A 37-year-old client diagnosed with chronic kidney disease (CKD) is being treated for renal osteodystrophy. Which nursing diagnosis is most likely to be included in this client's plan of care?
Hygiene self-care deficit related to uremic frost.
High risk for infection related to subclavian catheter.
High risk for injury related to ambulation.
Knowledge deficit related to high-protein diet.
The Correct Answer is A
Choice A: Uremic frost is a symptom of advanced kidney disease and can result in deposits of urea crystals on the skin. This can cause itching and discomfort, making it difficult for the client to maintain good hygiene and self-care. Therefore, addressing hygiene self-care deficit related to uremic frost is a priority in the plan of care for a client with renal osteodystrophy.
Choice B: This is not directly related to renal osteodystrophy and is more related to the presence of a catheter.
Choice C: This is not typically associated with renal osteodystrophy unless there are specific mobility issues related to bone problems.
Choice D: This may be relevant for clients with CKD, but it is not specific to renal osteodystrophy, which primarily involves bone mineral imbalances.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A: The nurse should determine the pH value of the aspirated fluid to confirm the placement of the NGT. Gastric aspirate typically has an acidic pH (usually below 5), which indicates that the tube is correctly placed in the stomach.
Choice B: Withdrawing the NGT and reinserting it is not necessary if the pH of the aspirate confirms gastric placement.
Choice C: Connecting the NGT to wall suction is not appropriate until placement has been confirmed with a pH test.
Choice D: Sending the fluid specimen to the lab is not the first step in verifying NGT placement. Checking the pH is a more immediate and reliable method.
Correct Answer is C
Explanation
Choice A: Bread is generally considered a suitable food choice for individuals with cholelithiasis and is not typically associated with exacerbating symptoms or gallstone formation.
Choice B: Beef broth is a liquid and does not contain the same types of fats and cholesterol that can contribute to gallstone formation. It is not typically a concern for individuals with cholelithiasis.
Choice C: Ketchup is often high in sugar and can be made with vinegar, which may exacerbate symptoms in some individuals with cholelithiasis. It is advisable to omit or limit foods high in sugar and vinegar-based condiments.
Choice D: Ice cream, while high in fat, is generally tolerated by most individuals with cholelithiasis unless they experience specific dietary sensitivities. It is not typically recommended to omit ice cream from the diet unless advised by a healthcare provider.
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