A nurse is reviewing laboratory findings for four clients. Which of the following clients has manifestations of acute kidney injury?

 

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.

Choice A reason: This statement is incorrect because, during dehydration, water does not move towards areas of lower sodium concentration.

Choice B reason: This is correct because, during dehydration, the body retains sodium, and water follows by osmosis to areas where sodium concentration is higher, which can result in elevated sodium levels.

Choice C reason: Sodium does not typically move across membranes in response to solute concentration gradients; water does.

Choice D reason: Water moves independently of sodium particles, not necessarily together, and it moves towards areas of higher solute concentration.