Nokea
A client is hospitalized in the oliguric phase of acute kidney injury (AKI) and is receiving tube feedings. The nurse is teaching the client's spouse about the kidney-specific formulation for the enteral solution compared to standard formulas. What components should be discussed in the teaching plan? (Select all that apply.)
- A. Lower sodium
- B. Lower potassium
- C. Higher phosphorus
- D. A & B
Correct Answer: D
Rationale: In the oliguric phase of acute kidney injury (AKI), clients may require tube feedings with kidney-specific formulas. These formulations are lower in sodium and potassium, which are crucial considerations due to impaired kidney function. Higher phosphorus content is not a feature of kidney-specific formulations for AKI. Therefore, options A and B (lower sodium and lower potassium) should be discussed in the teaching plan. Option C, higher phosphorus, is incorrect as kidney-specific formulas are not intended to be higher in phosphorus content for AKI patients.
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When a patient is receiving high doses of a cephalosporin, which laboratory values will this patient's nurse monitor closely?
- A. Blood urea nitrogen (BUN), serum creatinine, and liver function tests
- B. Complete blood count and electrolytes
- C. Serum calcium and magnesium
- D. Serum glucose and lipids
Correct Answer: A
Rationale: When a patient is receiving high doses of a cephalosporin, such as cefazolin, the nurse should closely monitor laboratory values that indicate renal and hepatic function. This includes checking the Blood Urea Nitrogen (BUN) and serum creatinine levels to assess kidney function. Additionally, monitoring liver function tests, such as AST, ALT, ALP, LDH, and bilirubin, is essential as cephalosporins can affect liver enzymes. Therefore, options B, C, and D are incorrect as they do not specifically address the parameters that are most pertinent when administering high doses of cephalosporins.
A healthcare professional is monitoring the respiratory status of a client who has just undergone surgery and is wearing a pulse oximeter. Which of the following coexisting problems is cause for the healthcare professional to suspect that the oxygen saturation readings are not entirely accurate?
- A. Infection
- B. Hypertension
- C. Low blood pressure
- D. Loss of cough reflex
Correct Answer: C
Rationale: Low blood pressure (hypotension), shock, and the use of peripheral vasoconstricting medications can lead to inaccurate pulse oximetry readings due to impaired peripheral perfusion. Hypertension and infection are not typically associated with inaccurate pulse oximetry readings, while the loss of cough reflex does not directly affect oxygen saturation readings.
A client with acute glomerulonephritis (GN) is being evaluated by a nurse. Which manifestation should the nurse recognize as a positive response to the prescribed treatment?
- A. The client has lost 11 pounds in the past 10 days.
- B. The client's urine specific gravity is 1.048.
- C. No blood is observed in the client's urine.
- D. The client's blood pressure is 152/88 mm Hg.
Correct Answer: A
Rationale: A weight loss of 11 pounds in the past 10 days indicates fluid loss, a positive response to treatment for acute glomerulonephritis. It signifies that the glomeruli are functioning adequately to filter excess fluid. A urine specific gravity of 1.048 is high, indicating concentrated urine, which is not a positive response in this context. Blood in the urine is not a typical finding in glomerulonephritis, so its absence is expected and does not indicate a positive response to treatment. A blood pressure of 152/88 mm Hg is elevated and may suggest kidney damage or fluid overload, which are not positive responses to treatment.
A patient has begun taking spironolactone (Aldactone) in addition to a thiazide diuretic. With the addition of the spironolactone, the nurse will counsel this patient to
- A. not take a potassium supplement daily.
- B. recognize that abdominal cramping is a common side effect.
- C. report decreased urine output to the provider.
- D. take these medications in the morning.
Correct Answer: C
Rationale: When combining a potassium-sparing diuretic like spironolactone with a thiazide diuretic, there is an increased risk of hyperkalemia, especially in patients with poor renal function. Therefore, the patient should be educated to report any decrease in urine output, which could indicate a potential issue with kidney function. Choice A is incorrect because taking additional potassium supplements can further increase the risk of hyperkalemia. Choice B is incorrect as abdominal cramping is not a common side effect of spironolactone. Choice D is incorrect because the timing of medication administration is not directly related to the addition of spironolactone and thiazide diuretic; there is no specific recommendation to take these medications only at bedtime.
A nurse teaches a client who is recovering from a nephrectomy secondary to kidney trauma. Which statement should the nurse include in this client's teaching?
- A. Since you only have one kidney, a salt and fluid restriction is required.
- B. Your therapy will include hemodialysis while you recover.
- C. Medication will be prescribed to control your high blood pressure.
- D. You need to avoid participating in contact sports like football.
Correct Answer: D
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.