A nurse is caring for a postoperative 70-kg patient who had major blood loss during surgery and now has acute kidney injury. The patient does not have signs of fluid overload. Which intervention would be most effective as a fluid challenge to promote kidney perfusion?

Administering normal saline 500-1000 mL infused over 1 hour.

Administering drugs to suppress aldosterone release.

Having the patient drink several large glasses of water.

Instilling 500-1000 mL of normal saline through a nasogastric tube.

Answer and Explanation

The Correct Answer is A

Choice A reason: Administering normal saline 500-1000 mL infused over 1 hour is an effective fluid challenge to promote kidney perfusion in patients with acute kidney injury and no signs of fluid overload. This intervention helps increase intravascular volume, improving renal blood flow and potentially enhancing urine output.

Choice B reason: Administering drugs to suppress aldosterone release is not appropriate for promoting kidney perfusion in this context. Suppressing aldosterone could potentially decrease sodium and water reabsorption, which may not be beneficial for improving renal perfusion in a patient with acute kidney injury.

Choice C reason: Having the patient drink several large glasses of water is not the most effective method for a fluid challenge. Oral intake may not provide the rapid volume expansion needed to improve kidney perfusion, especially in a patient with acute kidney injury where fluid balance and perfusion are critical.

Choice D reason: Instilling 500-1000 mL of normal saline through a nasogastric tube is not an appropriate fluid challenge for promoting kidney perfusion. This method is not typically used for volume expansion in the context of acute kidney injury, as it may not provide the rapid intravascular volume increase needed to enhance renal blood flow.

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Correct Answer is B

Explanation

Choice A reason: Administering 2 tablets of digoxin 0.125 mg would provide the correct dosage of 0.25 mg. However, given the client's heart rate of 54/min, administering the medication could further lower the heart rate, which can be dangerous. The nurse should withhold the medication and notify the physician.

Choice B reason: Withholding the digoxin dose for decreased heart rate is the correct action. Digoxin is used to slow down the heart rate and strengthen heart contractions. A heart rate of 54/min is considered bradycardia (slow heart rate), and administering digoxin could exacerbate the bradycardia, leading to potential complications such as heart block or severe arrhythmias. Therefore, it is critical to withhold the medication and inform the physician of the client's current heart rate.

Choice C reason: Administering one tablet of digoxin 0.125 mg would not provide the full prescribed dose of 0.25 mg. More importantly, the client's low heart rate makes it unsafe to administer any dose of digoxin at this time.

Choice D reason: Withholding the digoxin dose for elevated blood pressure is not appropriate. Although the client has elevated blood pressure (144/96), the more immediate concern is the low heart rate. Digoxin affects heart rate more than blood pressure, and the risk of exacerbating bradycardia takes precedence.

A. Percutaneous Coronary Intervention (PCI). B. Echocardiography. C. Exercise testing. D. Electrocardiography.

Correct Answer is B

Explanation

Choice A reason: Percutaneous Coronary Intervention (PCI) is a procedure used to open narrowed coronary arteries, usually with a balloon or stent. It is not a diagnostic test for assessing heart valves but rather a treatment for coronary artery disease.

Choice B reason: Echocardiography is a non-invasive imaging test that uses ultrasound waves to create detailed images of the heart's structures, including the heart valves. It allows for the assessment of valve function, structure, and blood flow, making it an essential tool for diagnosing valvular heart disease.

Choice C reason: Exercise testing, also known as a stress test, evaluates the heart's response to physical activity. While it can provide information on how well the heart handles increased workload and detect issues like ischemia, it is not specifically used for assessing heart valves.

Choice D reason: Electrocardiography (ECG or EKG) records the electrical activity of the heart and is used to detect arrhythmias, heart attacks, and other cardiac conditions. However, it does not provide detailed information about the heart valves' structure or function.

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A nurse is caring for a postoperative 70-kg patient who had major blood loss during surgery and now has acute kidney injury. The patient does not have signs of fluid overload. Which intervention would be most effective as a fluid challenge to promote kidney perfusion?

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

The healthcare provider recommends to a patient that diagnostic testing be performed to assess for valvular heart disease. The nurse teaches the patient about which test that is commonly used to assess the valves?

Correct Answer is B

Explanation

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