A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which of the following actions should the nurse take?

Provide a diet high in protein.

Provide ibuprofen for retroperitoneal discomfort.

Monitor intake and output hourly

Encourage the client to consume at least 2 L of fluid daily

Answer and Explanation

The Correct Answer is C

A. Provide a diet high in protein.

During the oliguric phase of acute kidney injury (AKI), there is a risk of electrolyte imbalances, including elevated levels of blood urea nitrogen (BUN) and creatinine. Restricting protein intake is often recommended during this phase to manage azotemia and prevent the accumulation of waste products that the kidneys may struggle to excrete.

B. Provide ibuprofen for retroperitoneal discomfort.

Ibuprofen and other nonsteroidal anti-inflammatory drugs (NSAIDs) are contraindicated in AKI. They can further compromise renal function and may contribute to acute tubular necrosis. NSAIDs can also affect renal blood flow, leading to worsening kidney function.

C. Monitor intake and output hourly.

Monitoring intake and output (I&O) is a critical nursing intervention during the oliguric phase of AKI. Hourly monitoring helps assess renal function, fluid balance, and the effectiveness of interventions. It allows for early detection of changes that may require prompt intervention.

D. Encourage the client to consume at least 2 L of fluid daily.

In the oliguric phase of AKI, fluid intake is often restricted to prevent fluid overload. Encouraging excessive fluid intake may contribute to fluid retention and worsen the oliguria. Fluid management is carefully regulated based on the individual client's needs and renal function.

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Correct Answer is B

Explanation

A. “I wish I didn’t have to attach the electrodes to my skin.”

This statement reflects a common sentiment. Attaching electrodes to the skin is part of using TENS, and it's a non-invasive procedure where electrodes are placed on the skin surface to deliver electrical impulses for pain relief.

B. “It’s unfortunate that I have to be in the hospital for this treatment.”

This statement indicates a need for further teaching. TENS is typically an outpatient treatment, and individuals can use TENS units at home after receiving appropriate instructions and training. It does not require being in the hospital.

C. “I’ll need to shave the hair off the skin where I place the electrodes.”

This statement is accurate. To ensure proper contact and effectiveness, it is often recommended to shave or trim the hair in the area where the electrodes will be placed.

D. “I hope I don’t have to take as many pain pills.”

This statement reflects an understanding of the potential benefits of TENS. TENS is used as an adjunct therapy to help manage pain, and one of its goals may be to reduce the need for pain medications.

A. “I will keep my baby’s head slightly elevated during the feeding.” B. “I will hold my baby close to me while feeding.” C. “Each feeding should last about 15 minutes.” D. “Propping a bottle can cause otitis media.”

Correct Answer is C

Explanation

A. “I will keep my baby’s head slightly elevated during the feeding.”

This statement is correct. Keeping the baby's head slightly elevated during feeding can help prevent ear infections (otitis media) and is a recommended practice.

B. “I will hold my baby close to me while feeding.”

Holding the baby close during feeding promotes bonding and is generally considered a good practice for both bottle-feeding and breastfeeding.

C. “Each feeding should last about 15 minutes.”

This statement indicates a need for further teaching. The duration of a feeding can vary among infants, and it's not advisable to put a strict time limit on each feeding. It's important to follow the baby's cues and allow for individual variations in feeding patterns.

D. “Propping a bottle can cause otitis media.”

This statement is correct. Propping a bottle can lead to ear infections (otitis media) and is not a safe or recommended practice. The baby should be held during feedings to prevent these issues.

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A nurse is caring for a client who is in the oliguric phase of acute kidney injury. Which of the following actions should the nurse take?

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