A client who has developed acute kidney injury (AKI) due to an aminoglycoside antibiotic has moved from the oliguric phase to the diuretic phase of AKI Which parameters are most important for the nurse to plan to carefully monitor?
Hypovolemia and electrocardiographic (ECG) changes.
Uremic irritation of mucous membranes and skin surfaces.
Side effects of total parental nutrition (TPN) and Intralipids.
Elevated creatinine and blood urea nitrogen (BUN)
The Correct Answer is A
A. Hypovolemia and electrocardiographic (ECG) changes:
During the diuretic phase of AKI, there is an increased urine output, and the risk of dehydration and hypovolemia is elevated. The nurse should closely monitor fluid balance to prevent dehydration, and ECG changes may occur due to electrolyte imbalances (such as hypokalemia) associated with diuresis.
B. Uremic irritation of mucous membranes and skin surfaces:
Uremic symptoms are more prominent in the oliguric phase of AKI when waste products accumulate in the blood. In the diuretic phase, the focus shifts more toward managing fluid and electrolyte balance.
C. Side effects of total parental nutrition (TPN) and Intralipids:
TPN and Intralipids are not directly related to the diuretic phase of AKI. Monitoring for side effects of TPN and Intralipids may be relevant in other clinical contexts but is not the primary concern in the diuretic phase.
D. Elevated creatinine and blood urea nitrogen (BUN):
Monitoring creatinine and BUN levels is important for assessing kidney function, but in the diuretic phase, the focus shifts to managing fluid and electrolyte balance. The risk of hypovolemia and electrolyte imbalances is more immediate during this phase.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Platelet count 40,000 x10/μL (40.000 x109/L):
This is the correct answer. A platelet count of 40,000 x10/μL is significantly below the normal range (usually around 150,000 to 450,000/μL). Low platelet count (thrombocytopenia) can increase the risk of bleeding during and after a surgical procedure. The healthcare provider should be alerted to assess the risk and determine the appropriate management.
B. White blood cells 9,000/μL (9x109/L):
The white blood cell count is within the normal range, and it is not a significant concern for a vertebroplasty procedure.
C. Hematocrit 38% (0.38):
The hematocrit level is within the normal range and is not a significant concern for a vertebroplasty procedure.
D. Hemoglobin 12 g/dL (120 g/L):
The hemoglobin level is within the normal range and is not a significant concern for a vertebroplasty procedure.
Correct Answer is B
Explanation
A. Activity level of bowel sounds:
Bowel sounds are important to assess, but they may not directly influence or be influenced by the abdominal pain associated with chronic pancreatitis.
B. Eating patterns and dietary intake.
Clients with chronic pancreatitis often experience abdominal pain exacerbated by the intake of food, especially fatty meals. Monitoring the client's eating patterns and dietary intake is crucial for identifying triggers that may worsen the abdominal pain. By understanding the relationship between food intake and pain, the nurse can provide guidance on dietary modifications to help manage the symptoms.
C. Level and amount of physical activity:
While physical activity is important for overall health, it may not be the primary factor contributing to or alleviating the abdominal pain in a client with chronic pancreatitis.
D. Color and consistency of feces:
Monitoring the color and consistency of feces is important for assessing pancreatic function, but it may not be the most immediate factor to address in the context of managing abdominal pain. Dietary patterns are more directly related to pain management in this case.
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