A client is admitted to the hospital and has a diagnosis of early-stage chronic renal failure. Which of the following would the nurse expect to note on assessment of the client?
A. Polyuria
B. Polydipsia
C. Oliguria
D. Anuria
Correct Answer: A. Polyuria
Polyuria occurs early in chronic renal failure and if untreated can cause severe dehydration. Polyuria progresses to anuria, and the client loses all normal functions of the kidney. It is suggested that at this stage of chronic renal failure the mechanism of a diuresis increase is not due to osmotic diuresis but rather to secretion of prostaglandin E2 which inhibits cation reabsorption and stimulates diuresis.
Option B: Polydipsia is unrelated to chronic renal failure. Polydipsia is the term given to excessive thirst and is one of the initial symptoms of diabetes. It is also usually accompanied by temporary or prolonged dryness of the mouth.
Option C: In patients with acute oliguria, one of the most common functional derangements that are observed is the sudden fall in the GRF, leading to acute renal failure. It results in rapid increment in plasma urea and creatinine levels, metabolic acidosis with hyperkalemia, other electrolyte abnormalities, and volume overload.
Option D: Anuria is not an early sign. When loss of kidney function is mild or moderately severe, the kidneys cannot absorb water from the urine to reduce the volume of urine and concentrate it. Later, the kidneys have less ability to excrete the acids normally produced by the body and the blood becomes more acidic, a condition called acidosis.
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