A nurse is caring for a client who has end-stage kidney disease (ESKD) and reports having shortness of breath and swelling in his lower extremities. Upon assessment, the nurse notes the client has crackles in his lungs and an elevated blood pressure. The nurse should suspect which of the following based on the client's manifestations?

Hyponatremia

Hyperkalemia

Hypovolemia

Hypervolemia

Answer and Explanation

The Correct Answer is D

A.   Hyponatremia is characterized by low sodium levels in the blood and is not typically associated with crackles in the lungs or elevated blood pressure.
B.   While hyperkalemia is a concern in end-stage kidney disease, it is not typically associated with crackles in the lungs or elevated blood pressure.
C.   Hypovolemia, or low blood volume, is not consistent with the client's reported symptoms of swelling in the lower extremities and crackles in the lungs.
D.   Hypervolemia, or fluid overload, is common in end-stage kidney disease and can manifest with symptoms such as shortness of breath, lower extremity edema, crackles in the lungs (due to pulmonary congestion), and elevated blood pressure.

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Correct Answer is D

Explanation

A. Furosemide use is more commonly associated with hyponatremia rather than hypernatremia due to its diuretic effect.
B. Furosemide does not typically cause hypercalcemia; instead, it may lead to hypocalcemia.
C. Hyperchloremia is not a primary concern with furosemide, as the drug can cause a loss of chloride ions alongside sodium.
D. Furosemide can cause an increase in uric acid levels by reducing its excretion through the kidneys.

A. Metabolic Alkalosis. Partially Compensated B. Respiratory Acidosis, Partially Compensated C. Respiratory Alkalosis. Uncompensated D. Metabolic Alkalosis. Uncompensated

Correct Answer is D

Explanation

A. Metabolic Alkalosis, Partially Compensated, is incorrect because there is no evidence of respiratory compensation (normal PaCO2).
B. Respiratory Acidosis, Partially Compensated, is incorrect because the pH is high, not low as would be expected in acidosis, and the PaCO2 is normal, not high.
C. Respiratory Alkalosis, Uncompensated, is incorrect because the primary problem is metabolic (high HCO3), not respiratory, and the PaCO2 is normal, not low as would be seen in respiratory alkalosis.
D. Metabolic alkalosis is characterized by elevated pH and bicarbonate levels. In this scenario, the pH is elevated (7.5) and the bicarbonate (HCO3) level is high (34 mmol/L), indicating alkalosis. Vomiting leads to loss of gastric acid (hydrochloric acid), causing metabolic alkalosis. The respiratory system has not yet compensated fully for the alkalosis, as indicated by the normal PaCO2 (40 mm Hg).

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has heart failure and is receiving IV furosemide. The nurse should monitor the client for which of the following electrolyte imbalances?

Correct Answer is D

Explanation

Correct Answer is D

Explanation

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