A male presents to the emergency department with confusion, lethargy, and a decreased level of consciousness. His friends report that he ingested a large quantity of unknown pills in a suicide attempt. Laboratory results reveal severe metabolic acidosis, high anion gap, and elevated serum creatinine. Which of the following is the most urgent indication for initiating dialysis in this patient?
Overdose
Chronic Kidney Disease
Hypertension
Dehydration
The Correct Answer is A
A. Overdose: The patient has ingested a large quantity of unknown pills, leading to severe metabolic acidosis, high anion gap, and possible toxic accumulation. Dialysis is often indicated to clear toxins in the case of overdose, especially if renal function is impaired (as indicated by elevated creatinine).
B. Chronic Kidney Disease: While chronic kidney disease may eventually require dialysis, the acute overdose and metabolic acidosis are the more immediate concerns requiring urgent dialysis.
C. Hypertension: Hypertension may require management, but it is not the primary reason to initiate urgent dialysis in this scenario. The overdose and metabolic acidosis take precedence.
D. Dehydration: Dehydration alone does not necessitate dialysis. However, the overdose, metabolic acidosis, and renal impairment are the critical reasons for initiating dialysis.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Administer a proton pump inhibitor (PPI) as prescribed to decrease gastric acid production: Proton pump inhibitors (PPIs) are a cornerstone of therapy for peptic ulcer disease as they effectively reduce gastric acid production, which helps the ulcer heal and relieves symptoms.
B. Provide a diet high in fiber and low in fat to promote gastrointestinal health: A high-fiber diet is not specifically indicated for PUD. While diet modifications may help, managing gastric acid production and avoiding irritants is more critical.
C. Encourage the patient to eat small, frequent meals to prevent the secretion of gastric acid: Although small, frequent meals may help some patients, they are not as effective in managing PUD compared to PPIs. Additionally, frequent eating can stimulate gastric acid production in some cases.
D. Instruct the patient to increase the intake of dairy products to help neutralize stomach acid:
Dairy products can initially neutralize stomach acid, but they can also stimulate further acid production, which may worsen symptoms in the long term. This is not recommended for managing PUD.
Correct Answer is ["B","C","D","E"]
Explanation
A. Frothy urine: Frothy urine is typically associated with proteinuria, seen in nephrotic syndrome, not pyelonephritis.
B. Hypertension: Hypertension can occur due to kidney inflammation and impaired function in pyelonephritis.
C. Fish-type urine odor: A foul or fishy-smelling urine odor is often associated with a urinary tract infection, including pyelonephritis.
D. Mental confusion: Mental confusion can occur in elderly patients with pyelonephritis due to systemic infection or sepsis.
E. Lower abdominal pain: Lower abdominal pain can occur with pyelonephritis due to infection in the urinary tract.
F. Weak urine stream: A weak urine stream is more characteristic of lower urinary tract issues, such as benign prostatic hyperplasia (BPH), rather than pyelonephritis.
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