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The patient is complaining of severe flank pain when he tries to urinate. His urinalysis shows sediment and crystals along with a few bacteria. Using this information along with the clinical picture, the nurse realizes that the patient’s condition is
- A. prerenal.
- B. postrenal.
- C. intrarenal.
- D. not renal related.
Correct Answer: C
Rationale: The correct answer is C: intrarenal. The presence of sediment, crystals, and bacteria in the urinalysis indicates an issue within the kidneys themselves. The flank pain suggests renal involvement. Prerenal would involve issues before the kidneys, such as inadequate blood flow. Postrenal would involve issues after the kidneys, such as urinary tract obstruction. Not renal related is incorrect as the symptoms and urinalysis findings clearly point to a renal issue.
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Continuous venovenous hemodialysis is used to
- A. remove fluids and solutes through the process of convection.
- B. remove plasma water in cases of volume overload.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection and dialysis Continuous venovenous hemodialysis (CVVHD) is similar to CVVH in that ultrafiltration removes plasma water. It differs in that dialysate solution is added around the hemofilter membranes to facilitate solute removal by the process of diffusion. Continuous venovenous hemofiltration (CVVH) is used to remove fluids and solutes through the process of convection. Slow continuous ultrafiltration (SCUF) is also known as isolated ultrafiltration and is used to remove plasma water in cases of volume overload. Continuous venovenous hemodiafiltration (CVVHDF) combines ultrafiltration, convection, and dialysis to maximize fluid and solute removal.
Correct Answer: D
Rationale: The correct answer is D because continuous venovenous hemodiafiltration (CVVHDF) combines ultrafiltration, convection, and dialysis to maximize fluid and solute removal. Ultrafiltration removes plasma water, convection removes fluids and solutes, and dialysis facilitates solute removal through diffusion.
Choice A is incorrect because convection alone does not remove solutes, but CVVHDF combines convection with other methods.
Choice B is incorrect because CVVHDF is not specifically used for volume overload, although it does remove fluids.
Choice C is incorrect because CVVHDF does not involve adding dialysate to remove solutes; instead, it relies on diffusion for solute removal.
In summary, the correct answer D is the best choice as it encompasses all the components needed for comprehensive fluid and solute removal in CVVHDF.
Which of the following is a high-priority nursing diagnosis for both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome?
- A. Activity intolerance
- B. Fluid volume deficient
- C. Hyperthermia
- D. Impaired nutrition, more than body requirements
Correct Answer: B
Rationale: The correct answer is B: Fluid volume deficient. Both diabetic ketoacidosis and hyperosmolar hyperglycemic syndrome can lead to severe dehydration and electrolyte imbalances. Addressing fluid volume deficiency is crucial to stabilize the patient's condition. Choice A is not the priority as the main concern is the fluid imbalance, not activity intolerance. Hyperthermia (choice C) may be present but is not the primary concern compared to fluid volume deficit. Impaired nutrition (choice D) is not the immediate priority in these emergency situations. In summary, maintaining fluid balance is essential to manage both conditions effectively.
Noninvasive diagnostic procedures used to determine kidney function include which of the following? (Select all that apply.)
- A. Kidney, ureter, bladder (KUB) x-ray
- B. Renal ultrasound
- C. Magnetic resonance imaging (MRI)
- D. Intravenous pyelography (IVP)
Correct Answer: A
Rationale: The correct answer is A: Kidney, ureter, bladder (KUB) x-ray. KUB x-ray is a noninvasive diagnostic procedure that provides information about the size, shape, and position of the kidneys, ureters, and bladder. It can help detect abnormalities such as kidney stones or structural issues.
Rationale:
1. KUB x-ray is noninvasive, meaning it does not require any incisions or insertion of instruments into the body.
2. It is commonly used as an initial screening tool to assess kidney function.
3. Renal ultrasound (Choice B) is also noninvasive but primarily used for imaging the kidneys and not the entire urinary system.
4. MRI (Choice C) and IVP (Choice D) are more invasive procedures that involve injecting contrast agents and may not be routinely used for initial kidney function assessment.
In summary, the KUB x-ray is the correct choice as it is a noninvasive procedure specifically designed to evaluate kidney
The patient has been admitted to the hospital with nausea and vomiting that started 5 days earlier. Blood pressure is 80/44 mm Hg and heart rate is 122 beats/min; the patient has not voided in 8 hours, and the bladder is not distended. The nurse anticipates a prescription for “stat” administration of
- A. a blood transfusion.
- B. fluid replacement with 0.45% saline.
- C. infusion of an inotropic agent.
- D. an antiemetic.
Correct Answer: B
Rationale: The correct answer is B: fluid replacement with 0.45% saline. The patient's symptoms suggest dehydration and hypovolemia, indicated by low blood pressure, elevated heart rate, and lack of urine output. Fluid replacement with isotonic saline would help restore intravascular volume and improve blood pressure. Blood transfusion (A) is not indicated without evidence of significant blood loss. Inotropic agents (C) are used to improve cardiac function, which is not the primary issue in this case. Antiemetics (D) may help with nausea and vomiting but do not address the underlying cause of hypovolemia.
The nurse has been assigned the following patients. Which patients require assessment of blood glucose control as a nursing priority? (Select all that apply.)
- A. 18-year-old male who has undergone surgical correction of a fractured femur
- B. 29-year-old female who is undergoing evaluation for pheochromocytoma
- C. 43-year-old male with acute pancreatitis who is receiving total parenteral nutrition (TPN)
- D. 62-year-old morbidly obese female who underwent a hysterectomy for ovarian cancer
Correct Answer: C
Rationale: The correct answer is C because the patient with acute pancreatitis receiving TPN is at risk for hyperglycemia due to the high glucose content in TPN. Monitoring blood glucose levels is crucial to prevent complications.
Explanation for why other choices are incorrect:
A: The 18-year-old male post-surgery for a fractured femur does not have a direct correlation to blood glucose control assessment.
B: The 29-year-old female undergoing evaluation for pheochromocytoma is not directly related to blood glucose control assessment.
D: The 62-year-old morbidly obese female post-hysterectomy for ovarian cancer does not specifically require immediate blood glucose control assessment.