Which assessment findings would alert a nurse to suspected kidney insufficiency in a client with chronic kidney disease?

• A. Facial flushing
• B. Edema and pruritus
• C. Dribbling after voiding
• D. Diminished force of urination

Answer: (B)

In chronic kidney disease, the kidneys lose their ability to filter waste and regulate fluids, so signs of both fluid overload and toxin buildup appear. Edema happens because the kidneys retain sodium and water, leading to swelling in the extremities and sometimes the face. Pruritus, or itching, is a common uremic symptom from the accumulation of waste products and disruptions in mineral metabolism that irritate the skin. Together, edema and pruritus reflect the impaired filtration and toxin accumulation that define kidney insufficiency.

Facial flushing isn’t specific to kidney problems and can arise from many sources. Dribbling after voiding points to urinary incontinence or obstruction of the lower urinary tract rather than a direct sign of kidney failure. Diminished force of urination suggests a problem with the bladder or urethra, not the kidney’s filtration ability.