A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency?

Stomatitis and Diarrhea

Dyspnea and Anuria

Confusion and Vomiting

Nocturia and Oliguria

Answer and Explanation

The Correct Answer is D

Choice A rationale: These are symptoms of advance renal failure. Stomatitis and diarrhea are signs of uremia, which is the accumulation of waste products in the blood.

Choice B rationale: Dyspnea and anuria are signs of fluid overload and kidney shutdown and indicate advanced renal failure.

Choice C rationale: Confusion and vomiting are signs of acidosis and electrolyte disturbances and occur in advanced stages of renal failure.

Choice D rationale: One of the early symptoms of renal insufficiency is nocturia, which is the need to urinate frequently at night. This occurs because the kidneys are unable to concentrate urine during the day and produce more urine at night. Another early symptom is oliguria, which is the production of less than 400 mL of urine per day. This occurs because the kidneys are unable to excrete enough urine to maintain fluid balance.

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Correct Answer is A

Explanation

Choice A rationale: Arterial blood gas (ABG) findings provide direct information about oxygenation and acid-base balance in the blood, which can indicate hypoxemia and metabolic acidosis.

Choice B rationale: Oxygen saturation level provides information about oxygen saturation in the blood but doesn't give a complete assessment of acid-base balance or other gases in the blood.

Choice C rationale: White blood cell differential assesses different types of white blood cells and is not directly related to evaluating hypoxemia or metabolic acidosis.

Choice D rationale: Red blood cells (RBCs) and hemoglobin count findings are important but do not directly assess hypoxemia or metabolic acidosis.

A. Provide thickened fluids with a straw. B. Listen to bilateral lung and bowel sounds. C. Check the client's Hypoglossal nerve and Vestibulocochlear cranial nerve function. D. Check the client's Glossopharyngeal nerve and Vagus cranial nerve function.

Correct Answer is D

Explanation

Choice A rationale: Providing thickened fluids with a straw is more related to swallowing difficulties and is not the priority in this context.

Choice B rationale: While assessing lung and bowel sounds is important, it's not directly related to offering oral intake after a gastroscopy.

Choice C rationale: Assessing the Hypoglossal nerve and Vestibulocochlear cranial nerve function isn't directly related to offering oral intake post-gastroscopy.

Choice D rationale: Checking the client's Glossopharyngeal nerve and Vagus cranial nerve function is crucial as these nerves play roles in swallowing, taste, and the gag reflex, which are important before allowing oral intake post-gastroscopy.

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A client with a 16-year history of diabetes mellitus is having renal function tests because of recent fatigue, weakness, elevated blood urea nitrogen, and serum creatinine levels. Which finding should the nurse conclude as an early symptom of renal insufficiency?

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