During the diuretic phase of ATN, the nurse should closely monitor the patient for which of the following complications?
Hypervolemia
Hyperkalemia
Hypernatremia
Hypertension
The Correct Answer is C
A. Hypervolemia: This is unlikely during the diuretic phase, as the patient is typically losing large volumes of fluid.
B. Hyperkalemia: Hyperkalemia is more common in the oliguric phase of ATN, not the diuretic phase, when potassium levels usually decrease due to fluid loss.
C. Hypernatremia: During the diuretic phase of ATN, the kidneys start to recover but may not be able to concentrate urine effectively, leading to large volumes of dilute urine. This can result in fluid and electrolyte imbalances, particularly hypernatremia (high sodium levels) due to excessive fluid loss.
D. Hypertension: Hypotension is more likely due to excessive fluid loss during the diuretic phase, not hypertension.
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Related Questions
Correct Answer is D
Explanation
A. The glomerular filtration rate decreases because inflammatory cells invade the already damaged kidneys: Inflammation is not the primary mechanism of decreased GFR in ATN. It is more related to cellular damage and dysfunction.
B. The glomerular filtration rate decreases because there is a reduction of blood flow to the kidneys: While reduced blood flow can contribute to acute kidney injury, the ongoing decline in GFR in ATN is due to tubular damage, not ongoing ischemia.
C. The glomerular filtration rate decreases because there is obstruction leading to the filtration system backing up and eventually shutting the kidneys down: Obstruction is not the key issue in ATN; rather, it’s the tubular cell injury that disrupts filtration.
D. The glomerular filtration rate decreases because there is injury to the renal tubular cells. Acute tubular necrosis (ATN) involves damage to the renal tubular cells, which disrupts the ability of the nephrons to filter blood efficiently. This cellular injury is the primary cause of the decline in glomerular filtration rate (GFR) in ATN.
Correct Answer is ["B","C","D","E"]
Explanation
A. Incontinence: Incontinence is not a typical symptom of renal calculi. Pain, urgency, and difficulty urinating are more common.
B. Gastrointestinal upset: Nausea, vomiting, and gastrointestinal upset can occur as a result of renal colic due to the proximity of the kidneys to the gastrointestinal system.
C. Urinary urgency: Clients with renal calculi may experience urinary urgency due to irritation of the urinary tract.
D. Fever: Fever may indicate an infection related to the obstruction caused by the stone, such as pyelonephritis.
E. Flank pain: Flank pain, often severe and radiating to the lower abdomen or groin, is a classic symptom of renal calculi as the stone moves through the urinary tract.
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