
ultrafiltrate. Typically, some of the ultrafiltrate is replaced through the
continuous renal replacement therapy circuit by a sterile replacement
fluid. Diffusion is the movement of solutes along a concentration
gradient from a high concentration t o a low concentration across a
semipermeable membrane. Convection occurs when a pressure gradient
is set up so that the water is pushed or pumped across the dialysis filter
and carries the solutes from the bloodstream with it.
PTS: 1 DIF: Cognitive Lev el: Appl ying OBJ: Nursing
Process Step: Implementation TOP: Kidney
, Disorders and Therapeutic Management MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
2. What is the most common site for short -term vascular access for
immediate hemodialysis?
a. Subclavian artery
b. Subclavian vein
c. Femoral artery
d. Radial vein
ANS: B
Subclavian and femoral veins are catheterized when short -term access
is required or when a graft or fistula vascular access is nonfunctional
in a patient requiring immediate hemodi alysis. Subclavian and femoral
catheters are routinely inserted at the bedside. Most temporary
catheters are venous lines onl y. Blood flows out toward the dial yzer
and flows back to the patient through the same catheterized vein. A
dual-lumen venous cathet er is most commonl y used.
PTS: 1 DIF: Cognitive Level: Understanding OBJ:
Nursing Process Step: Planning TOP: Kidney Disorders and
Therapeutic Management MSC: NC LEX:
Physiological Integrity: Reduction of Risk Potential
3. The practitioner has orde red dial ysis for a patient with acute heart
failure who is unresponsive to diuretics. Which t ype of dial ysis would
the nurse anticipate being started on this patient?
a. Intermittent ultrafiltration
b. Continuous venovenous hemofiltration (CVVH)
