A nurse is caring for a patient who is receiving IV fluids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the patient is effectively responding to treatment?

Urine specific gravity of 1.020

Serum sodium of 165 mEq/L

Hematocrit of 48%

Blood urea nitrogen (BUN) of 12 mg/dL

Answer and Explanation

The Correct Answer is A

Choice A reason: Urine specific gravity measures the kidney's ability to concentrate urine. A normal range is typically 1.005–1.030. A value of 1.020 indicates adequate hydration and suggests that the patient is responding well to IV fluid therapy.

Choice B reason: Serum sodium levels reflect electrolyte balance. The normal range is 135–145 mEq/L. A level of 165 mEq/L is significantly elevated, indicating hypernatremia, which could be a sign of inadequate hydration and not a positive response to treatment.

Choice C reason: Hematocrit represents the proportion of blood volume occupied by red blood cells. Normal ranges are 38.3–48.6% for men and 35.5–44.9% for women. A hematocrit of 48% is at the upper limit of normal and does not specifically indicate the effectiveness of dehydration treatment.

Choice D reason: Blood urea nitrogen (BUN) levels can indicate renal function and hydration status. The normal range is 7–20 mg/dL. A BUN of 12 mg/dL is within the normal range and does not specifically reflect the patient's response to IV fluids for dehydration.

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Correct Answer is D

Explanation

Choice A reason: Infusing packed RBCs over 1 hour is typically too rapid for most patients and can increase the risk of adverse reactions, especially in those with cardiovascular compromise.

Choice B reason: A 2hour infusion may be appropriate in certain emergency situations where rapid correction of anemia is required, but it is not the standard practice for routine transfusions.

Choice C reason: A 3hour infusion is less commonly used and does not provide any specific advantage over the standard 4hour infusion time.

Choice D reason: The standard practice is to complete the transfusion of packed RBCs within 4 hours. This duration minimizes the risk of bacterial growth and transfusion reactions, as recommended by the American Society of Hematology and other clinical guidelines.

A. Hypernatremia B. Hyperkalemia C. Hypophosphatemia D. Hypercalcemia

Correct Answer is B

Explanation

Choice A reason: Hypernatremia is not typically associated with prerenal AKI. Prerenal AKI is characterized by conditions that reduce blood flow to the kidneys, not directly causing high sodium levels.

Choice B reason: This choice is correct. Hyperkalemia, which is a high level of potassium in the blood, is a common electrolyte imbalance seen in prerenal AKI due to decreased kidney function and the inability to excrete potassium.

Choice C reason: Hypophosphatemia, or low levels of phosphate in the blood, is not a typical finding in prerenal AKI.

Choice D reason: Hypercalcemia, or high levels of calcium in the blood, is not commonly associated with prerenal AKI. It is more often related to other conditions such as hyperparathyroidism or malignancy.

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A nurse is caring for a patient who is receiving IV fluids to correct dehydration. Which of the following laboratory values should indicate to the nurse that the patient is effectively responding to treatment?

Nursing Test Bank

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