A nurse is caring for a client who has end-stage renal disease (ESRD). Which of the following are expected findings? (Select all that apply).
Bone pain
Slurred speech
Hypotension
Pruritus
Bradypnea.
Correct Answer : A,B,D
A. Bone pain can occur in ESRD due to mineral and bone disorders associated with chronic kidney disease.
B. Slurred speech can be seen in ESRD patients with uremic encephalopathy.
C. Hypotension is less common in ESRD; hypertension is more typical due to fluid overload and retention.
D. Pruritus is a common symptom of ESRD, often due to accumulation of uremic toxins.
E. Bradypnea is not typically associated with ESRD.
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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 B
Explanation
A. This option can be ruled out because the pH and PaCO2 levels indicate acidosis, but the compensation is not partial as the HCO3 is also low.
B. Maria's symptoms and the arterial blood gas values support this diagnosis. Metabolic acidosis is indicated by a low pH and a decreased bicarbonate (HCO3) level. The body attempts to compensate for this acidosis by hyperventilating, which is evidenced by her Kussmaul breathing, to decrease PaCO2. This compensation is partial because, despite the body's efforts, the pH is still significantly lower than normal.
C. This option can be ruled out because the pH is low (acidosis) rather than high (alkalosis), and the HCO3 is low rather than high.
D. Respiratory Acidosis, Uncompensated is ruled out because the pH is low (acidosis), but the PaCO2 is normal, indicating metabolic rather than respiratory involvement.
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