A nurse in the emergency room is performing an assessment on a burn victim. She notes his face is a cherry-red color and suspects which of the following problems?

Choice A reason: Decreased calcium is expected in end-stage chronic kidney disease (CKD) due to impaired kidney function. The kidneys are responsible for converting vitamin D into its active form, which helps in calcium absorption. Reduced kidney function leads to decreased active vitamin D, resulting in lower calcium levels.

Choice B reason: Decreased blood urea nitrogen (BUN) is not typical in CKD. Instead, BUN levels usually increase because the kidneys are less able to remove urea from the blood. Urea is a waste product of protein metabolism, and elevated BUN is indicative of impaired kidney function.

Choice C reason: Decreased hemoglobin is expected in CKD due to reduced production of erythropoietin by the kidneys. Erythropoietin stimulates the production of red blood cells, and a lack of it leads to anemia, reflected by lower hemoglobin levels.

Choice D reason: Decreased potassium is not typically seen in CKD. In fact, potassium levels often increase because the kidneys are less able to excrete it. Hyperkalemia (high potassium) is a common complication in CKD and requires careful monitoring.

Choice E reason: Elevated creatinine is expected in CKD. Creatinine is a waste product of muscle metabolism, and elevated levels indicate impaired kidney function as the kidneys are less able to clear it from the blood.

Choice F reason: Increased phosphorus is a common finding in CKD due to the kidneys' reduced ability to excrete phosphorus. This can lead to hyperphosphatemia, which can cause secondary hyperparathyroidism and further complications.

Choice G reason: Decreased glomerular filtration rate (GFR) is a hallmark of CKD. GFR measures how well the kidneys are filtering blood, and a lower GFR indicates reduced kidney function. It is used to stage the severity of CKD.

Choice A reason: The supine position is when a patient lies flat on their back. Although it is commonly used for many procedures and treatments, it is not the best position for improving oxygenation in clients with ARDS. Lying flat on the back can cause the lungs to become compressed, reducing the efficiency of gas exchange and potentially leading to further respiratory complications.

Choice B reason: The prone position, where the patient is lying face down, is the recommended position to improve oxygenation in clients with ARDS. Prone positioning helps to recruit more alveoli, improves ventilation-perfusion matching, and reduces the shunting of blood through non-ventilated areas of the lung. Studies have shown that placing patients in the prone position can significantly improve oxygenation and decrease mortality in ARDS patients.

Choice C reason: The lateral side position, where the patient lies on their side, can be used for patients with certain conditions or during recovery from some surgical procedures. However, it does not provide the same benefits for improving oxygenation in ARDS as the prone position does. Lateral positioning might help with comfort and prevent pressure sores, but it does not enhance lung function and gas exchange in the same way.

Choice D reason: The Semi-Fowler's position, where the patient's head and torso are elevated to a 30-45 degree angle, is useful for promoting respiratory comfort and reducing the risk of aspiration. While it can help improve ventilation and is beneficial for patients with respiratory distress, it does not offer the same degree of improvement in oxygenation for ARDS patients as the prone position.