A nurse is monitoring an older adult female client who had a myocardial infarction (MI) for the development of acute kidney injury (AKI). Which of the following findings should the nurse identify as indicating an increased risk of AKI?
Serum creatinine 1.8 mg/dL
Blood urea nitrogen (BUN) 200 mg/dL
Serum osmolality 290 mOsm/kg H2O
Magnesium 2.0 mEq/L
Correct Answer : A,B
Choice A reason: The normal range for serum creatinine in adult females is approximately 0.6–1.1 mg/dL. A level of 1.8 mg/dL is elevated and indicates impaired kidney function, which is a risk factor for AKI.
Choice B reason: Normal BUN levels are generally between 6 to 24 mg/dL⁸. A BUN level of 200 mg/dL is significantly elevated and suggests kidney dysfunction, which can lead to AKI.
Choice C reason: Serum osmolality in the normal range, which is typically between 275 to 295 mOsm/kg H2O for adults⁹[13][^10^][14][16], does not indicate an increased risk of AKI.
Choice D reason: The normal range for serum magnesium is typically 1.7 to 2.2 mg/dL or 0.85 to 1.10 mmol/L. A level of 2.0 mEq/L (which is equivalent to 2.0 mg/dL) is within the normal range and does not indicate an increased risk for AKI.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D","E","F"]
Explanation
Choice A reason: A WBC count can help determine the presence of infection.
Choice B reason: Blood cultures may be ordered if there is a concern for a systemic infection or sepsis.
Choice C reason: Foley catheter placement is not typically indicated for UTI and can increase the risk of infection.
Choice D reason: A broad-spectrum antibiotic may be prescribed to treat the suspected UTI until specific causative bacteria are identified.
Choice E reason: IV fluids may be administered to ensure hydration, especially if the client is unable to maintain adequate oral intake due to nausea or vomiting.
Choice F reason: A clean-catch urinalysis and urine culture are essential to identify the specific bacteria causing the UTI and to determine the appropriate antibiotic therapy.
Correct Answer is A
Explanation
The correct answer is Choice A
Choice A rationale: Headache and restlessness can be signs of a seizure or neurological disturbance, which phenytoin is used to treat. Phenytoin is an anticonvulsant medication that helps control seizures by stabilizing neuronal membranes and reducing excitability.
Choice B rationale: Decreased blood pressure and rapid pulse are not indications for phenytoin administration. These symptoms may suggest hypotension or cardiovascular issues, which require different interventions such as fluid resuscitation or vasopressors.
Choice C rationale: Muscle cramps and chest heaviness are not treated with phenytoin. These symptoms could indicate electrolyte imbalances or cardiac issues, which need specific treatments like electrolyte replacement or cardiac monitoring.
Choice D rationale: Pain and tingling at the access site are not indications for phenytoin administration. These symptoms may suggest local irritation or infection at the dialysis access site, requiring appropriate wound care or antibiotics.
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