A nurse is caring for a client who is in the diuresis phase of acute kidney injury. The nurse should closely monitor the client for what complication during this phase?
Hypocalcemia
Hypovolemia
Increased blood pressure
Hyperkalemia
The Correct Answer is B
Choice A reason: Hypocalcemia may occur in AKI due to impaired vitamin D activation, but it is not a primary concern in the diuresis phase, where kidneys produce large urine volumes. Calcium imbalances are less immediate than fluid losses, which can rapidly destabilize hemodynamics during this phase.
Choice B reason: In the diuresis phase of AKI, kidneys regain function, producing excessive urine, which can lead to hypovolemia. Fluid loss depletes intravascular volume, causing hypotension, tachycardia, and organ hypoperfusion. Monitoring is critical to prevent dehydration and ensure adequate fluid replacement to maintain hemodynamic stability during recovery.
Choice C reason: Increased blood pressure is more common in the oliguric phase of AKI due to fluid overload. In the diuresis phase, excessive urine output reduces volume, potentially lowering blood pressure. Hypertension is not a typical complication during this phase, making it an incorrect focus for monitoring.
Choice D reason: Hyperkalemia is a concern in the oliguric phase of AKI due to reduced potassium excretion. In the diuresis phase, increased urine output facilitates potassium clearance, reducing hyperkalemia risk. Hypovolemia from excessive fluid loss is a more immediate concern during this phase of AKI recovery.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason: Silence allows the client to process trauma at their own pace, creating a safe, non-pressurized environment. Fearful clients may need time to feel secure before speaking. This technique fosters trust, encourages emotional expression, and is particularly effective in trauma, where verbalization can be challenging due to psychological distress.
Choice B reason: Giving information provides facts but may overwhelm a fearful client, who may not be ready to process details post-trauma. This technique is less effective for engagement, as it does not address emotional barriers or encourage self-expression, which are critical for therapeutic interaction in trauma recovery.
Choice C reason: Focusing directs the conversation to specific topics, which can feel intrusive for a traumatized client. It assumes readiness to discuss, potentially increasing anxiety or withdrawal. This technique is less effective than silence, which allows the client to initiate dialogue when emotionally prepared, fostering trust.
Choice D reason: Broad opening encourages the client to choose topics but may be too vague for a fearful, traumatized client, who may feel overwhelmed by the lack of structure. Silence is more effective, as it provides space for emotional processing without pressuring the client to verbalize prematurely.
Correct Answer is A
Explanation
Choice A reason: This response reinforces professional boundaries while therapeutically redirecting the client to explore external social support, addressing potential dependency. It validates the client’s feelings without personalizing the relationship, promoting healthy coping and social integration, which are critical for mental health recovery and maintaining therapeutic integrity.
Choice B reason: Bluntly denying friendship dismisses the client’s feelings, potentially damaging trust and therapeutic rapport. This approach risks alienating the client, who may feel rejected, hindering open communication and progress in addressing underlying emotional needs, making it non-therapeutic in a mental health context.
Choice C reason: Suggesting other friends without exploration dismisses the client’s expressed feelings, potentially invalidating their emotional experience. The assumption about existing friends may not apply, and the response lacks therapeutic engagement, failing to address the client’s dependency or need for social connection, making it less effective.
Choice D reason: Affirming the client’s view of friendship blurs professional boundaries, fostering dependency and compromising therapeutic objectivity. While validating feelings is important, reinforcing a personal connection risks hindering the client’s ability to develop external support systems, making this response non-therapeutic for mental health progress.
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