The client has been admitted to the hospital with a diagnosis of acute kidney injury (AKI).
Which of the following is a priority nursing intervention?
Administer pain medication.
Monitor urine output.
Encourage ambulation.
Assist with meals.
The Correct Answer is B
This is a priority nursing intervention for a client with acute kidney injury (AKI) because it helps to assess the renal function and fluid status of the client. Urine output is also an indicator of the response to treatment and the need for further interventions.
Choice A is wrong because pain medication is not a priority intervention for AKI unless the client has other conditions that cause pain.
Pain medication may also have adverse effects on the kidney function and should be used with caution.
Choice C is wrong because ambulation is not a priority intervention for AKI and may not be appropriate for a client who is fluid overloaded or hypotensive.
Ambulation may also increase the risk of falls and injury in a client who is confused or fatigued.
Choice D is wrong because assisting with meals is not a priority intervention for AKI and may not be necessary for a client who has adequate oral intake.
A client with AKI may also have dietary restrictions such as low protein, low potassium, low sodium, and low phosphorus, which should be considered when providing meals.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","C","D"]
Explanation
Furosemide is a loop diuretic that causes the kidneys to excrete more water and salt, which can lead to dehydration and electrolyte imbalance.
Electrolyte imbalance can cause muscle cramps, numbness and tingling, weakness and fatigue, and other symptoms.
Therefore, the client should monitor for these signs and report them to the doctor if they occur.
Choice B is wrong because dry mouth is not a sign of electrolyte imbalance, but rather a sign of dehydration.
Dehydration can also cause thirst, decreased urination, drowsiness, and confusion.
Choice E is wrong because tachycardia is not a sign of electrolyte imbalance, but rather a sign of hypovolemia (low blood volume) or hypotension (low blood pressure).
Furosemide can lower blood pressure by reducing fluid volume in the body.
Therefore, the client should also monitor their blood pressure and pulse regularly while taking furosemide.
Correct Answer is C
Explanation
A urinary tract infection (UTI) is a common complication after bladder cancer surgery, especially if the patient has an indwelling urinary catheter.
A UTI can cause symptoms such as fever, pain, burning or urgency when urinating, blood in the urine, or cloudy or foul-smelling urine.
Choice A is wrong because urinary retention (the inability to empty the bladder completely) is unlikely to occur with an indwelling catheter, which drains urine continuously.
Choice B is wrong because urinary incontinence (the loss of bladder control) is more likely to occur after partial or radical cystectomy, which remove part or all of the bladder, respectively.
In these cases, reconstructive surgery is needed to create a new way for urine to leave the body.
Choice D is wrong because urinary urgency (the sudden and strong need to urinate) is also more likely to occur after partial or radical cystectomy, which can affect the nerves and muscles that control urination.
Urinary urgency can also be a symptom of a UTI, but it’s not the only one.
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