A nurse has identified a fluid volume deficit in the patient who has suffered prolonged vomiting and diarrhea.

Which assessment data is most important in identifying that the patient may be developing prerenal acute kidney injury (AKI)?

Choice A rationale
Nausea and vomiting can be caused by various conditions, including gastrointestinal issues and brain injuries, but they are not specifically indicative of a diffuse brain stem injury.
Choice B rationale
Nuchal rigidity, or neck stiffness, is a classic sign of meningeal irritation, often due to meningeal edema in conditions like meningitis.
Choice C rationale
Bilateral fixed and dilated pupils are more commonly associated with severe brain injury or increased intracranial pressure, not specifically a cerebellar brain attack.
Choice D rationale
Brudzinski’s sign is a physical exam finding indicative of meningeal irritation, commonly seen in bacterial meningitis, not specifically viral meningitis.

Choice A rationale
Cerebral edema is the swelling of the brain due to fluid accumulation, which can occur after excessive alcohol consumption. However, it is not related to myxedema, which is a condition associated with severe hypothyroidism.
Choice B rationale
The deposit of fatty tissue is associated with conditions like hyperaldosteronism, where there is an excess production of aldosterone. This condition does not cause the characteristic skin changes seen in myxedema.
Choice C rationale
Proliferation of tissue behind the eyes, known as exophthalmos, is common in hyperthyroidism, particularly in Graves’ disease. Myxedema, on the other hand, is related to severe hypothyroidism and involves different pathophysiological mechanisms.
Choice D rationale
Myxedema is characterized by the accumulation of mucopolysaccharides in the skin and other tissues, leading to swelling and thickening of the skin. This condition is a result of severe hypothyroidism and can lead to a myxedema crisis if left untreated.