A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

Respiratory therapy

Hospice care

Occupational therapy

Dietary services

Answer and Explanation

The Correct Answer is D

Choice A Reason:

Respiratory therapy is not typically required for clients with chronic kidney disease unless they have concurrent respiratory issues. CKD primarily affects the kidneys and related systems, so respiratory therapy is not a standard referral for these patients.

Choice B Reason:

Hospice care is generally reserved for clients with terminal illnesses who are nearing the end of life. While CKD can be a serious condition, many clients manage it with appropriate treatment and lifestyle changes. Therefore, hospice care is not a standard referral for newly diagnosed CKD patients.

Choice C Reason:

Occupational therapy may be beneficial for clients with CKD who experience difficulties with daily activities due to fatigue or other symptoms. However, it is not the most immediate or essential referral upon initial diagnosis.

Choice D Reason:

Dietary services are crucial for clients with chronic kidney disease. Proper nutrition can help manage symptoms, slow disease progression, and improve overall health. A dietitian can provide personalized dietary plans to ensure the client avoids foods that may exacerbate their condition and includes those that support kidney health.

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Correct Answer is C

Explanation

Choice A Reason

“Tube drainage should be rust-colored.” This statement is incorrect. Normal NG tube drainage is typically greenish-yellow due to bile or clear if it is from the stomach. Rust-colored drainage could indicate bleeding and should be reported immediately.

Choice B Reason

“Nutrition will be provided through the tube.” This statement is incorrect. While NG tubes can be used for feeding, in the context of a postoperative colectomy, the primary purpose of the NG tube is usually to decompress the stomach and prevent nausea and vomiting. Enteral feeding is typically done through a different type of tube, such as a nasojejunal tube.

Choice C Reason

“The tube decreases pressure within the stomach.” This is the correct statement. An NG tube is often used postoperatively to decompress the stomach, which helps to reduce pressure, prevent vomiting, and allow the gastrointestinal tract to heal.

Choice D Reason

“The tube should be irrigated with sterile water.” This statement is partially correct but needs context. NG tubes should be irrigated to maintain patency, but the type of solution (sterile water, saline) can vary based on hospital protocol. The primary focus here is on the purpose of the NG tube rather than the irrigation technique.

A. Urine specific gravity 1.02 (1.005 to 1.03) B. Sodium 119 mEq/L (136 to 145 mEq/L) C. BUN 8 mg/dL (10 to 20 mg/dL) D. Calcium 8.7 mg/dL (9 to 10.5 mg/dL)

Correct Answer is A

Explanation

Choice A Reason:

A urine specific gravity of 1.02 falls within the normal range (1.005 to 1.03) and indicates that the kidneys are excreting water appropriately. In SIADH, urine is typically concentrated due to excessive antidiuretic hormone (ADH) secretion. A normal urine specific gravity suggests that the ADH levels are normalizing and the condition is resolving.

Choice B Reason:

A sodium level of 119 mEq/L is significantly below the normal range (136 to 145 mEq/L) and indicates persistent hyponatremia. This finding suggests that the SIADH is not resolving, as effective treatment should lead to an increase in serum sodium levels.

Choice C Reason:

A BUN level of 8 mg/dL is slightly below the normal range (10 to 20 mg/dL) but is not a primary indicator of SIADH resolution. BUN levels can be influenced by various factors, including hydration status and renal function.

Choice D Reason:

A calcium level of 8.7 mg/dL is slightly below the normal range (9 to 10.5 mg/dL) but does not directly indicate the resolution of SIADH. Calcium levels are not typically used to monitor the effectiveness of SIADH treatment.

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A nurse is preparing to discharge a client who has a new diagnosis of chronic kidney disease (CKD). Which of the following referrals should the nurse plan to initiate?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is providing instructions to a newly licensed nurse about NG intubation for a client who is postoperative following a colectomy. Which of the following statements should the nurse include?

Correct Answer is C

Explanation

A nurse is caring for a client who has syndrome of inappropriate antidiuretic hormone (SIADH) and is receiving 3% sodium chloride via continuous IV. Which of the following laboratory findings should the nurse identify as an indication that the SIADH is resolving?

Correct Answer is A

Explanation

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