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 D
Explanation
A. Encourage regular turning:
While turning is important for preventing complications like pressure ulcers, in this acute situation, addressing fluid imbalance and potential sepsis take precedence.
B. Monitor skin for breakdown:
Monitoring for skin breakdown is essential but is not the most critical intervention at this moment.
C. Assess wound drainage daily:
Daily assessment of wound drainage is important for evaluating the status of the surgical site. However, in this situation of potential anastomosis leakage with signs of systemic infection and hypotension, immediate interventions to stabilize the client's condition are of higher priority.
D. Strict IV fluid replacement:
This is the correct answer. The client is displaying signs of systemic infection (fever) and possible sepsis (tachycardia, hypotension), which might be due to an anastomosis leakage following gastric bypass surgery. Ensuring adequate IV fluid replacement is crucial to address hypotension, maintain perfusion, and support hemodynamic stability in this critical situation.

Correct Answer is B
Explanation
A. Carcinogens are substances that contain cancerous cells:
This statement is incorrect. Carcinogens are substances that have the potential to cause cancer, but they do not necessarily contain cancerous cells themselves.
B. Substances that change a cell so that it becomes cancerous are potential sources of cancer:
This is the correct answer. Carcinogens are agents that can induce changes in the genetic material of cells, leading to the development of cancer. They can initiate or promote the process of carcinogenesis.
C. Environmental factors such as sunlight and chemicals can cause cancer to spread:
This statement is not accurate. Carcinogens can contribute to the initiation or promotion of cancer, but the spread of cancer (metastasis) involves complex biological processes and is not directly caused by environmental factors.
D. Carcinogens are in the environment and cannot be avoided:
This statement is not accurate. While carcinogens may be present in the environment, efforts can be made to minimize exposure and adopt preventive measures. Avoidance of known carcinogens and the promotion of a healthy lifestyle can contribute to cancer prevention.
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