The nurse and an unlicensed assistive personnel (UAP) are caring for a group of clients. Which intervention should the nurse perform?

Provide water for a client diagnosed with chronic kidney disease

Instruct the client on appropriate fluid restrictions

Measure the client's output from the indwelling catheter

Record the client’s intake and output in the EMR

Answer and Explanation

The Correct Answer is B

A. Provide water for a client diagnosed with chronic kidney disease: Fluid intake must be controlled in CKD. A nurse should determine if water intake is appropriate.

B. Instruct the client on appropriate fluid restrictions: Client education is a nursing responsibility and cannot be delegated to a UAP. The nurse should educate clients on fluid restrictions in conditions like chronic kidney disease (CKD) to prevent fluid overload and electrolyte imbalances.

C. Measure the client’s output from the indwelling catheter: This task can be delegated to a UAP.

D. Record the client’s intake and output in the EMR: UAPs can record I&O but cannot interpret the data.

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Correct Answer is D

Explanation

A. Respiratory Acidosis: Respiratory acidosis results from inadequate ventilation leading to CO₂ retention, which is unrelated to kidney failure.

B. Metabolic Alkalosis: Metabolic alkalosis occurs due to excessive loss of acids (e.g., vomiting) or excess bicarbonate intake. Acute renal failure causes acid retention, not loss.

C. Respiratory Alkalosis: Respiratory alkalosis is caused by hyperventilation and excessive CO₂ loss, not renal dysfunction.

D. Metabolic acidosis: The kidneys play a vital role in acid-base balance by excreting hydrogen ions and reabsorbing bicarbonate. Acute renal failure impairs these functions, leading to acid retention and metabolic acidosis.

A. Chloride level would be decreed B. Sodium level would be elevated C. Magnesium level would be elevated. D. Potassium level would be decreased

Correct Answer is A

Explanation

A. Chloride level would be decreased: Metabolic alkalosis is often associated with hypochloremia, especially when caused by vomiting or diuretics. However, hypokalemia is more clinically significant.

B. Sodium level would be elevated: Sodium levels are not directly affected by metabolic alkalosis.

C. Magnesium level would be elevated: Magnesium levels are not significantly altered in metabolic alkalosis.

D. Potassium level would be decreased: A bicarbonate level of 30 mEq/L indicates metabolic alkalosis. In alkalosis, hydrogen ions shift out of the cells, and potassium moves into the cells, leading to hypokalemia.

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