During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Hyperkalemia and hypernatremia

Hypokalemia and hypernatremia

Hyperkalemia and hyponatremia

Hypokalemia and hyponatremia

Answer and Explanation

The Correct Answer is D

A.   Hyperkalemia and hypernatremia are generally not associated with the diuretic phase of AKI. In the diuretic phase, the primary issue is excessive loss of electrolytes and fluid, rather than their accumulation.
B.   Hypokalemia can occur during the diuretic phase because diuretics increase the excretion of potassium along with water. Hypernatremia is not typical of the diuretic phase. Instead, sodium levels might decrease or remain normal due to the loss of fluid and electrolytes.
C.   Hyperkalemia is unlikely during the diuretic phase as diuretics often lead to increased potassium loss. Hyponatremia is a more likely outcome during the diuretic phase due to the loss of sodium and fluid through increased urine output.

D.   During the diuretic phase of AKI, there is significant loss of electrolytes, including potassium and sodium. Diuretics increase urine output, leading to the loss of potassium and sodium, which can occur as a result of excessive fluid and electrolyte loss.

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Correct Answer is A

Explanation

A. BPH is a common condition in older men that causes the prostate gland to enlarge, obstructing the urethra and leading to difficulty urinating, urinary retention, and pelvic pain. The symptoms described, including urinary frequency, weak urinary stream, severe pelvic pain, and a significantly elevated post- void residual urine volume, are consistent with BPH.
B. ESRD can cause urinary symptoms. However, the presentation in this case is more consistent with a urinary obstruction, not a kidney failure issue. ESRD typically involves more systemic symptoms like fatigue, edema, and electrolyte imbalances.
C. This is unlikely given the patient's age and lack of significant comorbidities. Additionally, the primary issue appears to be urinary obstruction, not a decrease in renal perfusion.
D. This is a chronic condition that typically presents with flank pain, and it does not usually cause acute urinary retention.

A. Proceed with hemodialysis. B. Notify the provider immediately. C. Raise the arm above the level of the patient's heart. D. Apply warm packs to the fistula site and reassess.

Correct Answer is B

Explanation

A. This is incorrect and potentially dangerous. A non-functioning fistula will not provide adequate blood flow for dialysis and can lead to complications.
B. This is the correct action. The nurse should immediately inform the healthcare provider about the compromised fistula. The provider can order further diagnostic tests or interventions as needed.

C. This might improve blood flow temporarily, but it is not a definitive solution and does not address the underlying issue.
D. While warm packs can sometimes improve circulation, it is unlikely to resolve the serious issues found in this case.

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During the diuretic phase of acute kidney injury, the nurse understands that the client is at risk for which of the following electrolyte imbalances?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

A nurse is assessing a client's arteriovenous fistula prior to hemodialysis, but does not hear a bruit or feel a thrill. Pulses distal to the fistula are not palpable, and the capillary refill is slow. Which of the following actions is the nurse's priority?

Correct Answer is B

Explanation

A female client has undergone surgery to remove a large struvite kidney stone. Based on the cause of struvite stones, which medication therapy should the nurse anticipate will be ordered to prevent recurrence of the stones?

A client with chronic kidney disease (CKD) has a serum potassium level of 6.5 mEq/L. Which of the following medications removes excess potassium from the body?

A patient who performs dialysis at home using a catheter placed through the abdominal wall reports nausea, vomiting, diarrhea, and fluid discharge from the catheter site. The laboratory reports reveal an increased white blood cell count (WBC). Which condition does the nurse suspect in the patient?

A client with acute kidney injury (AKI) has a serum potassium level of 6.5 mEq/L. The nurse recognizes that administering IV calcium gluconate to this client will result in which of the following effects?

A nurse is assessing a client who has chronic kidney disease (CKD) for fluid volume overload prior to scheduled hemodialysis. Which of the following methods provides a reliable measurement of the amount of fluid the client has retained since the last dialysis treatment?

Which of the following clients is at risk of developing acute kidney injury from a post-renal cause?