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 A
Explanation
A. A urine output of 175 ml over 8 hours indicates oliguria, which can be concerning in a client with impaired renal function. It suggests decreased kidney function and inadequate elimination of waste products and fluids, necessitating prompt notification of the healthcare provider.
B. This amount of urine output over 24 hours is within normal range and does not typically warrant immediate notification unless there are other concerning symptoms.
C. Cloudy urine may indicate the presence of urinary tract infection or other issues, but it alone may not require immediate notification of the provider.
D. While strong-smelling urine can be indicative of various conditions, it alone may not necessitate immediate provider notification unless accompanied by other concerning symptoms.
Correct Answer is A
Explanation
A. Hyperkalemia is a common finding in the oliguric phase of acute kidney injury due to impaired renal function, leading to decreased potassium excretion.
B. Hypomagnesemia is not typically associated with the oliguric phase of acute kidney injury.
C. In the oliguric phase, the glomerular filtration rate is typically decreased, not increased.
D. In acute kidney injury, creatinine levels typically rise due to decreased renal function, rather than decrease.
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