A nurse is caring for a client experiencing kidney failure. The nurse recognizes that kidney failure causes the loss of which of the following processes integral to maintaining homeostasis?
Distribution of protein
Filtration of the blood
Metabolism of medications
Ability to hold urine
The Correct Answer is B
A. Distribution of protein: While protein distribution may be affected in kidney disease, it is not a primary function of the kidneys.
B. Filtration of the blood: The kidneys are responsible for filtering waste products and excess substances from the blood. In kidney failure, this filtration process is impaired, leading to the accumulation of toxins in the body.
C. Metabolism of medications: Although the kidneys do play a role in drug excretion, drug metabolism primarily occurs in the liver. Kidney failure may affect the excretion phase.
D. Ability to hold urine: While kidney failure can affect urinary function, the ability to hold urine is primarily a bladder function, not directly a function of the kidneys.
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Correct Answer is D
Explanation
A. Digoxin: Digoxin requires caution with elevated potassium levels, as hyperkalemia can increase the risk of digoxin toxicity. A potassium level of 5.3 mEq/L is borderline high, so it should be used cautiously.
B. Lisinopril: Lisinopril, an ACE inhibitor, can also increase potassium levels. It may not be the best choice for this client due to the elevated potassium.
C. Potassium iodide: Potassium iodide would further increase the client's potassium level and is contraindicated.
D. Furosemide: Furosemide is a loop diuretic that can help to lower serum potassium levels by promoting potassium excretion. Therefore, it is appropriate for this client with an elevated potassium level.
Correct Answer is C
Explanation
A. Urine-specific gravity: While urine-specific gravity can provide information on kidney function, it does not specifically measure renal impairment or disease progression, especially in SLE.
B. Serum potassium: Serum potassium levels can be affected by renal function but are not a direct indicator of renal health and can be influenced by many other factors.
C. Serum creatinine: Serum creatinine is a more reliable indicator of renal function, as it reflects how well the kidneys are filtering waste. In clients with SLE, kidney involvement is a common complication.
D. Serum sodium: Serum sodium levels do not directly indicate renal function, though kidney impairment can impact electrolyte levels.