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Continuous renal replacement therapy (CRRT) differs from conventional intermittent hemodialysis in that
- A. a hemofilter is used to facilitate ultrafiltration.
- B. it provides faster removal of solute and water.
- C. it does not allow diffusion to occur.
- D. the process removes solutes and water slowly.
Correct Answer: D
Rationale: The correct answer is D because CRRT removes solutes and water slowly, which is beneficial for hemodynamically unstable patients. This slow removal allows for gradual fluid and electrolyte balance adjustments, reducing the risk of hemodynamic instability.
A: Incorrect - A hemofilter is indeed used in CRRT, but this choice does not highlight the key difference between CRRT and intermittent hemodialysis.
B: Incorrect - CRRT actually provides slower solute and water removal compared to intermittent hemodialysis.
C: Incorrect - Diffusion does occur in CRRT, as it is a key mechanism for solute removal in the process.
In summary, the key difference between CRRT and intermittent hemodialysis is the slow removal of solutes and water in CRRT, making choice D the correct answer.
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The nurse is caring for a patient in the critical care unit whaobi,r ba.cfotemr/ tebset ing declared brain dead, is being managed by the OPO transplant coordinator. Thir ty minutes into the shift, assessment by the nurse includes a blood pressure 75/50 mm Hg, hear t rate 85 beats/min, and respiratory rate 12 breaths/min via assist/control ventilation. The oxygen saturation (SpO ) is 99% and 2 core temperature 93.8° F. Which primary care provider ord er should the nurse implement first?
- A. Apply forced air warming device to keep temperature > 96.8° F
- B. Obtain basic metabolic panel every 4 hours until surgery
- C. Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg
- D. Draw arterial blood gas every 4 hours until surgery
Correct Answer: C
Rationale: The correct answer is C: Begin phenylephrine (Neo-Synephrine) for systolic BP < 90 mm Hg. The nurse should implement this order first because the patient's low blood pressure (75/50 mm Hg) indicates hypotension, which can lead to inadequate perfusion to vital organs. Phenylephrine is a vasoconstrictor that can help increase the patient's blood pressure and improve perfusion. It is crucial to address hypotension promptly to prevent further complications.
Choice A is incorrect because maintaining the patient's temperature above 96.8°F is not the most urgent concern in this scenario. Choice B is incorrect as obtaining a basic metabolic panel every 4 hours is not the immediate priority when the patient is experiencing hypotension. Choice D is incorrect as drawing arterial blood gas every 4 hours is not the most urgent intervention needed to address the patient's low blood pressure.
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. This procedure is noninvasive and commonly used to assess kidney function by visualizing the size, shape, and position of the kidneys. Renal ultrasound is also noninvasive and can provide detailed images of the kidneys. However, MRI and IVP are more invasive procedures that involve the use of contrast agents and are not typically used solely for diagnostic purposes to assess kidney function. Overall, KUB x-ray and renal ultrasound are the preferred noninvasive options for evaluating kidney function.
The nurse is assessing a child's weight and height during a clinic visit prior to starting school. The nurse plots the child's weight on the growth chart and notes that the child's weight is in the 95th percentile for the child's height. What action should the nurse take?
- A. Question the type and quantity of foods eaten in a typical day.
- B. Encourage giving two additional snacks each day to the child.
- C. Recommend a daily intake of at least four glasses of whole milk.
- D. Assess for signs of poor nutrition, such as a pale appearance.
Correct Answer: A
Rationale: The correct answer is A: Question the type and quantity of foods eaten in a typical day. When a child's weight is in the 95th percentile for their height, it indicates possible overweight or obesity. To address this, the nurse should assess the child's dietary habits to identify any unhealthy eating patterns contributing to excess weight. By questioning the type and quantity of foods eaten, the nurse can provide appropriate guidance on nutrition and healthy eating habits.
Summary:
B: Encouraging additional snacks may further contribute to weight gain and is not recommended without knowing the current eating habits.
C: Recommending a high intake of whole milk may increase calorie intake and potentially worsen the weight concern.
D: Assessing for signs of poor nutrition, such as a pale appearance, is important but not directly addressing the weight concern in this scenario.
A 10-year-old female patient in ICU receiving chemotherapy has requested that her dog be allowed to visit her. She is currently sharing a room with another patient. The nurse knows that the hospital does allow for pet visits with owners, but has strict guidelines. Which of the following scenarios is most likely to be permitted?
- A. The girls father may bring the dog in on a leash for a 20-minute visit.
- B. The girls sister may bring the dog in with a shirt on (to prevent shedding) for an overnight stay.
- C. The girls mother may bring the dog in on a leash for a visit as long as he has had all his vaccinations.
- D. The dog may be brought in for a brief visit once the girl is moved to a private room.
Correct Answer: A
Rationale: The correct answer is A because it follows the hospital's guidelines for pet visits. It allows the dog to be brought in on a leash, which ensures control and safety during the visit. The 20-minute duration is appropriate to limit potential stress on the patient and other individuals in the room. Additionally, having the father bring the dog in maintains consistency with the hospital's policy of pet visits with owners.
Choices B, C, and D are incorrect because they do not adhere to the hospital's guidelines. Choice B allows for an overnight stay, which is typically not permitted due to potential disruptions and hygiene concerns. Choice C mentions vaccinations but overlooks other important factors like leash control and visit duration. Choice D suggests waiting until the girl is moved to a private room, which may not align with the hospital's policy of allowing pet visits with owners.
Comparing the patient’s current (home) medications with those ordered during hospitalization and communicating a complete list of medications to the next care provider when the patient is transferred within an organization or to another setting a re strategies toward best achieving what patient related goal?
- A. Improving accuracy of patient identification.
- B. Preventing errors related to look-alike and sound-alike medications.
- C. Reconciling medications across the continuum of care.
- D. Reducing harms associated with administration of anti coagulants.
Correct Answer: C
Rationale: Step 1: Reconciling medications is essential for patient safety as it involves comparing current and ordered medications to ensure accuracy.
Step 2: This process helps prevent medication errors, adverse drug reactions, and duplications across different care settings.
Step 3: Communicating a complete list of medications to the next care provider ensures continuity of care and reduces the risk of medication discrepancies.
Step 4: By reconciling medications across the continuum of care, healthcare providers can better coordinate patient care and optimize treatment outcomes.
In summary, choice C is correct as it focuses on medication reconciliation to improve patient safety and care coordination. Choices A, B, and D are incorrect as they do not directly address the comprehensive process of reconciling medications across care settings.