A nurse is responsible for screening client’s history for risk factors for possible complications.

Vital signs

BP 188/93

P 80
A nurse is correlating data documented in a client's medical history. The nurse should recognize that which client data indicates risk factors for acute kidney injury? (Select all that apply.)

low serum albumin

Renal Calculi

Hypertension

Hypovolemia

ineffective wound healing

Answer and Explanation

Correct Answer : B,C,D

A. Low serum albumin: While low albumin indicates poor nutrition or liver disease, it's not a direct cause of AKI.

B. Renal Calculi: Can cause obstruction in the urinary tract, leading to post-renal AKI.

C. Hypertension: Chronic high BP damages renal vasculature, increasing AKI risk.

D. Hypovolemia: Decreased perfusion leads to prerenal AKI.

E. Ineffective wound healing: Indicates poor nutrition or infection, but is not a primary AKI risk factor.

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Correct Answer is []

Explanation

Potential Condition: Urinary Tract Infection (UTI)
The client is reporting frequency, burning, and urgency, classic symptoms of a lower UTI (cystitis). The recent removal of the urinary catheter (which increases infection risk) further supports this.

Actions to take:

Check a urine culture and sensitivity: A urine culture will confirm the presence of infection and identify the specific organism, allowing for appropriate antibiotic selection.
Request a prescription for an antispasmodic agent: Bladder spasms can contribute to frequency and urgency, especially post-catheter removal. An antispasmodic (e.g., oxybutynin) may help relieve discomfort.

Parameters to monitor:

Temperature: Fever can indicate progression of the UTI to pyelonephritis or worsening infection. The current low-grade fever of 100.4°F may be an early sign.
Fluid intake: Adequate hydration helps flush bacteria from the urinary tract and is essential in promoting recovery from a UTI.

Incorrect diagnoses:

The post-void residual is only 22 mL, which rules out urinary retention. No evidence points to STIs like gonorrhea, nor to incontinence.

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

Correct Answer is A

Explanation

A. Hyperkalemia: In AKI, the kidneys cannot excrete potassium efficiently, leading to elevated potassium levels.

B. Hypernatremia: More common in dehydration but not typically associated with prerenal AKI, where sodium may actually be low due to dilution.

C. Hypophosphatemia: Phosphate tends to increase due to impaired excretion in AKI, not decrease.

D. Hypercalcemia: Calcium levels tend to decrease in AKI due to phosphate retention and reduced vitamin D activation.

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Naxlex Comprehensive Predictor Exams

Correct Answer is []

Explanation

A nurse is reviewing the laboratory test results from a client who has prerenal acute kidney injury (AKI). Which of the following electrolyte Imbalances should the nurse expect?

Correct Answer is A

Explanation

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