A nurse is planning care for a client who is Chinese American and reports adhering to Chinese cultural postpartum practices. Which of the following should the nurse anticipate?

Rationale:

A. Alkaline phosphatase: This enzyme is typically used to assess liver or bone disorders, not renal function. Although some values may rise due to medications or illness, it is not a primary marker for kidney health in transplant clients.

B. Amylase: Amylase is used to evaluate pancreatic function and is not directly related to kidney function. It may be elevated in pancreatitis or abdominal conditions, but it does not provide information about renal performance.

C. Creatinine: Serum creatinine is a key indicator of renal function and is commonly monitored alongside BUN in clients taking nephrotoxic drugs like cyclosporine. Elevations may signal impaired kidney function or transplant rejection.

D. Bilirubin: Bilirubin reflects liver function and bile metabolism rather than kidney function. Although important in overall health assessment, it is not used to evaluate renal function in clients post-transplant.

Rationale:

A. The client experiences self-doubt when making decisions: Indecisiveness and self-doubt are common symptoms of major depressive disorder and do not reflect improvement. They typically indicate ongoing low self-esteem and cognitive impairment.

B. The client exhibits a flat affect: A flat or blunted affect is a hallmark of depressive states. Persistence of this symptom suggests the depression is still significantly impacting the client’s emotional expression.

C. The client can express angry feelings: Being able to express emotions such as anger can indicate emotional engagement and increased energy, which are signs of clinical improvement in depression.

D. The client looks down when speaking to others: This behavior suggests ongoing feelings of worthlessness or poor self-confidence, commonly seen in depressive states and not indicative of recovery.