After an older client receives treatment for drug toxicity, the healthcare provider prescribes a 24-hour creatinine clearance test. Prior to starting the urine collection, the nurse notes that the client's serum creatinine is 0.3 mg/dL (22.9 μmol/L). Which action should the nurse implement?
Creatinine [Reference Range: 0.5 to 1.1 mg/dL (44 to 97 μmol/L)]
Initiate the urine collection as prescribed.
Evaluate the client's serum BUN level.
Notify the healthcare provider of the results.
Assess the client for signs of hypokalemia.
The Correct Answer is A
A low serum creatinine level indicates decreased muscle mass or impaired kidney function. However, it does not necessarily indicate that the 24-hour creatinine clearance test should be withheld or delayed.
Initiating the urine collection as prescribed allows for the accurate assessment of creatinine clearance and provides valuable information about the client's kidney function. The test results can help guide further evaluation and management of the client's condition.
Assessing the client's serum BUN level, notifying the healthcare provider of the results, or assessing for signs of hypokalemia may be relevant in certain situations but are not the immediate priority based on the information provided.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Given the client's difficulty with memory, concentration, and recent life changes, it is
important for the nurse to acknowledge the possibility of delirium as a potential cause of the client's symptoms. Delirium is an acute state of confusion that can be caused by various factors, including physical illness, medication side effects, and emotional stressors. It is often reversible when the underlying cause is identified and treated.
By mentioning the possibility of delirium and its potential reversibility, the nurse opens up the conversation to exploring other factors that may be contributing to the client's symptoms. This response also provides hope to the family by suggesting that the client's condition may improve with appropriate interventions and management.
Stating that dementia resulting from Alzheimer's disease is often reversible even in the late stages is incorrect. Alzheimer's disease is a progressive neurodegenerative disorder that currently has no cure, and the symptoms tend to worsen over time.
Reversibility is not typically associated with Alzheimer's disease.
Indicating that the client's symptoms of dementia are permanent due to age is a generalization and may not be accurate. While age is a risk factor for certain types of dementia, such as Alzheimer's disease, it does not mean that all memory and cognitive difficulties in older adults are irreversible.
Suggesting that delirium is often a sign of underlying mental illness and institutionalization is necessary is not appropriate. Delirium is a medical condition that requires thorough assessment and appropriate management, including addressing any underlying causes. Institutionalization may be considered in certain situations, but it is not the primary focus of communication in this context.
Correct Answer is D
Explanation
A) Incorrect- This test is used to assess for infection or inflammation and is not specifically related to monitoring diabetes insipidus.
B) Incorrect- This test is used to monitor blood sugar levels in individuals with diabetes mellitus, not diabetes insipidus.
C) Incorrect- While urine specific gravity can provide information about urine concentration, it is not the most important laboratory test to monitor in a client with diabetes insipidus. Serum sodium level is a more critical indicator of electrolyte balance and potential complications in DI.
D) Correct- Diabetes insipidus (DI) is a condition characterized by excessive thirst and urination due to the body's inability to regulate fluid balance. In DI, the body either lacks antidiuretic hormone (ADH), which regulates water reabsorption in the kidneys, or the kidneys are resistant to its effects. As a result, clients with DI can produce large volumes of dilute urine. The most significant concern in DI is the potential for electrolyte imbalances, particularly low serum sodium levels (hyponatremia). Excessive loss of water in the urine can lead to dehydration and concentration of the blood's sodium levels. This can result in neurological symptoms, such as confusion, seizures, and even coma. Monitoring the serum sodium level is crucial to ensure that it remains within a safe range.
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