A student nurse is reviewing clinical manifestations of chronic kidney disease. Which of the following findings are consistent with this diagnosis? (Select all that apply)

Hypokalemia

Anemia

Hypertension

Crackles in the lungs

Lethargy

Proteinuria

Answer and Explanation

Correct Answer : B,C,E,F

Choice A: Hypokalemia, or low potassium levels in the blood, is not typically associated with CKD. In fact, patients with advanced CKD are more likely to experience hyperkalemia, which is an elevated potassium level, due to the kidneys’ decreased ability to excrete potassium. The normal range for serum potassium is 3.5 to 5.0 mmol/L.

Choice B: Anemia is a common finding in CKD and is due to the kidneys’ reduced production of erythropoietin, a hormone that stimulates the bone marrow to produce red blood cells. Symptoms of anemia include fatigue, weakness, and pale skin. The normal range for hemoglobin in adults is 13.8 to 17.2 grams per deciliter for men and 12.1 to 15.1 grams per deciliter for women.

Choice C: Hypertension, or high blood pressure, is both a cause and a complication of CKD. The kidneys play a crucial role in regulating blood pressure, and as their function declines, hypertension becomes more common. The normal range for blood pressure is typically considered to be 120/80 mmHg.

Choice D: Crackles in the lungs Crackles in the lungs are not a direct manifestation of CKD, but they can occur if the condition leads to fluid overload and heart failure, resulting in pulmonary edema. This is a secondary complication rather than a direct symptom of CKD.

Choice E: Lethargy and a general feeling of malaise are common in CKD due to the buildup of toxins and waste products in the blood that the kidneys can no longer effectively filter out. This can also lead to decreased mental sharpness and a reduced quality of life.

Choice F: Proteinuria, or the presence of excess protein in the urine, is a hallmark sign of CKD. It indicates damage to the kidneys’ filtering units, allowing protein that would normally be retained to leak into the urine. Persistent proteinuria is a sign of chronic kidney damage.

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Correct Answer is ["125"]

Explanation

- Step 1: Identify the required dose in micrograms (mcg). The client is scheduled to receive 125 mcg of digoxin.

- Step 2: Identify the concentration of the available tablet. The available tablet contains 0.25 mg of digoxin.

- Step 3: Convert the tablet concentration from mg to mcg. We know that 1 mg = 1000 mcg. So, 0.25 mg = 0.25 × 1000 mcg = 250 mcg.

- Step 4: Calculate the number of tablets needed to deliver the required dose. We can set up a proportion to solve for this:

- 250 mcg is to 1 tablet as 125 mcg is to X tablets.

- In other words, 250 mcg : 1 tablet = 125 mcg : X tablets.

- Step 5: Solve for X using cross-multiplication and division:

- Cross-multiplication gives us: 250 mcg × X tablets = 125 mcg × 1 tablet.

- Simplifying this gives us: 250X = 125.

- Dividing both sides by 250 gives us: X = 125 ÷ 250.

- Calculating the division gives us: X = 0.5.

So, the nurse should administer 0.5 tablets per dose to deliver the required dose of 125 mcg.

A. Instruct the client to lean forward. B. Ask the client to extend the arms. C. Dorsiflex the client's foot. D. Measure the abdominal girth.

Correct Answer is B

Explanation

Choice A: Instruct the client to lean forward This action is not related to the assessment of asterixis. Leaning forward can be part of the physical examination for other conditions, such as assessing for spinal issues or abdominal pain, but it does not provoke the characteristic flapping motion of the hands seen in asterixis.

Choice B: Ask the client to extend the arms This is the correct method to assess for asterixis. The patient is asked to extend their arms and dorsiflex their wrists. The nurse then observes for any involuntary flapping movements of the hands, which would indicate the presence of asterixis. This sign is indicative of a disturbance in the central nervous system’s regulation of muscle tone, often due to metabolic liver dysfunction. To assess for asterixis, the nurse should ask the client to extend their arms, which is the standard method for eliciting this sign. The presence of asterixis can help in the diagnosis of hepatic encephalopathy and other metabolic conditions affecting the brain’s control of muscle tone.

Choice C: Dorsiflex the client’s foot Dorsiflexion of the foot is not a method used to assess for asterixis. While changes in muscle tone can be assessed in the lower limbs, asterixis is specifically a hand tremor and is best observed in the upper extremities.

Choice D: Measure the abdominal girth Measuring abdominal girth is relevant in the assessment of ascites, which can occur in cirrhosis, but it is not a method for assessing asterixis. Ascites refers to the accumulation of fluid in the peritoneal cavity, leading to increased abdominal size, which is a common complication of cirrhosis.

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A student nurse is reviewing clinical manifestations of chronic kidney disease. Which of the following findings are consistent with this diagnosis? (Select all that apply)

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Naxlex Comprehensive Predictor Exams

Correct Answer is ["125"]

Explanation

The nurse is reviewing the record of a client with a diagnosis of cirrhosis and notes that there is documentation of the presence of asterixis. How should the nurse assess for asterixis?

Correct Answer is B

Explanation

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