A client with chronic kidney disease (CKD) has elevated blood urea nitrogen (BUN) and serum creatinine levels. The client reports feeling fatigued and is unable to concentrate during the morning assessments.
What action should the nurse take based on these findings?
Administer PRN oxygen.
Provide high protein snacks.
Monitor glucose levels every 4 hours.
Schedule frequent rest periods.
The Correct Answer is D
Choice D rationale
Scheduling frequent rest periods can help manage the fatigue and concentration problems reported by the client. These symptoms are common in clients with CKD and elevated BUN and serum creatinine levels.
Choice A rationale
Administering PRN oxygen may not be necessary unless the client is showing signs of respiratory distress or hypoxia. There is no indication of this in the question.
Choice B rationale
Providing high protein snacks is not recommended for clients with CKD. High protein diets can increase the workload on the kidneys and worsen kidney function.
Choice C rationale
Monitoring glucose levels every 4 hours is not directly related to the client’s reported symptoms or the elevated BUN and serum creatinine levels.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
The neonatal screening test, which includes thyroxine (T4) and thyroid-stimulating hormone (TSH) levels, is a routine blood test required by law to screen for metabolic deficiencies. This test helps diagnose thyroid conditions. T4 is a thyroid hormone, and too much or too little of it can indicate an issue with the thyroid. TSH is a hormone your pituitary gland makes. It stimulates your thyroid to produce T4 and T3 (triiodothyronine) hormones. A TSH test is the best way to initially assess thyroid function. In fact, T4 tests more accurately reflect thyroid function when combined with a TSH test. Measuring T4 levels might not be necessary in all thyroid conditions. Other names for a T4 test include: Free thyroxine, Total T4 concentration, Thyroxine screen, Free T4 concentration, Free T4 index (FTI)1.
Choice B rationale
While the T4 and TSH tests can help diagnose thyroid conditions, they are not specifically used to determine dosages for thyroid replacement therapy. The dosage of thyroid replacement therapy is usually determined by a healthcare provider based on the patient’s medical condition, weight, age, laboratory test results, and response to treatment.
Choice C rationale
The neonatal screening test is not specifically used for the early detection of intellectual disabilities. However, it is important to note that untreated congenital hypothyroidism can lead to intellectual disabilities. Therefore, early detection and treatment of hypothyroidism generally result in normal growth and development.
Choice D rationale
While these laboratory values can provide data about the thyroid function of the newborn, they do not directly provide data to anticipate delays in growth and development. However, untreated congenital hypothyroidism can lead to growth and developmental delays. Therefore, early detection and treatment of hypothyroidism generally result in normal growth and development.
Correct Answer is B
Explanation
Choice A rationale
A blood glucose level of 90 mg/dL (5 mmol/L) is within the normal range and would not need to be reported to the surgeon.
Choice B rationale
A serum creatinine level of 5 mg/dL (442 µmol/L) is significantly elevated, indicating impaired kidney function. This is a critical lab value that should be reported to the surgeon immediately, as it could impact the patient’s ability to safely undergo surgery and recover postoperatively.
Choice C rationale
A hemoglobin level of 13 g/dL (130 g/L) is within the normal range and would not need to be reported to the surgeon.
Choice D rationale
A potassium level of 4 mEq/L (4 mmol/L) is within the normal range and would not need to be reported to the surgeon.
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