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A nurse is assessing a client diagnosed with chronic renal disease for fluid volume excess. The nurse should recognize that which of the following provides a reliable measure of fluid retention?

Sodium level

Tissue edema

Urinary output

Daily weight

Answer and Explanation

The Correct Answer is D

A. Sodium level: Serum sodium levels can vary and are not a direct measure of fluid retention.

B. Tissue edema: Edema is subjective and can be influenced by other conditions.

C. Urinary output: Many CKD patients have limited or no urine output despite fluid retention.

D. Daily weight: Daily weights are the most reliable non-invasive measure for fluid status.

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Correct Answer is A

Explanation

A. Hyperkalemia: In AKI, the kidneys cannot excrete potassium efficiently, leading to elevated potassium levels.

B. Hypernatremia: More common in dehydration but not typically associated with prerenal AKI, where sodium may actually be low due to dilution.

C. Hypophosphatemia: Phosphate tends to increase due to impaired excretion in AKI, not decrease.

D. Hypercalcemia: Calcium levels tend to decrease in AKI due to phosphate retention and reduced vitamin D activation.

A. Hamburger on a bun and a banana B. Spaghetti and meat sauce with a breadsticks C. Carrots and spinach D. Cold cuts with bun and fresh pears

Correct Answer is B

Explanation

A. Hamburger on a bun and a banana: Bananas are high in potassium, which must be restricted in CKD. Processed hamburger meat may also be high in sodium and phosphorus.

B. Spaghetti and meat sauce with breadsticks: Pasta and meat sauce are generally low in potassium and phosphorus if made without salt substitutes. Breadsticks are low in potassium.

C. Carrots and spinach: Spinach is high in potassium and phosphorus. Cooked carrots are borderline and must be portion-controlled.

D. Cold cuts with bun and fresh pears: Cold cuts are typically high in sodium and phosphorus. Pears are generally acceptable, but the entire meal is unsuitable due to the cold cuts.

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A nurse is assessing a client diagnosed with chronic renal disease for fluid volume excess. The nurse should recognize that which of the following provides a reliable measure of fluid retention?

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