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 B
Explanation
A. Eat a diet high in calcium oxalate-rich foods: This is incorrect. A diet high in oxalate can promote stone formation, so it should be avoided.
B. Drink plenty of fluids during the day. Adequate hydration is the most important strategy to prevent the formation of renal calculi, especially in hot climates where fluid loss through sweat increases the risk.
C. Eat a diet high in purine-rich foods: This is incorrect. Purine-rich foods can increase uric acid levels and contribute to uric acid stone formation, especially in clients with gout.
D. Continue to take your prescribed gout medication: While this is important for managing gout, it does not directly prevent renal calculi, so it is not the most relevant intervention.
Correct Answer is C
Explanation
A. Encouraging the patient to drink ginger tea for nausea: While ginger tea may help with nausea in some cases, it is not an appropriate intervention for acute cholecystitis, which requires more aggressive management.
B. Applying ice packs to the abdomen: Ice packs are not a standard treatment for acute cholecystitis and would not effectively alleviate the patient’s pain or inflammation.
C. Administering prescribed intravenous analgesics: The most appropriate intervention is to administer prescribed intravenous analgesics to relieve pain in patients with acute cholecystitis. Pain management is a priority to alleviate discomfort while awaiting further treatment, such as surgery or antibiotics.
D. Advising the patient to eat small, frequent meals: Dietary changes like eating small, frequent meals may be advised after the acute phase to prevent future attacks, but they are not appropriate for addressing acute symptoms.
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