A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?

Bounding peripheral pulses

Hyperreflexia

Cool skin

Hypotension

Answer and Explanation

The Correct Answer is D

A) Bounding peripheral pulses: Metabolic acidosis typically does not cause bounding peripheral pulses. In metabolic acidosis, vasodilation might occur, but it usually leads to weaker, not bounding, pulses due to decreased cardiac output and blood pressure.

B) Hyperreflexia: Hyperreflexia is not commonly associated with metabolic acidosis. Instead, metabolic acidosis may cause symptoms like muscle weakness or fatigue due to the effect of acid-base imbalance on neuromuscular function.

C) Cool skin: While cool skin can sometimes be associated with poor perfusion in severe cases, it is not a direct manifestation of metabolic acidosis. Metabolic acidosis more commonly affects internal physiology rather than peripheral skin temperature directly.

D) Hypotension: Hypotension is a common manifestation of metabolic acidosis. The acidosis leads to vasodilation and decreased cardiac contractility, resulting in a drop in blood pressure. This is a critical sign for the nurse to monitor as it indicates the severity of the acid-base imbalance and its effect on the cardiovascular system.

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Correct Answer is D

Explanation

A) Expect optimum visual acuity to return in 4 to 6 weeks: While some improvement in vision can be noted soon after cataract surgery, optimal visual acuity typically returns within 1 to 2 months. It's important to set realistic expectations for recovery. Telling the patient to expect optimum visual acuity to return in 4 to 6 weeks provides a more accurate timeframe for complete visual recovery.

B) Notify the provider if new floaters persist for more than 3 days: The presence of new floaters can be a sign of complications such as retinal detachment or vitreous hemorrhage. However, patients are generally advised to notify their provider immediately if they notice any new floaters, flashes of light, or a sudden decrease in vision, rather than waiting for three days. Immediate notification can lead to prompt evaluation and treatment if necessary.

C) Take aspirin every 4 to 6 hr for mild discomfort: Aspirin is generally avoided postoperatively due to its blood-thinning properties, which can increase the risk of bleeding. Instead, non-aspirin pain relievers like acetaminophen are usually recommended to manage mild discomfort after cataract surgery, as they do not carry the same risk of bleeding complications.

D) Avoid lifting objects that weigh 9.07 kg (20 lb) or more: Patients are advised to avoid lifting heavy objects and engaging in strenuous activities after cataract surgery to prevent increased intraocular pressure, which can interfere with healing and potentially cause complications such as bleeding or dislocation of the intraocular lens. This instruction helps ensure the safety and proper healing of the surgical site.

A. "I should make sure that most of my meals contain fried foods to maintain my calorie count." B. "I should change to a gluten-free diet to rest my bowel." C. "I should try to limit foods containing lactose to prevent bloating and cramping." D. "I should eat a high-fiber diet daily to decrease my episodes of flare ups."

Correct Answer is C

Explanation

A) "I should make sure that most of my meals contain fried foods to maintain my calorie count": Fried foods are generally high in fat and can be difficult to digest, particularly for individuals with malabsorption syndrome. They are not recommended as a primary source of calories due to their potential to exacerbate gastrointestinal symptoms.

B) "I should change to a gluten-free diet to rest my bowel": A gluten-free diet is beneficial for individuals with celiac disease, but it is not universally required for all inflammatory bowel diseases. The decision to adopt a gluten-free diet should be based on specific medical advice rather than general guidelines for inflammatory bowel disease.

C) "I should try to limit foods containing lactose to prevent bloating and cramping": Limiting lactose-containing foods is a common recommendation for individuals with malabsorption syndrome, especially if lactose intolerance is present. Lactose can exacerbate bloating and cramping, so managing intake can help alleviate these symptoms.

D) "I should eat a high-fiber diet daily to decrease my episodes of flare-ups": High-fiber diets are not always recommended for individuals with inflammatory bowel disease, as fiber can exacerbate symptoms and contribute to flare-ups. A low-fiber or modified fiber diet may be more appropriate depending on the individual’s symptoms and disease state.

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A nurse is assessing a client who has acute kidney failure and is in a state of metabolic acidosis. The nurse should monitor for which of the following manifestations?

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