A nurse is caring for a client who has impaired renal function. For which of the following findings should the nurse notify the provider?
Urine output of 175 ml in the past 8 hrs
Urine output of 2,200 ml in the past 24 hr
Urine is cloudy after sitting in the urinal for 6 hr
First-voided urine in the morning has a strong odor
The Correct Answer is A
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.
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Related Questions
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.
Correct Answer is D
Explanation
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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