Nokea
The nurse is assessing a client receiving peritoneal dialysis. Which laboratory result should immediately be reported to the primary healthcare provider (PHCP)?
- A. WBC 19,000 mm3 [5,000-10,000 mm3]
- B. Hemoglobin 9 g/dL [Male: 14-18 g/dL (140-180 g/L) Female: 12-16 g/dL (120-160 g/L)]
- C. Calcium 8.6 mg/dL [9.0-10.5 mg/dL]
- D. Serum pH 7.33 [7.35-7.45]
Correct Answer: A
Rationale: Elevated WBC (19,000 mm3) suggests infection, a serious complication in peritoneal dialysis.
You may also like to solve these questions
The nurse is caring for a client with end-stage renal disease who receives prescribed sevelamer. Which of the following findings would indicate a therapeutic response?
- A. Decreased serum calcium levels
- B. Increased hemoglobin and hematocrit
- C. Decreased serum potassium levels
- D. Decreased serum phosphorus levels
Correct Answer: D
Rationale: Sevelamer is a phosphate binder used to lower serum phosphorus levels in end-stage renal disease, making decreased phosphorus levels the therapeutic response. It does not directly affect calcium (A), hemoglobin/hematocrit (B), or potassium (C).
A nurse on a medical-surgical unit cares for a client who has just undergone a procedure for a Kock pouch as a treatment for bladder cancer. The initial nursing interventions for this client would include:
- A. Monitoring urine output, checking for indications of ostomy pouch leaks, and noting the size, shape, and color of the stoma.
- B. Speaking to the client's family and updating them regarding the client's status.
- C. Educating the client about stoma care and skincare.
- D. Irrigating the catheters as needed.
Correct Answer: A
Rationale: Initial interventions for a Kock pouch include monitoring urine output and stoma condition to ensure proper function and detect complications.
The nurse is reviewing the client's laboratory data. Which current prescription should the nurse clarify with the primary healthcare provider (PHCP)?
- A. hydrochlorothiazide
- B. lisinopril
- C. naproxen
- D. tamsulosin
Correct Answer: C
Rationale: Naproxen can impair renal function, requiring clarification in clients with kidney issues.
The nurse is caring for a client who has fluid volume deficit receiving intravenous fluids. Which of the following would indicate the client is achieving the treatment goals?
- A. urine output 20 mL/hr
- B. BUN 15 mg/dL (5.355 mmol/L) [10-20 mg/dL (3.6-7.1 mmol/L)]
- C. urine specific gravity 1.039 [1.005-1.030]
- D. flattened jugular veins
Correct Answer: B
Rationale: Normal BUN (15 mg/dL) indicates improved renal perfusion and fluid balance, suggesting effective treatment for fluid volume deficit.
The nurse is assigned to care for a client with a sodium level of 122 mEq/L (mmol/L) [135-145 mEq/L, mmol/L]. Which assessment findings does the nurse anticipate based on this lab result?
- A. Confusion
- B. Abdominal cramps
- C. Tall, peaked t-waves
- D. Hypoactive bowel sounds
- E. Nausea and vomiting
Correct Answer: A,B,E
Rationale: Hyponatremia causes confusion, abdominal cramps, and nausea/vomiting due to cerebral edema and gastrointestinal irritation.