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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Placing the client in Trendelenburg position is not appropriate in this situation. It may worsen respiratory depression caused by magnesium sulfate.
B. Absent deep-tendon reflexes and respiratory depression are signs of magnesium toxicity.
Discontinuing the medication infusion is essential to prevent further toxicity.
C. While preeclampsia can lead to complications necessitating emergency cesarean birth, the immediate concern here is addressing magnesium toxicity.
D. Assessing maternal blood glucose is not relevant to the management of magnesium toxicity.
Correct Answer is D
Explanation
A. Consuming excessive animal protein can increase the risk of kidney stones due to the metabolism of protein leading to increased excretion of calcium and oxalate.
B. Restricting calcium intake is not recommended for preventing calcium oxalate kidney stones. Adequate calcium intake from dietary sources can actually help prevent kidney stone formation by binding to oxalate in the intestines and reducing its absorption.
C. High doses of vitamin C can increase oxalate levels in the urine, which can contribute to the formation of calcium oxalate kidney stones.
D. Adequate fluid intake, typically recommended at least 3 liters (about 100 ounces) per day, helps dilute urine and reduce the concentration of stone-forming substances, thereby reducing the risk of kidney stone formation.
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