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) "Limit sodium intake to 3,500 milligrams per day.":
Limiting sodium intake is crucial for managing heart failure to prevent fluid retention and exacerbation of symptoms. However, the recommended limit is typically much lower, around 1,500 to 2,000 milligrams per day, not 3,500 milligrams.

B) "Take ibuprofen for discomfort.":
Ibuprofen and other NSAIDs are not recommended for clients with heart failure as they can cause fluid retention, worsen heart failure symptoms, and increase the risk of kidney problems. Alternatives such as acetaminophen are generally safer for pain relief.

C) "Increase the distance you walk by 100 feet daily, even if you feel fatigued.":
While regular exercise is important, clients with heart failure should not push through fatigue, as overexertion can lead to worsening symptoms. Exercise recommendations should be tailored to the individual's tolerance and should be adjusted based on their energy levels.

D) "Include no more than 2,000 milliliters of fluid intake in 24 hours.":
Restricting fluid intake to 2,000 milliliters per day helps prevent fluid overload, which is critical for managing heart failure. Monitoring and limiting fluid intake can help control symptoms such as edema and shortness of breath.

A. Consume a diet low in cholesterol." B. Increase your intake of refined carbohydrates." C. Consume a diet high in calories." D. Reduce your dietary fiber intake

Correct Answer is A

Explanation

A) Consume a diet low in cholesterol: A diet low in cholesterol is beneficial for preventing cholelithiasis (gallstones), as high cholesterol levels can contribute to the formation of cholesterol stones in the gallbladder. By reducing dietary cholesterol, the risk of gallstone formation can be minimized.

B) Increase your intake of refined carbohydrates: Increasing the intake of refined carbohydrates can lead to higher levels of triglycerides and cholesterol in the blood, which can promote the formation of gallstones. This dietary change is not recommended for preventing cholelithiasis.

C) Consume a diet high in calories: A high-calorie diet, especially if it leads to obesity, increases the risk of developing gallstones. Obesity is a significant risk factor for cholelithiasis, and a high-calorie diet can contribute to weight gain and the development of gallstones.

D) Reduce your dietary fiber intake: Dietary fiber helps in reducing cholesterol levels by binding bile acids in the intestines, which in turn can prevent the formation of cholesterol gallstones. Reducing fiber intake would be counterproductive and increase the risk of cholelithiasis.

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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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