Nokea
The patient is admitted with acute kidney injury from a postrenal cause. Acceptable treatments for that diagnosis include: (Select all that apply.)
- A. bladder catheterization.
- B. increasing fluid volume intake.
- C. ureteral stenting.
- D. placement of nephrostomy tubes.
Correct Answer: A
Rationale: The correct answer is A. Bladder catheterization helps relieve urinary obstruction, a common postrenal cause of acute kidney injury. It allows urine to drain freely from the bladder.
- B: Increasing fluid volume intake may worsen the condition by increasing the pressure on the obstructed kidneys.
- C: Ureteral stenting is used for intrarenal causes, not postrenal causes.
- D: Placement of nephrostomy tubes bypasses the obstruction but is usually reserved for more severe cases.
You may also like to solve these questions
The term used to describe an increase in blood urea nitrogen (BUN) and serum creatinine is
- A. oliguria.
- B. azotemia.
- C. acute kidney injury.
- D. prerenal disease.
Correct Answer: B
Rationale: The correct answer is B: azotemia. Azotemia refers to elevated levels of nitrogenous waste products like BUN and creatinine in the blood. This occurs when the kidneys are not functioning properly, leading to decreased filtration and excretion of waste products. Oliguria (A) is reduced urine output, not specific to elevated BUN and creatinine levels. Acute kidney injury (C) is a broader term for sudden loss of kidney function. Prerenal disease (D) typically refers to conditions affecting blood flow to the kidneys, leading to decreased kidney function, but it does not specifically describe the increase in BUN and creatinine levels.
The nurse is caring for a patient who suffered a head trauma following a fall. The patient’s heart rate is 112 beats/min and blood pressure is 88/50 mm Hg. The patient has poor skin turgor and dry mucous membranes. The patient is confused and restless. The following laboratory values are reported: serum sodium is 115 mEq/L; blood urea nitrogen (BUN) 50 mg/dL; and creatinine 8 mg/dL. The findings are consistent with which disorder?
- A. Cerebral salt wasting
- B. Diabetes insipidus
- C. Syndrome of inappropriate secretion of antidiuretic hormone
- D. Thyroid storm
Correct Answer: A
Rationale: The correct answer is A: Cerebral salt wasting. This is indicated by the low serum sodium level (115 mEq/L), which can occur in patients with head trauma and lead to excessive sodium loss through the kidneys. This results in hypovolemia, leading to low blood pressure and tachycardia. The elevated BUN (50 mg/dL) and creatinine (8 mg/dL) levels suggest dehydration and renal impairment due to volume depletion. The patient's poor skin turgor, dry mucous membranes, confusion, and restlessness further support the diagnosis of cerebral salt wasting.
Summary:
B: Diabetes insipidus is characterized by excessive urination and thirst due to insufficient production of antidiuretic hormone (ADH). This patient's symptoms are not consistent with diabetes insipidus.
C: Syndrome of inappropriate secretion of antidiuretic hormone (SIADH) is characterized by excessive release of ADH, leading to water retention and
Which of the following laboratory values would be more common in patients with diabetic ketoacidosis?
- A. Blood glucose >1000 mg/dL
- B. Negative ketones in the urine
- C. Normal anion gap
- D. pH 7.24
Correct Answer: A
Rationale: The correct answer is A (Blood glucose >1000 mg/dL) because diabetic ketoacidosis is characterized by severe hyperglycemia. High blood glucose levels (>1000 mg/dL) are common due to insulin deficiency leading to increased glucose production.
B: Negative ketones in the urine would be incorrect as DKA results in ketone production, leading to ketonuria.
C: Normal anion gap would be incorrect as DKA typically presents with an elevated anion gap metabolic acidosis due to ketone accumulation.
D: pH 7.24 would be incorrect as DKA would present with a lower pH due to metabolic acidosis.
The patient is on intake and output (I&O), as well as daily weights. The nurse notes that output is considerably less than intake over the last shift, and daily weight is 1 kg more than yesterday. The nurse should
- A. draw a trough level after the next dose of antibiotic.
- B. obtain an order to place the patient on fluid restriction.
- C. assess the patient’s lungs.
- D. insert an indwelling catheter.
Correct Answer: C
Rationale: The correct answer is C: assess the patient's lungs. The discrepancy between intake, output, and weight gain indicates a potential fluid imbalance. By assessing the patient's lungs, the nurse can identify signs of fluid overload, such as crackles or difficulty breathing, which could explain the weight gain and imbalance. This step is crucial in determining the underlying cause and guiding further interventions. Drawing a trough level (A) or inserting an indwelling catheter (D) are not necessary at this point and may not address the immediate issue. Placing the patient on fluid restriction (B) should only be considered after a thorough assessment to determine the cause of the imbalance.
In hyperosmolar hyperglycemic syndrome, the laboratory results are similar to those of diabetic ketoacidosis, with three major exceptions. What differences would you expect to see in patients with hyperosmolar hyperglycemic syndrome?
- A. Lower serum glucose, lower osmolality, and greater ketosis
- B. Lower serum glucose, lower osmolality, and milder ketosis
- C. Higher serum glucose, higher osmolality, and greater ketosis
- D. Higher serum glucose, higher osmolality, and no ketosis
Correct Answer: D
Rationale: In hyperosmolar hyperglycemic syndrome, patients have high blood glucose levels, leading to dehydration and increased serum osmolality. Unlike diabetic ketoacidosis, there is no significant ketosis in hyperosmolar hyperglycemic syndrome. Therefore, the correct answer is D: Higher serum glucose, higher osmolality, and no ketosis.
A: Lower serum glucose, lower osmolality, and greater ketosis - This is incorrect because hyperosmolar hyperglycemic syndrome is characterized by high blood glucose levels and no significant ketosis.
B: Lower serum glucose, lower osmolality, and milder ketosis - This is incorrect because hyperosmolar hyperglycemic syndrome presents with higher glucose levels and no ketosis.
C: Higher serum glucose, higher osmolality, and greater ketosis - This is incorrect because hyperosmolar hyperglycemic syndrome does not typically involve significant ketosis.