A client with chronic renal failure is experiencing anorexia and nausea. What is the nurse's priority action?
Administer an antiemetic medication to relieve the nausea.
Encourage the client to increase protein intake.
Assess the client's serum electrolyte levels.
Monitor the client's weight and fluid intake.
The Correct Answer is D
A. Incorrect. Administering an antiemetic medication may help relieve nausea, but it is not the priority action in a client with chronic renal failure experiencing anorexia and nausea.
B. Incorrect. Encouraging the client to increase protein intake is not appropriate if they are experiencing anorexia and nausea. Protein intake may need to be adjusted based on the client's symptoms and kidney function.
C. Incorrect. While assessing serum electrolyte levels is important in chronic renal failure, it is not the priority action in this situation. The client's anorexia and nausea require immediate attention.
D. Correct. Monitoring the client's weight and fluid intake is the priority action when the client is experiencing anorexia and nausea. These symptoms may indicate fluid and electrolyte imbalances that need to be addressed promptly.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Incorrect. Hyperkalemia, or high potassium levels, can cause muscle weakness and potentially cardiac arrhythmias, but it is not typically associated with difficulty concentrating or irritability.
B. Incorrect. Hyponatremia, or low sodium levels, can cause neurological symptoms such as confusion and headache, but it is not typically associated with muscle cramps.
C. Incorrect. Hypocalcemia, or low calcium levels, can cause muscle cramps and neurological symptoms, but it is not specifically associated with difficulty concentrating and irritability.
D. Correct. Hyperphosphatemia, or high phosphorus levels, is common in chronic renal failure due to impaired kidney function. Elevated phosphorus levels can lead to the binding of calcium, resulting in decreased ionized calcium in the blood. This can cause neuromuscular irritability, difficulty concentrating, and muscle cramps.
Correct Answer is B
Explanation
A. Incorrect. Pruritus (itching) is a common symptom of chronic renal failure and is related to the buildup of waste products and toxins in the blood, leading to skin irritation.
B. Correct. Pruritus is a common and distressing symptom of chronic renal failure, caused by the retention of uremic toxins in the blood. These toxins can irritate the skin and lead to itching.
C. Incorrect. While medications can sometimes cause pruritus as a side effect, it is not the primary cause of itching in clients with chronic renal failure.
D. Incorrect. Persistent pruritus in a client with chronic renal failure is not necessarily indicative of an allergic reaction to medications. It is more likely related to the buildup of waste products in the blood.
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