A nurse is assessing a client who is experiencing acute kidney injury. The client is found to have a significant change in mental status, is lethargic, and confused. The nurse auscultates crackles in the client's lungs. Upon reviewing labs, it is noted that the client's BUN is 140 mg/dL and the potassium is 6.7 mEq/L. Which treatment will the nurse anticipate to be ordered for a client with these findings?
Sodium polystyrene sulfonate (Kayexalate)
Bolus with 1 liter of lactated ringer's (LR)
Renal replacement therapy (RRT)
Patiromer (Veltassa)
The Correct Answer is C
A. While this medication is used to treat hyperkalemia, it is a slower acting treatment. Given the patient's critical condition with altered mental status, hyperkalemia, and elevated BUN, a more rapid intervention is needed.
B. Fluid resuscitation is important in some cases of AKI but it is not the priority in this patient. The patient is already showing signs of fluid overload (crackles in the lungs) and the primary issue is the inability of the kidneys to remove waste products and excess fluids.
C. This is the most appropriate treatment for this patient. RRT, such as hemodialysis or continuous renal replacement therapy (CRRT), can rapidly remove waste products, excess fluid, and electrolytes from the blood, correcting the imbalances and improving the patient's condition.
D. This medication is used for long-term management of hyperkalemia, but it is not effective in an acute setting like this.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. This method is the most reliable for measuring fluid retention. Weight changes are a direct indicator of fluid balance because fluid retention or loss affects body weight. By comparing the client's current weight to their post-dialysis weight, you can determine the amount of fluid they have retained.
B. Creatinine and blood urea nitrogen (BUN) levels are indicators of kidney function rather than fluid volume status. Elevated levels can indicate worsening kidney function but do not directly measure fluid retention or overload.
C. While assessing skin turgor and peripheral edema can provide some clues about fluid overload, these signs are less precise and subjective compared to weight measurements. Skin turgor changes and edema can be influenced by various factors, including skin elasticity and other conditions, making them less reliable for accurately measuring fluid volume changes since the last dialysis.
D. Crackles in lung sounds can indicate pulmonary congestion due to fluid overload, but this method is not as precise for quantifying the amount of fluid retained. Crackles suggest fluid accumulation in the lungs, which is a sign of more severe fluid overload but does not provide a specific measurement of fluid volume compared to changes in body weight.
Correct Answer is A
Explanation
A. This is an inflammation of the peritoneum, the lining of the abdominal cavity. It's a common complication of peritoneal dialysis (PD). Symptoms include nausea, vomiting, diarrhea, abdominal pain, and fever. Fluid discharge from the catheter site and an increased white blood cell count are also indicative of infection, supporting the diagnosis of peritonitis.
B. This is inflammation of the pericardium, the sac surrounding the heart. Symptoms typically include chest pain, shortness of breath, and irregular heartbeat.
C. This is inflammation of the pleura, the membranes surrounding the lungs. Symptoms include chest pain, shortness of breath, and dry cough.
D. This would present with severe abdominal pain, hypotension, and signs of shock. Nausea, vomiting, and diarrhea are not typical symptoms.
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