The nurse identifies that a patient with chronic kidney disease is at risk for which electrolyte disturbance?

Among the given options, the assessment data that indicate the need for immediate action by the nurse is a blood pressure of 103/54 mm Hg. This blood pressure reading indicates hypotension, which can be concerning for a post-angioplasty patient.

Angioplasty with stent placement is an invasive procedure, and patients may experience fluctuations in blood pressure during the immediate post-operative period. Hypotension after angioplasty can be a sign of inadequate cardiac output, which may be due to issues like bleeding, fluid loss, or heart dysfunction. Inadequate blood pressure can lead to decreased perfusion to vital organs, including the heart itself, and can be life-threatening.

Options A, B, and D are also important to address:

A) Heart rate 102 beats/min: A heart rate of 102 beats per minute may indicate tachycardia, which can be expected after a procedure like angioplasty. However, it is not as urgent of a concern as hypotension, and it may be a normal compensatory response to the body's stress.

B) Report of chest pain: Chest pain after angioplasty can be common, but it should be evaluated further to ensure it is not indicative of complications such as coronary artery spasms, clot formation, or restenosis of the treated artery. While this is an important issue to address, it does not take precedence over hypotension.

D) Pedal pulses 1+ bilaterally: This finding suggests that the peripheral pulses in the feet are weak, and it could be related to the patient's medical condition, medications, or positioning. While it requires attention, it is not an immediate threat to the patient's life compared to severe hypotension.

Therefore, the nurse should prioritize assessing and addressing the low blood pressure to prevent further complications and ensure the patient's stability. The nurse should promptly notify the healthcare provider and implement appropriate interventions, such as administering intravenous fluids, to increase blood pressure to a safe level.

Among the given laboratory test results for a client with recently diagnosed hypertension, the most important result to communicate to the health care provider is option (A), "Serum creatinine of 2.8 mg/dL."

Serum creatinine is a measure of kidney function, and a value of 2.8 mg/dL indicates elevated creatinine levels. Elevated serum creatinine is a concerning finding, as it suggests decreased kidney function or kidney impairment. Hypertension can have a significant impact on the kidneys, and kidney damage is a common complication of uncontrolled high blood pressure.

The kidneys play a crucial role in regulating blood pressure by excreting waste products and excess fluids from the body. When kidney function is compromised due to hypertension, it can further worsen the blood pressure control, leading to a vicious cycle of kidney damage and worsening hypertension.

Option (B), "Serum hemoglobin of 14.7 g/dL," is within the normal range and does not indicate an immediate concern related to the client's hypertension.

Option (C), "Blood glucose level of 96 mg/dL," is also within the normal range for blood glucose and may not be directly related to the client's hypertension.

Option (D), "Serum potassium of 4.5 mEq/L," is within the normal range. While potassium levels are essential to monitor, they are not the most critical concern compared to kidney function in this context.

The elevated serum creatinine level suggests a potential complication of hypertension, namely kidney damage or decreased kidney function. Therefore, it is essential to communicate this finding promptly to the health care provider for further evaluation and appropriate management to address the client's kidney health and optimize blood pressure control.