Nokea
The critical care nurse is responsible for monitoring the patient receiving continuous renal replacement therapy (CRRT). In doing so, the nurse should
- A. assess that the blood tubing is warm to the touch.
- B. assess the hemofilter every 6 hours for clotting.
- C. cover the dialysis lines to protect them from light.
- D. use clean technique during vascular access dressing changes.
Correct Answer: B
Rationale: Correct Answer: B
Rationale:
1. Hemofilter clotting can affect CRRT efficiency.
2. Assessing every 6 hours allows early detection and intervention.
3. Clotting can lead to treatment interruptions or complications.
4. Regular assessment ensures optimal therapy delivery.
Other Choices:
A: Assessing tubing warmth is not a reliable indicator of CRRT function or complications.
C: Covering dialysis lines to protect from light is not a standard practice in CRRT monitoring.
D: Using clean technique is not sufficient for vascular access dressing changes; aseptic technique is required for infection prevention.
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A patient with long-standing type 1 diabetes presents to the emergency department with a loss of consciousness and seizure activity. The patient has a history of renal insufficiency, gastroparesis, and peripheral diabetic neuropathy. Emergency personnel reported a blood glucose of 32 mg/dL on scene. When providing discharge teaching for this patient and family, the nurse instructs on the need to do which of the following? (Select all that apply.)
- A. Administer glucagon 1 mg intramuscularly any time the blood glucose is less than 70 mg/dL.
- B. Administer 15 grams of carbohydrate orally for severe episodes of hypoglycemia.
- C. Discontinue the insulin pump by removing the infusion set catheter.
- D. Increase home blood glucose monitoring and report patterns of hypoglycemia to the provider.
Correct Answer: B
Rationale: The correct answer is B: Administer 15 grams of carbohydrate orally for severe episodes of hypoglycemia. In this scenario, the patient is experiencing severe hypoglycemia (blood glucose of 32 mg/dL) leading to loss of consciousness and seizure activity. Administering 15 grams of carbohydrate orally is crucial to rapidly raise the blood glucose levels and address the hypoglycemia. This immediate intervention can help reverse the symptoms and prevent further complications.
The incorrect choices:
A: Administering glucagon intramuscularly is typically reserved for severe hypoglycemia when the patient cannot take anything by mouth. In this case, oral intake is preferred for faster absorption.
C: Discontinuing the insulin pump is not necessary in this situation since the primary concern is treating the acute hypoglycemia. Removing the infusion set can lead to hyperglycemia if not managed properly.
D: Increasing home blood glucose monitoring and reporting patterns of hyp
Slow continuous ultrafiltration is also known as isolated ultrafiltration and is used to
- A. remove plasma water in cases of volume overload.
- B. remove fluids and solutes through the process of convection.
- C. remove plasma water and solutes by adding dialysate.
- D. combine ultrafiltration, convection, and dialysis.
Correct Answer: A
Rationale: Rationale:
Slow continuous ultrafiltration is a method used to remove excess plasma water in cases of volume overload, making choice A the correct answer. This process does not involve adding dialysate (choice C) or combining ultrafiltration, convection, and dialysis (choice D). While ultrafiltration does involve the removal of fluids and solutes, it is primarily achieved through ultrafiltration rather than convection (choice B).
A patient is receiving hydrocortisone sodium succinate for adrenal crisis. What other medication does the nurse prepare to administer?
- A. Regular insulin
- B. A proton pump inhibitor
- C. Canagliflozin
- D. Propranolol
Correct Answer: B
Rationale: The correct answer is B: A proton pump inhibitor. When a patient is receiving hydrocortisone for adrenal crisis, it can lead to increased gastric acid secretion. A proton pump inhibitor helps reduce acid production and prevents gastric ulcers. Regular insulin (A) is not typically indicated in this scenario. Canagliflozin (C) is a medication used for diabetes management and is not relevant here. Propranolol (D) is a beta-blocker and may mask signs of hypoglycemia when used with insulin, which is not suitable in this case.
In calculating the glomerular filtration rate (GFR) results for women, the creatinine clearance is usually:
- A. the same as for men.
- B. greater than that for men.
- C. multiplied by 0.85.
- D. multiplied by 1.15.
Correct Answer: A
Rationale: The correct answer is A: the same as for men. GFR is calculated based on factors like age, weight, and serum creatinine levels, which are not directly influenced by gender. Therefore, the creatinine clearance for women is the same as for men. Choices B, C, and D are incorrect because there is no inherent biological difference between men and women that would cause a difference in creatinine clearance for GFR calculation.
The nurse is caring for a patient receiving peritoneal dialysis. The patient suddenly complains of abdominal pain and chills. The patient’s temperature is elevated. The nurse should
- A. assess peritoneal dialysate return.
- B. check the patient’s blood sugar.
- C. evaluate the patient’s neurological status.
- D. inform the provider of probable visceral perforation.
Correct Answer: D
Rationale: The correct answer is D: inform the provider of probable visceral perforation. This is the most urgent action as sudden abdominal pain, chills, and elevated temperature in a patient receiving peritoneal dialysis could indicate a serious complication like visceral perforation, which requires immediate medical attention to prevent further complications. Assessing peritoneal dialysate return (A) may provide some information but does not address the urgent need to address a potential visceral perforation. Checking the patient's blood sugar (B) and evaluating the patient's neurological status (C) are not priorities in this situation and do not address the potential life-threatening complication of visceral perforation.