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The 75-year-old client is hospitalized with end-stage chronic kidney disease. Which of the following serum lab findings would the nurse expect? Select all that apply.

Decreased calcium.

Decreased BUN.

Decreased hemoglobin.

Decreased potassium.

Elevated creatinine.

Increased phosphorus.

Decreased glomerular filtration rate (GFR).

Answer and Explanation

Correct Answer : A,C,E,F,G

Choice A reason: Decreased calcium is expected in end-stage chronic kidney disease (CKD) due to impaired kidney function. The kidneys are responsible for converting vitamin D into its active form, which helps in calcium absorption. Reduced kidney function leads to decreased active vitamin D, resulting in lower calcium levels.

Choice B reason: Decreased blood urea nitrogen (BUN) is not typical in CKD. Instead, BUN levels usually increase because the kidneys are less able to remove urea from the blood. Urea is a waste product of protein metabolism, and elevated BUN is indicative of impaired kidney function.

Choice C reason: Decreased hemoglobin is expected in CKD due to reduced production of erythropoietin by the kidneys. Erythropoietin stimulates the production of red blood cells, and a lack of it leads to anemia, reflected by lower hemoglobin levels.

Choice D reason: Decreased potassium is not typically seen in CKD. In fact, potassium levels often increase because the kidneys are less able to excrete it. Hyperkalemia (high potassium) is a common complication in CKD and requires careful monitoring.

Choice E reason: Elevated creatinine is expected in CKD. Creatinine is a waste product of muscle metabolism, and elevated levels indicate impaired kidney function as the kidneys are less able to clear it from the blood.

Choice F reason: Increased phosphorus is a common finding in CKD due to the kidneys' reduced ability to excrete phosphorus. This can lead to hyperphosphatemia, which can cause secondary hyperparathyroidism and further complications.

Choice G reason: Decreased glomerular filtration rate (GFR) is a hallmark of CKD. GFR measures how well the kidneys are filtering blood, and a lower GFR indicates reduced kidney function. It is used to stage the severity of CKD.

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Correct Answer is D

Explanation

Choice A reason: Administering a muscle relaxant addresses the symptom of muscle twitching and jerking, but it does not identify or treat the underlying cause. For patients with acute pancreatitis, muscle twitching and jerking could be indicative of a more serious condition.

Choice B reason: While a nutritional imbalance could potentially lead to symptoms like muscle twitching and jerking, in the context of acute pancreatitis, the nurse should consider more specific causes related to the condition. Nutritional imbalances do not usually explain these symptoms in patients with pancreatitis as well as hypocalcemia does.

Choice C reason: A reaction to morphine could include various symptoms such as itching, nausea, or constipation, but muscle twitching and jerking are not common side effects. The nurse should consider other causes related to the patient's condition of acute pancreatitis.

Choice D reason: Hypocalcemia, or low calcium levels, is a common complication of acute pancreatitis. It can lead to symptoms such as muscle twitching and jerking, as calcium is crucial for proper muscle function and nerve signaling. This makes hypocalcemia the most relevant and accurate interpretation of the patient's symptoms in this context.

A. Increased heart rate. B. Short period of asystole. C. Hypertension. D. Decreased intraocular pressure.

Correct Answer is B

Explanation

Choice A reason: An increased heart rate is not an expected therapeutic response to adenosine. Adenosine is used to slow the heart rate by temporarily blocking the electrical conduction through the atrioventricular (AV) node. This action is crucial in managing supraventricular tachycardia (SVT), as it can help restore a normal heart rhythm. An increased heart rate would suggest that the medication is not working as intended, and the underlying tachycardia may persist or worsen.

Choice B reason: A short period of asystole is the correct and expected therapeutic response when administering adenosine. Adenosine works by briefly stopping the heart's electrical activity, leading to a brief asystole (lack of heartbeat). This allows the heart's natural pacemaker to reset and potentially restore a normal rhythm. Although this can be alarming, it is a known and anticipated effect of the drug, and it typically resolves quickly as the heart resumes normal activity.

Choice C reason: Hypertension is not an expected response to adenosine. Adenosine generally causes vasodilation, which can lower blood pressure. The primary focus of adenosine in the context of SVT is on its cardiac effects rather than influencing blood pressure significantly. If hypertension occurs, it may be unrelated to the administration of adenosine and could indicate another underlying issue that needs to be addressed.

Choice D reason: Decreased intraocular pressure is not a relevant or expected response to adenosine administration in the context of managing SVT. Adenosine's primary effect is on the heart's electrical conduction system, and it does not significantly impact intraocular pressure. The focus should remain on observing the cardiac responses to ensure the medication is effectively managing the SVT.

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The 75-year-old client is hospitalized with end-stage chronic kidney disease. Which of the following serum lab findings would the nurse expect? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse notes that a client with acute pancreatitis occasionally experiences muscle twitching and jerking. How should the nurse interpret the relevance of these symptoms?

Correct Answer is D

Explanation

A nurse administers prescribed adenosine to a symptomatic patient in supraventricular tachycardia (SVT). Which response would the nurse assess for as an expected therapeutic response?

Correct Answer is B

Explanation

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